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Are Ocular Markers of Sun Exposure Associated With Skin Cancer? A Cross-Sectional Analysis of the Busselton Healthy Ageing Study.

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Title: Are Ocular Markers of Sun Exposure Associated With Skin Cancer? A Cross-Sectional Analysis of the Busselton Healthy Ageing Study.
Authors: Lingham G; Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), University of Western Australia, Perth, Australia.; Centre for Eye Research Ireland, Environment, Sustainability and Health Research Hub, Technological University Dublin, Dublin, Ireland.; Centre for Eye Research Australia, Melbourne, Australia., Nilagiri VK; Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), University of Western Australia, Perth, Australia., Brown H; Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), University of Western Australia, Perth, Australia., Bharat C; School of Population and Global Health, University of Western Australia, Perth, Australia.; National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia., Lee SSY; Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), University of Western Australia, Perth, Australia.; School of Optometry and Vision Science, University of New South Wales, Sydney, Australia., Franchina M; Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), University of Western Australia, Perth, Australia., Hunter M; School of Population and Global Health, University of Western Australia, Perth, Australia.; Busselton Population Medical Research Institute, Busselton, Australia., Murray K; School of Population and Global Health, University of Western Australia, Perth, Australia., Alonso-Caneiro D; School of Science, Technology, and Engineering, University of the Sunshine Coast, Petrie, Australia.; Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Australia., Olsen CM; Cancer Control Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia.; Dermatology Research Centre, Frazer Institute, The University of Queensland, Brisbane, Australia., Whiteman DC; Cancer Control Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia.; Faculty of Medicine, The University of Queensland, Brisbane, Australia., Mackey DA; Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), University of Western Australia, Perth, Australia.
Source: Clinical & experimental ophthalmology [Clin Exp Ophthalmol] 2026 Sep-Oct; Vol. 54 (7), pp. 866-874. Date of Electronic Publication: 2026 Jul 27.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Wiley-Blackwell Pub. Asia Country of Publication: Australia NLM ID: 100896531 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1442-9071 (Electronic) Linking ISSN: 14426404 NLM ISO Abbreviation: Clin Exp Ophthalmol Subsets: MEDLINE
Imprint Name(s): Publication: Carlton, Vic. : Wiley-Blackwell Pub. Asia
Original Publication: Carlton, Vic. : Blackwell Science Asia, c2000-
MeSH Terms: Skin Neoplasms*/etiology , Skin Neoplasms*/epidemiology , Skin Neoplasms*/diagnosis , Sunlight*/adverse effects , Pterygium*/diagnosis , Pterygium*/etiology , Pterygium*/epidemiology , Myopia*/etiology , Myopia*/diagnosis , Myopia*/epidemiology , Neoplasms, Radiation-Induced*/etiology , Neoplasms, Radiation-Induced*/diagnosis , Neoplasms, Radiation-Induced*/epidemiology , Conjunctiva*/radiation effects , Melanoma*/etiology , Melanoma*/diagnosis , Melanoma*/epidemiology, Western Australia/epidemiology ; Ultraviolet Rays/adverse effects ; Humans ; Cross-Sectional Studies ; Female ; Middle Aged ; Male ; Aged ; Risk Factors ; Non-Melanoma Skin Neoplasms
Abstract: Background: Higher past sun or ultraviolet radiation exposure increases the risk of skin cancer and three common ocular findings: pterygium, conjunctival ultraviolet autofluorescence (CUVAF) and myopia. We investigated whether ocular markers of past sun exposure are associated with a history of skin cancer.
Methods: A cross-sectional study of participants who attended the Phase 2 examination of the Busselton Healthy Ageing Study in Western Australia (2016-2022). Myopia was determined from autorefraction and pterygium and CUVAF from photographs of the anterior eye. Past diagnosis of a skin cancer was obtained from linked hospitalisation and cancer registry data (melanoma) or combining linked and self-reported data (keratinocyte cancer). Multivariable logistic regression with multiple imputation was used for analysis.
Results: Of 3888 participants who attended, 3829 (98.5%) had skin cancer history data (mean [standard deviation] age 64.2 [5.4] years). A history of keratinocyte cancer was present in 795 (20.8%) participants and cutaneous melanoma in 59 (1.5%) participants. After adjustments, keratinocyte skin cancer was associated with a current pterygium (odds ratio [OR] = 1.33, 95% confidence interval [CI]: 1.05, 1.69) and a previous self-reported pterygium excision (OR = 1.85, 95% CI: 1.21, 2.82). Neither CUVAF or myopia was associated with keratinocyte cancer or melanoma diagnoses.
