Supplemental Digital Content
Radon and skin cancer in south-west England: an ecological study Benedict W. Wheeler, James Allen, Michael H. Depledge & Alison Curnow
SDC eTable 1. Study area age-specific registration rate of non-melanoma skin cancer sub-types per 100,000 population per year (95% Confidence Interval), 2000-2004.
Age group
Non-melanoma skin cancer tumour type (% of total registrations) Basal cell carcinoma
(70%)
Squamous cell carcinoma (24%)
Other non-melanoma (6%)
15-29 3.5 (2.6, 4.7) 0.2 (0.0, 0.7) 0.5 (0.2, 1.1)
30-44 31.2 (28.5, 34.0) 2.1 (1.5, 3.0) 2.4 (1.7, 3.3) 45-59 132.4 (126.9, 138.0) 19.5 (17.4, 21.7) 7.8 (6.5, 9.2) 60-64 247.3 (233.3, 261.9) 48.5 (42.4, 55.2) 15.5 (12.2, 19.5) 65-74 374.5 (361.3, 388.1) 116.8 (109.5, 124.5) 30.2 (26.5, 34.2) 75-84 537.5 (518.8, 556.6) 246.5 (233.9, 259.6) 50.8 (45.2, 56.9) 85+ 606.0 (573.8, 639.6) 417.0 (390.3, 445.0) 86.1 (74.2, 99.3) Total 15+ 171.1 (168.0, 174.3) 58.2 (56.4, 60.1) 14.7 (13.8, 15.6)
SDC eTable 2. Registered cases of skin cancer in study area, 2000-2004.
Age
group Malignant melanoma
Non- melanoma skin cancer
Non-melanoma sub-types Basal cell
carcinoma
Squamous cell carcinoma
Other non- melanoma
15-29 67 56 46 - -
30-44 269 574 501 34 39
45-59 523 2672 2216 326 130
60-64 217 1464 1163 228 73
65-74 426 4233 3040 948 245
75-84 390 4866 3133 1437 296
85+ 126 2423 1324 911 188
Total 2018 16288 11423 3887 978
Notes: Counts below 10 have been suppressed to avoid any confidentiality issues. Malignant melanoma data are based on number of melanomas registered (i.e. number of tumours); non-melanoma data are based on the first instance of each type of tumour (i.e. number of individuals).
SDC eTable 3. Expanded Poisson regression results: outcome is postcode sector malignant melanoma registration rate 2000-2004 (n=287). RR: Rate Ratio; CI: Confidence Interval.
Explanatory
variable Value
Unadjusted modelsa
Fully adjusted
model Full model p-value (for trend where appropriate)
Unadjusted mean strata specific age- standardised registration rate
per 100,000 n (postcode sectors)
n (2001 population)
RR 95% CI RR 95% CI
Postcode sector mean radon concentration (Bq/m3)
0-39b 1.00 1.00 31.7 43 220133
40-44 1.05 (0.84,1.30) 1.05 (0.85,1.28) 34.2 19 88080
45-49 1.04 (0.88,1.24) 1.00 (0.84,1.20) 31.8 22 111600
50-59 0.92 (0.75,1.14) 0.89 (0.73,1.09) 30.8 30 155252
60-74 0.98 (0.79,1.22) 0.96 (0.77,1.19) 29.4 30 155139
75-99 1.05 (0.87,1.28) 0.96 (0.79,1.16) 29.5 38 163678
