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Epidemiological Assessments of Skin Outcomes in the Nurses' Health Studies.

ABSTRACT: To review the contribution of the Nurses' Health Studies (NHSs) to identifying epidemiological factors associated with multiple skin diseases, including skin cancer, psoriasis, and other inflammatory and autoimmune skin diseases.We carried out a narrative review of NHS articles published between 1976 and 2016.The NHSs have identified environmental and lifestyle factors related to psoriasis, supporting obesity and smoking as psoriasis risk factors; associations between psoriasis and diabetes, myocardial infarction, and Crohn's disease, supporting psoriasis as a systemic disorder; and associations of pigmentary traits, ultraviolet radiation, and lifestyle factors such as citrus consumption with risk of skin cancer. Genetic studies have identified novel genetic loci for skin pigmentation (e.g., IRF4, SLC24A4, NID1, and EDNRB) and skin cancer (e.g., TET2 and HERC2-OCA2). Work continues on highly prevalent but less studied skin conditions such as rosacea, acne, and atopic dermatitis. The NHS results have influenced public health policies on indoor tanning devices.The NHSs have provided invaluable resources on skin disease population science and contributed to the etiological understanding of multiple skin disorders.

SUBMITTER: Li WQ

PROVIDER: S-EPMC4981523 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

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Epidemiological Assessments of Skin Outcomes in the Nurses' Health Studies.

Li Wen-Qing WQ Cho Eunyoung E Weinstock Martin A MA Mashfiq Hasan H Qureshi Abrar A AA

American journal of public health 20160726 9

<h4>Objectives</h4>To review the contribution of the Nurses' Health Studies (NHSs) to identifying epidemiological factors associated with multiple skin diseases, including skin cancer, psoriasis, and other inflammatory and autoimmune skin diseases.<h4>Methods</h4>We carried out a narrative review of NHS articles published between 1976 and 2016.<h4>Results</h4>The NHSs have identified environmental and lifestyle factors related to psoriasis, supporting obesity and smoking as psoriasis risk factor ...[more]

PMID: 27459457

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Project description:BackgroundPhysical activity is generally associated with better outcomes following diagnosis; however, few studies have evaluated change in pre- to postdiagnosis activity and repeated measures of activity by intensity and type.MethodsWe evaluated physical activity and survival following a breast cancer diagnosis in the Nurses' Health Study and Nurses' Health Study II (n = 9308 women, n = 1973 deaths). Physical activity was evaluated as updated cumulative average of metabolic equivalent of task (MET)-h/wk (assigned per activity based on duration and intensity) and change in pre- to postdiagnosis activity. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsHigher postdiagnosis activity was inversely associated with breast cancer-specific mortality in categories from ≥9 MET-h/wk (vs <3 MET h/wk, HR≥9 to <18 = 0.74 [95% CI = 0.55 to 0.99]; HR≥27 = 0.69 [95% CI = 0.50 to 0.95]; Ptrend = .04) and all-cause mortality from ≥3 MET-h/wk (HR≥3 to <9 = 0.73 [95% CI = 0.61 to 0.88]; HR≥27 = 0.51 [95% CI = 0.41 to 0.63]; Ptrend < .001). Associations were predominantly observed for estrogen receptor-positive tumors and in postmenopausal women. Walking was associated with lower risk of all-cause mortality (≥9 vs <3 MET-h/wk, HR= 0.69 [95% CI = 0.57 to 0.84]) as was strength training. Relative to stable activity pre- to postdiagnosis (±3 MET-h/wk), increases from ≥3 to 9 MET-h/wk were associated with lower all-cause mortality risk (Ptrend < .001). Results were robust to adjustment for prediagnosis physical activity.ConclusionsPhysical activity was associated with lower risk of death following diagnosis. Increased pre- to postdiagnosis activity corresponding to at least 1-3 h/wk of walking was associated with lower risk of death. These results provide further impetus for women to increase their activity after a breast cancer diagnosis, though reverse causation cannot be fully excluded.

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Epidemiological Assessments of Skin Outcomes in the Nurses' Health Studies.

Publications

Epidemiological Assessments of Skin Outcomes in the Nurses' Health Studies.

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