***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND AND DESIGN Basal cell carcinoma ( BCC ) of the skin is the most common neoplasm in white population s , and solar radiation is generally accepted to be the dominant environmental risk factor for this disease . However , little information is available on the nature of the relationship between BCC and sunlight . The purpose of this study was to evaluate the nature of the relationship between sunlight exposure , pigmentary factors , and BCC of the skin . A population -based case-control study of 226 male patients with BCC diagnosed from January 1 , 1983 , through December 31 , 1984 , and 406 r and omly selected male control subjects was conducted in Alberta , Canada . The study was conducted using a st and ardized question naire , administered in person by trained interviewers . Data were analyzed using conditional logistic regression methods . RESULTS After controlling for other host and pigmentary factors , the risk of BCC was increased in subjects with light skin color and those who freckled in childhood . A history of severe sunburn in childhood also increased risk . Subjects of southern European ethnic origin were at significantly lower risk of BCC . Surprisingly , no association was seen between mean annual cumulative summer sunlight exposure and risk of BCC . A significantly increased risk of BCC was seen in subjects with increased recreational sunlight exposure  in adolescence and childhood ( age , 0 to 19 years ) , although an inverse relationship was seen with lifetime recreation exposure . The relationship with childhood sun exposure was most pronounced among sun-sensitive subjects whose skin tended to burn rather than tan in the sun . CONCLUSIONS The lack of association between cumulative sun exposure and BCC contradicts conventional wisdom about the cause of this tumor , and the increased risk with sun exposure at age 0 to 19 years suggests that childhood and adolescence may be critical periods for establishing adult risk for BCC BACKGROUND Alcohol consumption has been associated with an increased prevalence of sunburn , which is an established skin cancer risk factor . OBJECTIVE We investigated whether alcohol consumption is associated with risk of cutaneous basal cell carcinoma ( BCC ) .  DESIGN We conducted a prospect i ve analysis on alcohol consumption and risk of BCC on the basis of data from 167,765 women in the NHS ( Nurses ' Health Study ) ( 1984 - 2010 ) and NHS II ( 1991 - 2011 ) and 43,697 men in the Health Professionals Follow-Up Study ( 1986 - 2010 ) .  Alcohol intake  was repeatedly assessed every 2 - 4 y over the follow-up period . HRs and 95 % CIs for BCC in association with alcohol intake were computed with the use of Cox proportional hazards models with adjustment for sun exposure and other skin cancer risk factors . RESULTS A total of 28,951 incident BCC cases were documented over 3.74 million person-years of follow-up . Increased alcohol intake was associated with increased BCC risk in both women and men ( both P-trend < 0.0001 ) . Pooled multivariable-adjusted HRs over increasing cumulative averaged alcohol intake categories were 1.00 ( reference ) for nondrinkers , 1.13 ( 95 % CI : 1.06 , 1.20 ) for 0.1 - 9.9 g/d , 1.24 ( 95 % CI : 1.14 , 1.35 ) for 10.0 - 19.9 g/d , 1.27 ( 95 % CI : 1.20 , 1.35 ) for 20.0 - 29.9 g/d , and 1.22 ( 95 % CI : 1.15 , 1.30 ) for ≥30.0 g/d ( P-trend < 0.0001 , P-heterogeneity by study = 0.10 ) . The association remained consistent when we used alcohol intakes over different latency periods ( 0 - 4 , 4 - 8 , 8 - 12 , and 12 - 16 y ) as exposures and over categories of sun exposure-related factors . In the individual alcoholic beverages , white wine and liquor were positively associated with BCC risk . CONCLUSION Alcohol consumption is associated with increased risk of cutaneous BCC in both women and men Alcohol has not been linked definitively to non-melanoma skin cancer . We examined whether alcohol intake affects the risks for basal cell carcinoma ( BCC ) and squamous cell carcinoma ( SCC ) using data on 54,766 persons enrolled in the prospect i ve Diet , Cancer , and Health cohort . Statistical analyses were based on the Cox proportional hazards model . All hazard ratios ( HRs ) were multivariate adjusted . Adjustment for exposure to UVR was not possible , but all