Avoidance of sun exposure as a risk factor for major causes of death: a competing risk analysis of the Melanoma in Southern Sweden cohort

J Intern Med · 2016 · Mixed · Moderate evidence

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MixedModerate evidencePaper 6763

Study snapshot

PublicationJ Intern Med · 2016

Study typecohort

Reported directionMixed

Evidence ratingModerate

Abstract

Objective: Women with active sunlight exposure habits experience a lower mortality rate than women who avoid sun exposure; however, they are at an increased risk of skin cancer. We aimed to explore the differences in main causes of death according to sun exposure. Methods: We assessed the differences in sun exposure as a risk factor for all-cause mortality in a competing risk scenario for 29 518 Swedish women in a prospective 20-year follow-up of the Melanoma in Southern Sweden (MISS) cohort. Women were recruited from 1990 to 1992 (aged 25-64 years at the start of the study). We obtained detailed information at baseline on sun exposure habits and potential confounders. The data were analysed using modern survival statistics. Results: Women with active sun exposure habits were mainly at a lower risk of cardiovascular disease (CVD) and noncancer/non-CVD death as compared to those who avoided sun exposure. As a result of their increased survival, the relative contribution of cancer death increased in these women. Nonsmokers who avoided sun exposure had a life expectancy similar to smokers in the highest sun exposure group, indicating that avoidance of sun exposure is a risk factor for death of a similar magnitude as smoking. Compared to the highest sun exposure group, life expectancy of avoiders of sun exposure was reduced by 0.6-2.1 years. Conclusion: The longer life expectancy amongst women with active sun exposure habits was related to a decrease in CVD and noncancer/non-CVD mortality, causing the relative contribution of death due to cancer to increase.

Machine Enhanced Logic

AI evidence extraction

Structured fields below were generated from the paper’s abstract and metadata to make the evidence easier to inspect. Automated extraction may be incomplete or incorrect; verify important details against the original paper.

Study typecohort

Effect directionmixed

Population29,518 Swedish women (aged 25–64 at baseline) in the Melanoma in Southern Sweden (MISS) cohort

Sample size29518

Exposureprospective 20-year follow-up; baseline sun exposure habits assessed

Evidence strengthModerateConfidence: 78% · Peer reviewed: yes

Main findings

In this prospective cohort, women with active sun exposure habits had lower risk of CVD and noncancer/non-CVD death compared with women who avoided sun exposure. Due to increased survival, the relative contribution of cancer death increased among women with active sun exposure habits. Avoidance of sun exposure was associated with reduced life expectancy (0.6–2.1 years) compared with the highest sun exposure group, and nonsmokers who avoided sun exposure had life expectancy similar to smokers in the highest sun exposure group.

Outcomes measured

all-cause mortality
cardiovascular disease (CVD) mortality
cancer mortality
noncancer/non-CVD mortality
life expectancy

View raw extracted JSON

{
  "study_type": "cohort",
  "exposure": {
    "band": null,
    "source": "sun exposure (habitual sunlight exposure)",
    "frequency_mhz": null,
    "sar_wkg": null,
    "duration": "prospective 20-year follow-up; baseline sun exposure habits assessed"
  },
  "population": "29,518 Swedish women (aged 25–64 at baseline) in the Melanoma in Southern Sweden (MISS) cohort",
  "sample_size": 29518,
  "outcomes": [
    "all-cause mortality",
    "cardiovascular disease (CVD) mortality",
    "cancer mortality",
    "noncancer/non-CVD mortality",
    "life expectancy"
  ],
  "main_findings": "In this prospective cohort, women with active sun exposure habits had lower risk of CVD and noncancer/non-CVD death compared with women who avoided sun exposure. Due to increased survival, the relative contribution of cancer death increased among women with active sun exposure habits. Avoidance of sun exposure was associated with reduced life expectancy (0.6–2.1 years) compared with the highest sun exposure group, and nonsmokers who avoided sun exposure had life expectancy similar to smokers in the highest sun exposure group.",
  "effect_direction": "mixed",
  "limitations": [],
  "evidence_strength": "moderate",
  "confidence": 0.78,
  "peer_reviewed_likely": "yes",
  "keywords": [
    "sun exposure",
    "sun avoidance",
    "mortality",
    "cardiovascular disease",
    "cancer mortality",
    "life expectancy",
    "competing risks",
    "prospective cohort",
    "Sweden",
    "MISS cohort"
  ],
  "suggested_hubs": []
}

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AI-extracted fields are generated from the abstract and metadata and may be incomplete or incorrect. This material is for informational purposes and is not medical advice.

Identifiers and source

DOI: 10.1111/joim.12496
PubMed: 26992108

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