Conclusions: Having a current pterygium or previous pterygium excision is associated with a diagnosis of keratinocyte skin cancer. While causality cannot be determined, the association may reflect shared risk factors such as chronic ultraviolet radiation exposure, and people with a pterygium should be advised that they are at higher risk of skin cancer.
(© 2026 The Author(s). Clinical & Experimental Ophthalmology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Ophthalmologists.)
References: Clin Exp Ophthalmol. 2015 May-Jun;43(4):300-7. (PMID: 25307729)
Photochem Photobiol Sci. 2020 Mar 1;19(3):382-389. (PMID: 32010915)
Eye (Lond). 2004 Jun;18(6):635-9. (PMID: 14716324)
Sci Rep. 2021 Mar 18;11(1):6337. (PMID: 33737652)
J Am Acad Dermatol. 2023 Mar;88(3):521-530. (PMID: 36460257)
Cancer Epidemiol. 2020 Oct;68:101790. (PMID: 32745997)
Am J Ophthalmol. 2006 Feb;141(2):294-8. (PMID: 16458683)
J Med Genet. 2011 Mar;48(3):168-76. (PMID: 21097776)
JAMA. 2015 Sep 15;314(11):1142-8. (PMID: 26372583)
Eur J Cancer. 2005 Jan;41(1):45-60. (PMID: 15617990)
Int J Environ Res Public Health. 2022 Mar 08;19(6):. (PMID: 35328865)
Ann Epidemiol. 2007 Feb;17(2):106-11. (PMID: 16882464)
Photochem Photobiol. 2017 Oct;93(5):1294-1302. (PMID: 28432795)
Br J Ophthalmol. 2018 Apr;102(4):496-501. (PMID: 28844049)
Clin Exp Ophthalmol. 2021 Dec;49(9):1039-1047. (PMID: 34378302)
Invest Ophthalmol Vis Sci. 2014 Jun 26;55(7):4552-9. (PMID: 24970253)
JAMA Ophthalmol. 2015 Apr;133(4):406-12. (PMID: 25590795)
Eur J Epidemiol. 2004;19(3):239-47. (PMID: 15117117)
Australas J Dermatol. 2019 Nov;60(4):294-300. (PMID: 31012087)
Eye Contact Lens. 2011 Jul;37(4):214-24. (PMID: 21670690)
Cells. 2021 Jun 22;10(7):. (PMID: 34206333)
Sci Rep. 2023 Oct 6;13(1):16873. (PMID: 37803080)
Clin Exp Ophthalmol. 2011 Jul;39(5):462-71. (PMID: 21176045)
Optom Vis Sci. 2017 Feb;94(2):229-238. (PMID: 27811524)
Br J Ophthalmol. 2023 May;107(5):614-620. (PMID: 34815236)
Eur J Cancer. 2005 Sep;41(14):2040-59. (PMID: 16125929)
J Photochem Photobiol B. 2001 Oct;63(1-3):8-18. (PMID: 11684447)
J Am Acad Dermatol. 2023 Mar;88(3):534-542. (PMID: 36460256)
J Epidemiol. 2018 Jan 5;28(1):27-33. (PMID: 29176271)
Med J Aust. 2014 May 19;200(9):521-2. (PMID: 24835711)
Ophthalmic Epidemiol. 2021 Apr;28(2):105-113. (PMID: 32729768)
JAMA Dermatol. 2022 May 1;158(5):495-503. (PMID: 35353115)
Mol Vis. 2010 Apr 20;16:698-704. (PMID: 20431719)
Ophthalmology. 2013 Jul;120(7):1324-36. (PMID: 23601806)
Biometrics. 1977 Mar;33(1):159-74. (PMID: 843571)
Ocul Surf. 2014 Jan;12(1):69-76. (PMID: 24439048)
BMC Public Health. 2013 Oct 08;13:936. (PMID: 24099269)
Exp Eye Res. 2025 Jun;255:110353. (PMID: 40118135)
Grant Information: Australian Government; Government of Western Australia; 2026567 National Health and Medical Research Council of Australia; City of Busselton; Stan Perron Charitable Foundation; Busselton Population Medical Research Institute; Western Australia Future Health and Research Innovation Emerging Leaders Fellowship
Contributed Indexing: Keywords: Australia; eye; myopia; pterygium; skin cancer
Entry Date(s): Date Created: 20260727 Date Completed: 20261007 Latest Revision: 20261009
Update Code: 20261009
PubMed Central ID: PMC13643609
DOI: 10.1111/ceo.70148
PMID: 42509020
Database: MEDLINE
Description
ISSN:1442-9071
DOI:10.1111/ceo.70148