Journal article
Are Ocular Markers of Sun Exposure Associated With Skin Cancer? A Cross-Sectional Analysis of the Busselton Healthy Ageing Study
Clinical and Experimental Ophthalmology, Vol.Advanced access
27-Jul-2026
PMID: 42509020
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.
Details
- Title
- Are Ocular Markers of Sun Exposure Associated With Skin Cancer? A Cross-Sectional Analysis of the Busselton Healthy Ageing Study
- Authors
- Gareth Lingham - Lions Eye InstituteVinay Kumar Nilagiri - Lions Eye InstituteHolly Brown - Lions Eye InstituteChrianna Bharat - The University of Western AustraliaSamantha S Y Lee - Lions Eye InstituteMaria Franchina - Lions Eye InstituteMichael Hunter - The University of Western AustraliaKevin Murray - The University of Western AustraliaDavid Alonso-Caneiro - University of the Sunshine CoastCatherine M Olsen - The University of QueenslandDavid C Whiteman - The University of QueenslandDavid A Mackey (Corresponding Author) - Lions Eye Institute
- Publication details
- Clinical and Experimental Ophthalmology, Vol.Advanced access
- Publisher
- John Wiley & Sons, Inc.
- DOI
- 10.1111/ceo.70148
- ISSN
- 1442-9071
- PMID
- 42509020
- Copyright note
- © 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. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
- Data Availability
- The data that support the findings of this study are available from Busselton Population Medical Research Institute. Restrictions apply to the availability of these data, which were used under license for this study. Data are available from the author(s) with the permission of Busselton Population Medical Research Institute at https://bpmri.org.au/research/database-access.html.
- Grant note
- Core funding of the Busselton Healthy Ageing Study is provided by the Federal Government of Australia, the Government of Western Australia (Department of Health and Department of Jobs, Tourism, Science and Innovation), the National Health and Medical Research Council (NHMRC) Equipment Grant scheme, the City of Busselton and private donations to the Busselton Population Medical Research Institute. Samantha Lee is funded by a Western Australia Future Health and Research Innovation Emerging Leaders Fellowship. David Mackey is supported by a Stan Perron Charitable Foundation health research grant.
- Organisation Unit
- School of Science, Technology and Engineering
- Language
- English
- Record Identifier
- 991247285002621
- Output Type
- Journal article
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