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<p>Ultraviolet radiation (UVR) exposure has been linked to reduced risks of internal malignancies and increased risks of melanoma and keratinocyte carcinoma (KC). However, most studies have focused on middle-aged UVR exposure. We evaluated the association between sun exposure in young adulthood and cancer risk using prospective data from the Nurses’ Health Study (NHS) I and II cohorts. Participants within the NHS I and NHS II cohorts self-reported hours per week spent outdoors during summer in high school, college, and ages 25–35. Sun exposure was categorized as low (&lt; 1&#xa0;h/week), moderate (1–5&#xa0;h/week), and high (≥ 6&#xa0;h/week). Outcomes included incident cancer (excluding KC), cancer excluding melanoma, and melanoma only. We used Cox proportional hazards models adjusted for age and established cancer risk factors. We performed a meta-analysis of the cohorts using random-effects models. Heterogeneity was assessed using Cochran’s Q statistic. Among 143,900 participants (NHS I = 63,105; NHS II = 80,795) with 25,290 incident cancer cases, high sun exposure was not associated with the risk of any cancer overall. We observed an inverse association between high sun exposure and risk of any cancer excluding melanoma in NHS I (hazard ratio (HR) 0.96; 95% confidence interval (CI) 0.93–0.99; <i>P</i> = 0.04) and in the meta-analysis (HR: 0.97; 95% CI 0.94–1.00; <i>P</i> = 0.03; <i>P-het</i> = 0.42). In NHS II, high sun exposure was associated with increased melanoma risk (HR: 1.39; 95% CI 1.18–1.64; <i>P</i> &lt; 0.0001), though this was not observed in NHS I or in the meta-analysis. High sun exposure during young adulthood may be associated with a reduced risk of non-melanoma cancers. This association may involve mechanisms independent of vitamin D, such as nitric oxide signaling or immune modulation. Limitations of our study include recall bias from the NHS survey data, limited generalizability, and lack of data on sun exposure at other life stages. Future research should explore how UVR exposure throughout different life stages may be associated with cancer risk.</p>

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Young adulthood sun exposure and cancer risk: a prospective cohort study

  • 期刊论文

  • 发表日期：

    2026年2月26日

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  • Jonathan C. Hwang,
  • Mingyue Li,
  • Michael S. Chang,
  • Amina Ziad,
  • Nicole Trepanowski,
  • Edward L. Giovannucci,
  • Rebecca I. Hartman,
  • Hongmei Nan

摘要

Ultraviolet radiation (UVR) exposure has been linked to reduced risks of internal malignancies and increased risks of melanoma and keratinocyte carcinoma (KC). However, most studies have focused on middle-aged UVR exposure. We evaluated the association between sun exposure in young adulthood and cancer risk using prospective data from the Nurses’ Health Study (NHS) I and II cohorts. Participants within the NHS I and NHS II cohorts self-reported hours per week spent outdoors during summer in high school, college, and ages 25–35. Sun exposure was categorized as low (< 1 h/week), moderate (1–5 h/week), and high (≥ 6 h/week). Outcomes included incident cancer (excluding KC), cancer excluding melanoma, and melanoma only. We used Cox proportional hazards models adjusted for age and established cancer risk factors. We performed a meta-analysis of the cohorts using random-effects models. Heterogeneity was assessed using Cochran’s Q statistic. Among 143,900 participants (NHS I = 63,105; NHS II = 80,795) with 25,290 incident cancer cases, high sun exposure was not associated with the risk of any cancer overall. We observed an inverse association between high sun exposure and risk of any cancer excluding melanoma in NHS I (hazard ratio (HR) 0.96; 95% confidence interval (CI) 0.93–0.99; P = 0.04) and in the meta-analysis (HR: 0.97; 95% CI 0.94–1.00; P = 0.03; P-het = 0.42). In NHS II, high sun exposure was associated with increased melanoma risk (HR: 1.39; 95% CI 1.18–1.64; P < 0.0001), though this was not observed in NHS I or in the meta-analysis. High sun exposure during young adulthood may be associated with a reduced risk of non-melanoma cancers. This association may involve mechanisms independent of vitamin D, such as nitric oxide signaling or immune modulation. Limitations of our study include recall bias from the NHS survey data, limited generalizability, and lack of data on sun exposure at other life stages. Future research should explore how UVR exposure throughout different life stages may be associated with cancer risk.