Ambient ultraviolet radiation (UVR) was associated with a higher incidence of cutaneous angiosarcoma (cAS), an aggressive lymphatic/vascular endothelial-based cancer. 

Researchers publishing the findings in a research letter in Journal of the American Academy of Dermatology (JAAD) used data from 21 Surveillance, Epidemiology, and End Results (SEER) program cancer registries in the United States from 1992 to 2020, linked county-level ambient UVR estimates to cAS cases (n = 831).  Incidence was highest was highest among older, male, and non-Hispanic white populations, with the head and neck being the most frequently affected sites. Following Poisson regression analysis, the highest quartile of ambient UVR exposure had a significantly increased incidence rate ratio (IRR) for cAS versus the lowest quartile. Cases on the head and neck, areas with chronic sun exposure, were the most frequent.

The authors reported that while the findings were consistent across demographic groups, head and neck cases were particularly prevalent among non-Hispanic white individuals. The association was strongest in males, non-Hispanic whites, and those under 65 years of age, aligning the results with previous study findings linking UVR to melanoma and keratinocyte carcinomas, which also predominantly affect the head and neck.

"A major strength of this study is that the study population includes up to 48% of the US population residing in locations with substantial heterogeneity in ambient UVR," the authors wrote in the research letter. "Nondifferential misclassification of ambient UVR exposure may have resulted in bias towards the null because UVR was linked to location of residence only at diagnosis and individual exposure across the lifetime was not available. This may partly explain why the association was strongest in the youngest age group."

The authors wanted the results to serve "as a starting point for understanding the differences in the UVR relationship by age, sex, and race and ethnicity," they wrote, adding that physicians should be aware of the risk of cAS in their patients who may reside in areas with high ambient UVR.

Source: Ike E, et al. JAAD. 2024;91(1):102-104. Doi:https://doi.org/10.1016/j.jaad.2024.01.084