100-129 1.00 (0.83,1.19) 0.95 (0.80,1.14) 31.8 39 157720
130-159 1.08 (0.86,1.35) 0.98 (0.79,1.21) 37.1 19 77503
160-229 0.96 (0.80,1.16) 0.92 (0.76,1.11) 29.8 28 121082
>=230 0.81 (0.62,1.07) 0.85 (0.65,1.11) 0.200 26.2 19 72891
Mean daily hours bright sunshine April- September (quintilesc)
1b (lowest) 1.00 1.00 29.2 59 229880
2 1.05 (0.88,1.24) 1.06 (0.89,1.26) 28.9 56 240140
3 1.14 (0.94,1.39) 1.10 (0.91,1.33) 33.8 58 293451
4 1.13 (0.97,1.32) 1.06 (0.86,1.32) 30.7 57 308295
5 1.13 (0.95,1.34) 1.07 (0.86,1.33) 0.753 32.7 57 251312
Coastal proximity
>2km 1.00 1.00 28.2 130 599263
<=2km 1.14 (1.03,1.27) 1.14 (0.99,1.31) 0.062 33.5 157 723815 Population
density (people per hectare)
0 to <5b 1.00 1.00 32.4 165 595203
5 to <20 0.90 (0.79,1.02) 0.83 (0.69,0.99) 0.034 28.9 53 303781
20+ 0.93 (0.82,1.05) 0.87 (0.71,1.06) 0.159 29.7 69 424094
% Population in low socio- economic classifications (quintilesc)
1b (lowest %) 1.00 1.00 37.1 58 215756
2 0.88 (0.74,1.05) 0.88 (0.74,1.04) 32.8 57 209911
3 0.94 (0.82,1.08) 0.94 (0.81,1.10) 32.5 58 279267
4 0.77 (0.67,0.88) 0.79 (0.66,0.93) 28.2 57 290203
5 0.72 (0.62,0.83) 0.73 (0.60,0.89) 0.002 24.7 57 327941
% Population with no qualifications (quintilesc)
1b (lowest %) 1.00 1.00 38.2 58 235422
2 0.89 (0.75,1.05) 0.99 (0.84,1.17) 32.1 57 274766
3 0.81 (0.70,0.95) 1.01 (0.83,1.22) 27.9 58 262985
4 0.79 (0.68,0.93) 1.02 (0.84,1.24) 28.6 57 242152
5 0.78 (0.67,0.90) 1.10 (0.90,1.33) 0.293 28.5 57 307753
% Population unemployed (quintilesc)
1b (lowest %) 1.00 1.00 35.0 58 242949
2 1.00 (0.84,1.19) 1.01 (0.87,1.19) 31.8 57 273185
3 0.91 (0.77,1.08) 0.96 (0.83,1.10) 29.7 58 251312
4 0.96 (0.80,1.16) 1.01 (0.84,1.22) 32.0 57 272230
5 0.83 (0.70,0.99) 0.89 (0.74,1.07) 0.355 26.9 57 283402
% Population in primarily outside occupations (quintilesc)
1b (lowest %) 1.00 1.00 33.9 58 353120
2 0.86 (0.74,1.00) 0.91 (0.79,1.05) 28.6 57 317462
3 0.91 (0.80,1.05) 0.87 (0.74,1.01) 30.3 58 273818
4 0.87 (0.72,1.04) 0.77 (0.62,0.96) 29.4 57 209269
5 0.90 (0.76,1.06) 0.79 (0.63,0.99) 0.021 33.2 57 169409
a All univariate models adjust for age group and % male in postcode sector b Baseline category
c Quintiles across postcode sectors i.e. quintile 1 = lowest fifth of sectors across study area
SDC eTable 4. Expanded Poisson regression results: outcome is postcode sector basal cell carcinoma registration rate 2000-2004 (n=287). RR: Rate Ratio; CI: Confidence Interval.