analyses were adjusted for factors related to susceptibility to UVR , including sun sensitivity , degree of freckling , and number of nevi . A total of 2,409 BCC cases and 198 SCC cases were diagnosed within a median follow-up of 11.4 years . Total current alcohol intake was not associated with BCC risk , but beverage-specific analyses showed an increased BCC risk associated with intake of wine ( HR=1.05 , 95 % confidence interval ( CI ) : 1.02 - 1.08 , current average alcohol intake , per 10 g per day ) and spirits ( HR=1.11 , 95 % CI : 1.02 - 1.21 ) and a decreased risk with beer ( HR=0.97 , 95 % CI : 0.93 - 1.00 ) . No convincing associations were found between total alcohol intake and risk for SCC , perhaps because of the limited number of cases . Our findings indicate that alcohol intake may increase the risk for BCC , but the relations seemed to depend on beverage type We prospect ively investigated whether alcohol intake and smoking affect the risk of basal cell carcinoma ( BCC ) in subjects from the United States Radiological Technologists ( USRT ) cohort study . We evaluated 68,371 radiological technologists certified during 1926 - 1982 who were free of cancer at the time they answered a first question naire ( 1983 - 1989 ) and who completed a second question naire ( 1994 - 1998 ) . The first question naire provided baseline information on numerous risk factors , including smoking and alcohol intake , and the second provided self-reported cancer diagnoses . During 698,190 person-years of follow-up , we identified 1,360 cases of BCC : 1,036 in women and 324 in men . Cox proportional hazards regression indicated that the trend in BCC was significantly associated with increased alcohol intake ( P for trend = 0.001 ) . Compared with those who reported no alcohol consumption , those who drank < 1 - 2 , 3 - 6 , 7 - 14 , and > 14 drinks/week had multivariate risks of 1.1 [ 95 % confidence interval ( CI ) , 0.9 - 1.3 ] , 1.3 ( 95 % CI , 1.1 - 1.5 ) , 1.4 ( 95 % CI , 1.2 - 1.7 ) , and 1.0 ( 95 % CI , 0.7 - 1.6 ) , respectively . We found no clear association between smoking and BCC . This is the second large prospect i ve study to report a significant but nonmonotonic trend in increased risk associated with alcohol consumption Data -gathering instruments were used in a r and omized controlled trial , design ed to assess a structured preoperative educational program for elective surgical patients . The key dependent variable was the physical functional capacity of patients following surgery . Question naires were developed to measure physical functioning in the immediate postoperative period , after discharge from hospital , and 10 days and 33 days after surgery . Statistical techniques used to measure interobserver agreement and bias were Bowker 's chi square , Cicchetti 's statistic , the contingency coefficient , Kendall 's Taub , and Kendall 's coefficient of concordance W. The st and ardized question naires permitted classification of patients ' postoperative physical functions with results that agreed highly with the classification done by experienced clinicians who cared for the same patients Purpose The relationship between alcohol consumption and preference of alcohol type with hazard of melanoma ( MM ) and risk of non-melanoma skin cancer ( NMSC ) was examined in the Women ’s Health Initiative ( WHI ) Observational Study ( OS ) . Methods A prospect i ve cohort of 59,575 White postmenopausal women in the WHI OS ( mean age 63.6 ) was analyzed . Cox proportional hazards models and logistic regression techniques were used to assess the hazard and risk of physician-adjudicated MM and self-reported NMSC , respectively , after adjusting for potential confounders including measures of sun exposure and skin type . Results Over 10.2 mean years of follow-up , 532 MM cases and 9,593 NMSC cases occurred . A significant relationship between amount of alcohol consumed and both MM and NMSC was observed , with those who consume 7 + drinks per week having a higher hazard of MM ( HR 1.64 ( 1.09 , 2.49 ) , pglobal = 0.0013 ) and higher risk of NMSC ( OR 1.23 ( 1.11 , 1.36 ) , pglobal < 0.0001 ) compared to non-drinkers . Lifetime alcohol consumption was also positively associated with hazard of MM ( p = 0.0011 ) and risk of NMSC ( p < 0.0001 ) . Further , compared to non-drinkers , a preference