Date of Award

1-1-2018

Embargo Period

1-1-2020

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Public Health Sciences

College

College of Graduate Studies

First Advisor

Kristin Wallace

Second Advisor

Anthony Alberg

Third Advisor

Elizabeth Hill

Fourth Advisor

Bruce Thiers

Fifth Advisor

Brian Leach

Abstract

A growing body of evidence supports an association between a personal history of skin cancer and increased risk for adverse health outcomes. However, limitations in this evidence remain, such as incomplete control for confounding factors. Further, family history of skin cancer is likely to provide important etiologic clues but has yet to be thoroughly integrated in research to date. To address this gap, this dissertation investigates in a nationally representative cohort both personal and family history of skin cancer in relation to the risk of 1) developing an internal cancer and 2) mortality. Further, we investigate the translational potential of the association between skin cancer and risk for developing an internal cancer by introducing information for a personal history of skin cancer, family history of skin cancer, and relative’s age at skin cancer diagnosis into a model for breast cancer risk, the Gail model, to determine if this additional information could improve the model’s predictive ability. We observed that after adjusting for common cancer risk factors, such as smoking and BMI, a personal history of skin cancer was associated with increased risk for developing an internal cancer but not increased risk for mortality. Additionally our work showed that patients with a skin cancer diagnosed before the age of fifty were at increased risk for developing breast cancer. Also, the results for family history of skin cancer from Aim 3 revealed that age at relative’s skin cancer diagnosis may be crucial to studying the association between a family history of skin cancer and increased risk for developing an internal cancer. Finally, calibrating the Gail model for a patient’s personal and family history of skin cancer increased model sensitivity at the cost of lower specificity. Ultimately, a personal and family history of skin cancer and its role as a marker for increased risk for developing an internal malignancy makes skin cancer a rich opportunity to investigate the processes common to cancer development at several cancer sites.

Rights

All rights reserved. Copyright is held by the author.

Download

Share

COinS