Explanatory
variable Value
Unadjusted modelsa
Fully adjusted
model Full model p-value (for trend where appropriate)
Unadjusted mean strata specific age- standardised registration rate
per 100,000 n (postcode sectors)
n (2001 population)
RR 95% CI RR 95% CI
Postcode sector mean radon concentration (Bq/m3)
0-39b 1.00 1.00 163.5 43 220133
40-44 1.00 (0.90,1.11) 1.03 (0.90,1.19) 165.0 19 88080
45-49 1.12 (1.00,1.25) 1.15 (1.01,1.32) 195.7 22 111600
50-59 0.93 (0.75,1.16) 0.98 (0.84,1.16) 169.5 30 155252
60-74 1.12 (1.00,1.25) 1.20 (1.06,1.35) 182.9 30 155139
75-99 1.09 (0.97,1.22) 1.13 (1.00,1.28) 188.2 38 163678
100-129 0.89 (0.77,1.03) 0.91 (0.79,1.04) 153.5 39 157720
130-159 0.96 (0.82,1.13) 1.02 (0.88,1.18) 155.2 19 77503
160-229 0.94 (0.82,1.08) 1.01 (0.87,1.17) 166.9 28 121082
>=230 0.72 (0.60,0.86) 0.81 (0.66,1.00) 0.176 123.6 19 72891
Mean daily hours bright sunshine April- September (quintilesc)
1b (lowest) 1.00 1.00 163.9 59 229880
2 1.03 (0.95,1.12) 1.09 (0.97,1.21) 179.4 56 240140
3 0.88 (0.76,1.01) 0.89 (0.77,1.03) 156.2 58 293451
4 0.99 (0.91,1.08) 1.00 (0.89,1.13) 165.7 57 308295
5 1.05 (0.94,1.17) 1.08 (0.93,1.25) 0.446 174.2 57 251312
Coastal proximity
>2km 1.00 1.00 169.7 130 599263
<=2km 1.01 (0.92,1.10) 0.97 (0.89,1.06) 0.467 166.2 157 723815 Population
density (people per hectare)
0 to <5b 1.00 1.00 165.3 165 595203
5 to <20 1.07 (0.97,1.17) 0.93 (0.83,1.05) 0.236 177.3 53 303781
20+ 0.97 (0.87,1.08) 0.83 (0.73,0.94) 0.004 166.4 69 424094
% Population in low socio- economic classifications (quintilesc)
1b (lowest %) 1.00 1.00 163.3 58 215756
2 1.07 (0.95,1.21) 1.12 (1.00,1.26) 177.1 57 209911
3 1.03 (0.92,1.16) 1.02 (0.91,1.13) 170.0 58 279267
4 0.93 (0.80,1.07) 0.91 (0.78,1.06) 164.7 57 290203
5 1.00 (0.89,1.11) 0.99 (0.85,1.15) 0.19 163.8 57 327941
% Population with no qualifications (quintilesc)
1b (lowest %) 1.00 1.00 166.8 58 235422
2 0.95 (0.80,1.11) 0.94 (0.83,1.08) 165.2 57 274766
3 1.03 (0.92,1.15) 1.04 (0.92,1.17) 174.4 58 262985
4 0.97 (0.87,1.09) 1.00 (0.88,1.14) 169.0 57 242152
5 0.96 (0.85,1.08) 1.04 (0.91,1.20) 0.385 163.4 57 307753
% Population unemployed (quintilesc)
1b (lowest %) 1.00 1.00 169.1 58 242949
2 1.07 (0.92,1.25) 1.08 (0.96,1.22) 189.5 57 273185
3 1.00 (0.86,1.17) 1.04 (0.93,1.16) 164.9 58 251312
4 0.91 (0.77,1.07) 0.94 (0.82,1.08) 156.5 57 272230
5 0.97 (0.83,1.14) 1.02 (0.87,1.18) 0.528 158.8 57 283402
% Population in primarily outside occupations (quintilesc)
1b (lowest %) 1.00 1.00 171.6 58 353120
2 1.03 (0.90,1.18) 0.97 (0.88,1.07) 182.5 57 317462
3 0.97 (0.85,1.12) 0.90 (0.79,1.02) 170.2 58 273818
4 0.87 (0.75,1.00) 0.76 (0.65,0.88) 159.5 57 209269
5 0.90 (0.79,1.04) 0.73 (0.62,0.86) <0.001 154.9 57 169409
a All univariate models adjust for age group and % male in postcode sector b Baseline category
c Quintiles across postcode sectors i.e. quintile 1 = lowest fifth of sectors across study area
SDC eTable 5. Expanded Poisson regression results: outcome is postcode sector squamous cell carcinoma registration rate 2000-2004 (n=287). RR: Rate Ratio; CI: Confidence Interval.
