Document Type

Capstone Experience

Graduation Date

12-2019

Degree Name

Master of Public Health

Department

Epidemiology

First Committee Member

Christine Arcari, PhD, MPH

Second Committee Member

Eleanor Rogan, PhD

Third Committee Member

Dr. Ashley Wysong, M.D., M.S.

Abstract

Background: Melanoma is a deadly skin cancer at late stages, and its incidence has been increasing significantly over the last ten years in the United States. Chronic exposure to arsenic has been associated in many studies as a risk factor for non-melanoma skin cancer, notably squamous cell carcinoma. However, current knowledge is limited regarding melanoma and long-term arsenic exposure.

Methods: We conducted a cross-sectional study using the 2003-2016 cycles of the National Health and Nutrition Examination Survey (NHANES), to investigate the association between arsenic exposure and self-reported melanoma and non-melanoma skin cancer diagnoses. Univariate and multivariate logistic regressions were conducted. To evaluate the association with the source of tap water, an odds ratio was calculated across melanoma and non-melanoma compared to controls with no cancer diagnoses.

Results: White people, higher education, higher socioeconomic status (SES), and smokers were more likely to be diagnosed with melanoma or non-melanoma skin cancer. After adjusting for age and race/ethnicity, the crude odds ratio of people with > 50 ug/L of arsenic in their urine and having melanoma or non-melanoma was 1.87 (95%Cl: 0.58-6.05) and 2.23 (95% Cl: 1.12-4.45), respectively. Individuals with non-melanoma skin cancer diagnoses were 2.06 more likely to report drinking water from a non-municipal source.

Conclusion: A relationship between the incidence of melanoma and exposure to arsenic (measured in urine) among U.S. adults was not found using NHANES from 2003-2016. Non-municipal water sources were associated with non-melanoma and should be further investigated.

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