for either white wine or liquor was associated with an increased hazard of MM ( HR 1.52 ( 1.02 , 2.27 ) for white wine ; HR 1.65 ( 1.07 , 2.55 ) for liquor ) and risk of NMSC ( OR 1.16 ( 1.05 , 1.28 ) for white wine ; OR 1.26 ( 1.13 , 1.41 ) for liquor ) . Conclusions Higher current alcohol consumption , higher lifetime alcohol consumption , and a preference for white wine or liquor were associated with increased hazard of MM and risk of NMSC Objective : To investigate the association between total alcohol intake and intake of different types of alcoholic beverages in relation to the risk of basal cell ( BCC ) and squamous cell ( SCC ) carcinoma of the skin . Design : Prospect i ve cohort study . Setting : Follow-up data from a community-based skin cancer study in Australia . Subjects : R and omly selected sample of 1360 adult residents of the township of Nambour who completed a food frequency question naire in 1992 and were monitored for BCC and SCC until 31 December 2002 . Results : No significant association was found between overall BCC or SCC risk and total alcohol intake  , or intake of beer , white wine , red wine or sherry and port . However , among those with a prior skin cancer history , there was a significant doubling of risk of SCC for above-median consumption of sherry and port ( multivariable adjusted relative risk 2.46 , 95 % confidence interval 1.06–5.72 ) compared with abstainers . Conclusions : There are no associations between first occurrence of skin cancers and alcoholic beverage consumption . People with a history of skin cancer who consume above-average quantities of sherry or port may be at a raised risk of SCC , although replication of these findings in different study population s is needed to confirm this possible role of specific alcoholic beverages in secondary keratinocytic skin cancer risk INTRODUCTION AND DESIGN Squamous cell carcinoma of the skin ( SCC ) , a common cancer in white population s , is related to sunshine exposure ; however , relatively little information is available on how timing and character of exposure affect the relationship . The purpose of this study was to investigate the nature of the relationship of SCC to individual solar UV exposure after control for phenotype and pigmentary factors . All newly diagnosed cases of SCC were in men aged 25 through 79 years , ascertained in the province of Alberta from January 1 , 1983 , through December 31 , 1984 , who were approached for participation ; 80 % completed a st and ardized etiologic interview that was conducted in their homes by a trained interviewer . Control subjects were chosen at r and om from the Alberta Health Care Insurance Plan subscribers list , matched only by sex ( male ) and age ( within a 5-year age group ) . The response rate among controls was 71 % . RESULTS Subjects with pale skin and red hair had an elevated risk of SCC .  Subjects whose mother was of southern European ancestry had a reduced risk of SCC . After accounting for pigmentary factors , no association was seen between risk of SCC and cumulative lifetime sun exposure . However , a strong trend toward increasing risk was seen with increasing chronic occupational sun exposure in the 10 years prior to diagnosis . CONCLUSION The results suggest that recent sun exposure ( in the 10 years prior to diagnosis ) may be important in accounting for individual risk of SCC We prospect ively examined the intake of alcoholic beverages in relation to the  risk of basal cell carcinoma BCC in two large cohorts of men and women .  Alcohol intake was assessed with food frequency question naires every 2 - 4 years , and BCC was ascertained by self-report . We used a pooled logistic regression to model the association between alcohol intake and BCC adjusting for various health , sun exposure , and sun-sensitivity factors . During 8 years of follow-up in women ( 1986 - 19 
    Output:
    
While there was evidence suggesting a nonlinear association for BCC , it may be due to the sparse data at higher alcohol intake levels .
This meta- analysis found evidence that alcohol drinking is positively associated with both BCC and cSCC risk in a dose-dependent manner .
Nonetheless , because alcohol drinking is a prevalent and modifiable behaviour , it could serve as an important public health target to reduce the global health burden of NMSC