A population-based case-control study of 74 women with lip cancer diagnosed from 1978 to 1985 in Los Angeles County (California, United States) and frequency matched to 105 controls investigated the risk of solar radiation and protection from lip sunscreening agents to explore the hypothesis that excess incidence of lip cancer seen in men is due partly to lower rates in women, conferred by frequent use of lip protection. We confirm the importance in women of risk factors similar to those found in men, i.e., fair complexion, sun exposure, and smoking. Risk was related strongly to lifetime solar radiation (odds ratio [OR]=13.5 for highest quartile of exposure, 95 percent confidence interval [CI]=4.5–40.6, P trend <0.0001) and time spent outdoors (OR=4.7 for highest quartile of average yearly hours, CI=1.9–12.1, P trend=0.01). Further, among women with high lifetime solar-radiation exposure, those who used lip protection once a day or less had twice the risk of lip cancer than women who used lip protection more than once a day (OR=7.3, CI=1.9–27.2 cf OR=3.2, CI=1.1–9.2). These findings show that solar radiation is a major risk factor for lip cancer and suggest that lip sunscreening is protective, thereby supporting the hypothesis that use of lipstick and other sunscreening agents by women has contributed to their lower incidence of this disease.
Similar content being viewed by others
References
Silverman SJr, Gorsky M. Epidemiologic and demographic update in oral cancer: California and national data—1973 to 1985. J Am Dent Assoc 1990; 120: 495–9.
Chen J, Katz RV, Krutchkoff DJ, Eisenberg E. Lip cancer. Cancer 1992; 70: 2025–30.
Preston-Martin S, Henderson BE, Pike MC. Descriptive epidemiology of cancers of the upper respiratory tract in Los Angeles. Cancer 1982; 49: 2201–7.
Keller AZ. The epidemiology of lip, oral, and pharyngeal cancers, and the association with selected systemic diseases. Am J Public Health 1963; 53: 1214–28.
Keller AZ. Cellular types, survival, race, nativity, occupations, habits and associated diseases in the pathogenesis of lip cancer. Am J Epidemiol 1970; 91: 486–99.
Anderson DL. Cause and prevention of lip cancer. J Can Dent Assoc 1971; 37: 138–42.
Molnar L, Ronay P, Tapolcsanyi L. Carcinoma of the lip. Oncology 1974; 29: 101–21.
Spitzer WO, Hill GB, Chambers LW, Helliwell BE, Murphy HB. The occupation of fishing as a risk factor in cancer of the lip. N Engl J Med 1975; 293: 419–24.
Lindqvist C, Teppo L. Epidemiological evidence of sunlight as a risk factor of lip cancer. Br J Cancer 1978; 37: 983–9.
Lindqvist C. Risk factors of lip cancer: a critical evaluation based on epidemiological comparisons. Am J Public Health 1979; 69: 256–60.
Levi F, LaVecchia C, Te VC, Franceschi S. Trends in lip cancer incidence in Vaud, Switzerland. Br J Cancer 1993; 68: 1012–3.
Baker SR, Krause CJ. Carcinoma of the lip. Laryngoscope 1980; 90: 19–27.
Hisserich JC, Martin SP, Henderson BE. An areawide reporting network. Public Health Rep 1975; 90: 15–7.
Hartge P, Brinton LA, Rosenthal JF, Cahill JI, Hoover RN, Waksberg J. Random digit dialing in selecting a population-based control group. Am J Epidemiol 1984; 120: 825–33.
Bleinfante A. An analysis of telephone penetration. Washington, DC: Federal Communications Commission, 1986.
Climatic Atlas of the United States. Washington, DC: Environmental Science Services Administration, Department of Commerce, June 1968; reprinted by the National Oceanic and Atmospheric Administration, 1983.
Hollingshead A. Two Factor Index of Social Position. New Haven, CT (USA): AB Hollingshead, 1957.
Breslow NE, Day NE. Statistical Methods in Cancer Research, Vol. 1. Lyon, France: International Agency for Research on Cancer, 1980; IARC Sci. Pub. No. 32.
Bernier JL, Clark ML. Squamous cell carcinoma of the lip: a critical statistical and morphological analysis of 835 cases. Mil Surgeon 1951; 109: 379–405.
Schulze R, Grafe K. Considerations of sky ultraviolet radiation in the measurement of solar ultraviolet radiation. In: Urbach F, ed. The Biological Effects of Ultraviolet Radiation. Oxford, UK: Pergamon Press, 1969: 359.
Auerbach H. Geographic variation in incidence of skin cancer in the United States. Public Health Rep 1976; 76: 345.
Szpak CC, Stone MJ, Frenkel EP. Some observations concerning the demographic and geographic incidence of carcinoma of the lip and buccal cavity. Cancer 1977; 40: 343–8.
Cannon-Albright LA, Thomas A, Goldgar DE, et al. Familiality of cancer in Utah. Cancer Res 1994; 54: 2378–85.
Soderholm AL, Pukkala E, Lindqvist C, Teppo L. Risk of new primary cancer in patients with oropharyngeal cancer. Br J Cancer 1994; 69: 784–7.
Author information
Authors and Affiliations
Additional information
This work was supported in part by SIG-2 grant from the American Cancer Society and grant CA17054 from the National Cancer Institute. Recent descriptive data on lip cancer occurrence were provided by the Cancer Surveillance Program which is supported by the California Tumor Registry (contracts 050 (C-I)-8709) and the SEER Program (contract N01-CN-25403).
Rights and permissions
About this article
Cite this article
Pogoda, J.M., Preston-Martin, S. Solar radiation, lip protection, and lip cancer risk in Los Angeles County women (California, United States). Cancer Causes Control 7, 458–463 (1996). https://doi.org/10.1007/BF00052672
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00052672