{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T03:36:34Z","timestamp":1792726594236,"version":"4.5.0"},"reference-count":57,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2022,12,1]]},"abstract":"<jats:sec id=\"ab-doi220053-4\"><jats:title>Importance<\/jats:title><jats:p>To our knowledge, no study has prospectively investigated sunburn patterns over age periods from childhood to adulthood and their associations with skin cancer risk.<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi220053-5\"><jats:title>Objective<\/jats:title><jats:p>To identify lifetime trajectories of sunburns and compare the association between these trajectories and subsequent risk of cutaneous melanoma and squamous cell carcinoma (cSCC).<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi220053-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This population-based cohort study included participants from the Norwegian Women and Cancer Study, established in 1991, with follow-up through 2018. Baseline questionnaires were issued from 1991 to 2007, with follow-up questionnaires every 5 to 7 years. Data analysis was performed from March 16, 2021, to December 4, 2021.<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi220053-7\"><jats:title>Exposures<\/jats:title><jats:p>Participants reported pigmentation factors, sunbathing vacations, and indoor tanning. Annual frequencies of sunburns were reported for childhood, adolescence, and adulthood.<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi220053-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Information on cancer diagnoses, emigration, and death were obtained through linkage to the Cancer Registry of Norway using the unique personal identification number of Norwegian citizens.<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi220053-9\"><jats:title>Results<\/jats:title><jats:p>Of the 172\u202f472 women (age range, 31-70 years) who returned questionnaires, 169\u202f768 received questions about sunburns at study inclusion. Five classes (stable low, low-moderate-low, low to high, high to low, and stable high) of individual lifetime sunburn trajectories with similar shapes were estimated in 3 samples up to 39 years (n\u2009=\u2009159\u202f773), up to 49 years (n\u2009=\u2009153\u202f297), and up to 59 years (n\u2009=\u2009119\u202f170). Mean follow-up ranged from 14.3 to 19.5 years in the 3 samples, during which 1252 to 1774 women were diagnosed with incident primary melanoma and 739 to 871 women with incident primary cSCC. With hazard ratios (HRs) and 95% CIs estimated using a Cox proportional hazards model, the stable high and high to low trajectories showed statistically significant increased melanoma and cSCC risks compared with the stable low trajectory across all samples (\u226439 years for stable high and high to low trajectories: melanoma: HR, 1.50 [95% CI, 1.28-1.75] and HR, 1.44 [95% CI, 1.20-1.73]; cSCC: HR, 1.51 [95% CI, 1.22-1.87] and HR, 1.47 [95% CI, 1.14-1.91]). Other trajectories showed increased risk, though generally weaker and mainly estimates that were not statistically significant. There was no statistically significant heterogeneity between melanoma and cSCC estimates.<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi220053-10\"><jats:title>Conclusion and Relevance<\/jats:title><jats:p>This cohort study showed that high sunburn frequency throughout life was associated with increased melanoma and cSCC risk. Furthermore, sunburns in childhood are especially important for subsequent risk of these skin cancers. Avoiding sunburns throughout life, in particular in childhood, is therefore crucial.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamadermatol.2022.4053","type":"journal-article","created":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T15:01:08Z","timestamp":1664982068000},"page":"1367","source":"Crossref","is-referenced-by-count":41,"title":["Lifetime Sunburn Trajectories and Associated Risks of Cutaneous Melanoma and Squamous Cell Carcinoma Among a Cohort of Norwegian Women"],"prefix":"10.1001","volume":"158","author":[{"given":"Simon","family":"Lergenmuller","sequence":"first","affiliation":[{"name":"Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway"},{"name":"Now with Department of Clinical and Registry-Based Research, Institute of Population-Based Cancer Research, Cancer Registry of Norway, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corina 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