SKIN cancer is a growing global public health problem, and green spaces are usually considered health promoting environments. This large prospective cohort study examined how environmental greenery relates to melanoma and non-melanoma skin cancer risk and explored potential biological mechanisms behind these associations.
Using data from 318,738 adults, investigators quantified exposure to green space, domestic gardens and natural environments within 300 meter and 1,000 meter buffers around participants’ homes. Incident melanoma and non-melanoma skin cancer were ascertained, and hazard ratios were estimated with Cox regression models. Genetic susceptibility was captured with polygenic risk scores, and gene–environment interactions were evaluated. Metabolomics and mediation analyses were used to probe biological pathways, including air pollution and fine particulate matter.
Domestic Gardens And Skin Cancer Incidence
Domestic gardens emerged as the main type of environmental greenery associated with increased skin cancer risk. Participants in the highest quartile of exposure to gardens had a 23% higher risk of malignant melanoma compared with those in the lowest quartile, with a hazard ratio of 1.23 and a 95% confidence interval of 1.08 to 1.41. For non-melanoma skin cancer, living within 300 meters of a garden was associated with a hazard ratio of 1.10, and living within 1,000 meters with a hazard ratio of 1.11, with confidence intervals that did not cross unity. These findings suggest that proximity to domestic gardens may act as a proxy for behaviors that increase ultraviolet radiation exposure and time spent outdoors.
Susceptible Populations and Mediating Pathways
Gene–environment interaction analyses showed that domestic gardens conferred greater melanoma and non-melanoma skin cancer risk in genetically susceptible, light-skinned and sun-sensitive individuals. Metabolomic profiling identified several metabolites, including histidine and the non-melanoma skin cancer marker tyrosine, that were associated with melanoma, pointing to possible biochemical pathways linking environmental greenery and skin cancer risk.
Unexpectedly, analyses suggested that fine particulate matter with a diameter of 2.5 um or less appeared to mediate a reduced skin cancer risk, underscoring the complexity of interacting environmental exposures. Overall, the authors conclude that urban planning and prevention strategies should focus on genetically and phenotypically susceptible populations living near domestic gardens and integrate protective measures into routine clinical counseling.
Reference: Qian J et al. Environmental greenery and skin cancer risk: a prospective cohort study on incidence and mediating mechanisms. Arch Public Health. 2025;doi:10.1186/s13690-025-01775-1.
