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Cumulative sun exposure and intermittent sun exposure are known risk factors for the development of NMSC. Because obesity has been shown to decrease the risk of NMSC incidence, this study investigated whether the risk of NMSC with sun exposure was consistent across different levels of body size.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Body size was assessed with the body mass index (BMI) and the waist\u2010to\u2010hip ratio (WHR). Sun exposure was assessed in watts and langleys and by the amount of time spent outdoors per day in the summer during a person\u2019s 30s.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 71,645 postmenopausal women eligible for inclusion in this study, 13,351 participants (18.6%) developed NMSC. A BMI \u2265 25 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      or a WHR \u2265 0.80 was associated with lower NMSC hazard rates (hazard ratio for BMI, 0.78; hazard ratio for WHR, 0.89); however, the association between higher levels of sun exposure and a higher risk of NMSC was more apparent among women with a BMI \u2265 25 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      or a WHR \u2265 0.80 in comparison with those of a normal weight (\n                      <jats:italic>P<\/jats:italic>\n                      for interaction for BMI &lt; .001;\n                      <jats:italic>P<\/jats:italic>\n                      for interaction for WHR = .022).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although most studies have considered sun exposure as a covariate, none have addressed the potential interaction of body size with sun exposure; therefore, the effect size of being overweight or obese may have been overestimated. In comparison to the normal\u2010weight group, those in the overweight group had increasingly higher hazard rates with increasing sun exposure. Further studies are warranted to investigate how increased weight interacts with sun exposure to influence skin cancer pathogenesis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.31810","type":"journal-article","created":{"date-parts":[[2018,12,11]],"date-time":"2018-12-11T15:24:55Z","timestamp":1544541895000},"page":"1133-1142","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Interaction of body mass index or waist\u2010to\u2010hip ratio and sun exposure associated with nonmelanoma skin cancer: A prospective study from the Women\u2019s Health Initiative"],"prefix":"10.1002","volume":"125","author":[{"given":"Alfred A.","family":"Chan","sequence":"first","affiliation":[{"name":"Division of Dermatology Los Angeles Biomedical Research Institute at Harbor\u2010UCLA Medical Center Torrance California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliana","family":"Noguti","sequence":"additional","affiliation":[{"name":"Division of Dermatology Los Angeles Biomedical Research Institute at Harbor\u2010UCLA Medical Center Torrance California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youngju","family":"Pak","sequence":"additional","affiliation":[{"name":"Division of Dermatology Los Angeles Biomedical Research Institute at Harbor\u2010UCLA Medical Center Torrance California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lihong","family":"Qi","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences University of California Davis Davis California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bette","family":"Caan","sequence":"additional","affiliation":[{"name":"Early Stage Investigator Training Program Division of Research Kaiser Permanente Oakland California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Going","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences University of Arizona Tucson Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8309-7092","authenticated-orcid":false,"given":"Jiali","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Richard M. 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