Explanatory
variable Value
Unadjusted modelsa
Fully adjusted
model Full model p-value (for trend where appropriate)
Unadjusted mean strata specific age-
standardised registration rate
per 100,000 n (postcode sectors)
n (2001 population)
RR 95% CI RR 95% CI
Postcode sector mean radon concentration (Bq/m3)
0-39b 1.00 1.00 41.2 43 220133
40-44 1.00 (0.85,1.19) 1.00 (0.82,1.23) 42.5 19 88080
45-49 1.02 (0.85,1.22) 1.02 (0.84,1.25) 43.8 22 111600
50-59 1.06 (0.84,1.33) 1.11 (0.91,1.34) 49.3 30 155252
60-74 1.26 (1.07,1.49) 1.30 (1.10,1.54) 57.0 30 155139
75-99 1.47 (1.23,1.77) 1.44 (1.20,1.74) 65.7 38 163678
100-129 1.73 (1.46,2.05) 1.68 (1.42,1.99) 78.8 39 157720
130-159 1.56 (1.23,1.98) 1.55 (1.23,1.96) 66.0 19 77503
160-229 1.65 (1.35,2.02) 1.62 (1.31,2.00) 69.4 28 121082
>=230 1.75 (1.50,2.05) 1.76 (1.46,2.11) <0.001 80.0 19 72891 Mean daily
hours bright sunshine April- September (quintilesc)
1b (lowest) 1.00 1.00 46.4 59 229880
2 1.23 (1.05,1.45) 0.95 (0.81,1.11) 56.7 56 240140
3 1.36 (1.13,1.65) 1.05 (0.88,1.25) 66.4 58 293451
4 1.41 (1.20,1.66) 1.15 (0.98,1.36) 67.6 57 308295
5 1.30 (1.11,1.53) 0.98 (0.80,1.19) 0.595 59.8 57 251312
Coastal proximity
>2km 1.00 1.00 52.1 130 599263
<=2km 1.27 (1.14,1.42) 1.16 (1.04,1.30) 0.010 65.3 157 723815 Population
density (people per hectare)
0 to <5b 1.00 1.00 61.5 165 595203
5 to <20 0.93 (0.82,1.07) 0.96 (0.82,1.12) 0.568 58.6 53 303781
20+ 0.87 (0.75,1.01) 0.96 (0.80,1.16) 0.681 54.6 69 424094
% Population in low socio- economic classifications (quintilesc)
1b (lowest %) 1.00 1.00 59.2 58 215756
2 1.00 (0.83,1.21) 0.93 (0.80,1.09) 60.9 57 209911
3 1.02 (0.85,1.23) 0.98 (0.83,1.16) 60.8 58 279267
4 0.91 (0.74,1.11) 0.90 (0.74,1.10) 55.3 57 290203
5 1.07 (0.90,1.27) 1.09 (0.89,1.33) 0.652 60.3 57 327941
% Population with no qualifications (quintilesc)
1b (lowest %) 1.00 1.00 55.5 58 235422
2 0.97 (0.78,1.20) 0.92 (0.77,1.11) 60.9 57 274766
3 1.04 (0.85,1.26) 1.01 (0.84,1.22) 61.9 58 262985
4 1.04 (0.86,1.26) 1.01 (0.82,1.24) 60.4 57 242152
5 0.98 (0.81,1.19) 0.93 (0.75,1.16) 0.758 57.8 57 307753
% Population unemployed (quintilesc)
1b (lowest %) 1.00 1.00 49.4 58 242949
2 1.18 (0.99,1.40) 1.09 (0.94,1.27) 57.2 57 273185
3 1.29 (1.06,1.57) 1.19 (1.02,1.39) 59.6 58 251312
4 1.33 (1.13,1.57) 1.11 (0.94,1.32) 63.5 57 272230
5 1.36 (1.14,1.63) 1.15 (0.94,1.41) 0.217 66.9 57 283402
% Population in primarily outside occupations (quintilesc)
1b (lowest %) 1.00 1.00 50.2 58 353120
2 1.16 (0.99,1.37) 1.05 (0.92,1.21) 59.4 57 317462
3 1.16 (0.97,1.40) 1.00 (0.85,1.18) 62.1 58 273818
4 1.27 (1.07,1.52) 1.05 (0.86,1.29) 66.8 57 209269
5 1.17 (0.98,1.39) 1.06 (0.87,1.30) 0.676 58.1 57 169409
a All univariate models adjust for age group and % male in postcode sector b Baseline category
c Quintiles across postcode sectors i.e. quintile 1 = lowest fifth of sectors across study area