Association between urinary paraben concentrations and skin cancer among US Adults.
BACKGROUND Parabens are widely used preservatives in personal care products and have demonstrated endocrine-disrupting and photosensitizing properties. However, their potential role in human skin carcinogenesis remains unclear. METHODS We analyzed a nationally representative sample of 9756 adults (aged 20-80) using data from the 2005-2016 National Health and Nutrition Examination Survey for the association between paraben exposure and skin cancer. Exposure was determined by urinary concentrations of butylparaben (BP), ethylparaben (EP), methylparaben (MP), and propylparaben (PP). Self-reported skin cancer diagnosis included melanoma, nonmelanoma, and unspecified types. Multivariate logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs) for skin cancer across quartiles of creatinine-adjusted urinary paraben concentrations, adjusting for sociodemographic and behavioral covariates. RESULTS Among the 9756 participants, 286 reported a skin cancer diagnosis between 2005 and 2016 (weighted prevalence: 4.03%). Individuals with a skin cancer diagnosis exhibited significantly higher urinary MP concentrations (geometric mean: 72.93 μg/g creatinine) compared to those without (52.98 μg/g creatinine; p = 0.0029). Individuals in the highest quartile (Q4) of urinary MP (≥ 242.01 μg/g) had significantly greater odds of total skin cancer (adjusted OR [aOR]: 1.46; 95% CI: 1.13, 1.87) compared to the lowest quartile (Q1). Stratified analyses revealed significant associations with nonmelanoma skin cancer, whereas no significant associations were observed for melanoma. Specifically, those in Q4 for MP exhibited 1.69-fold higher odds of nonmelanoma skin cancer than those in Q1 (aOR: 1.69; 95% CI: 1.20, 2.37). CONCLUSION Higher urinary MP concentrations were associated with increased nonmelanoma skin cancer prevalence among US adults. The findings suggest a potential role of long-term paraben exposure in skin carcinogenesis and warrant confirmation through prospective and mechanistic investigations.