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Johnson-Obaseki SE, Labajian V, Corsten MJ, McDonald JT. Incidence of cutaneous malignant melanoma by socioeconomic status in Canada: 1992-2006. J Otolaryngol Head Neck Surg 2015; 44:53. [PMID: 26631308 PMCID: PMC4668648 DOI: 10.1186/s40463-015-0107-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 11/23/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There are no nationwide studies documenting changes in cutaneous malignant melanoma incidence or association of incidence with socioeconomic status (SES) in Canada. We sought to determine whether melanoma incidence increased from 1992 to 2006 and if there was an association between SES and melanoma incidence. Additionally, we studied whether there was a correlation between province of residence and melanoma incidence. METHODS Cases from the Canadian Cancer Registry were reviewed. Demographic and socioeconomic information were extracted from the Canadian Census of Population data. Cases were linked to income quintiles by postal code. A negative binomial regression was performed to identify relationships among these variables. RESULTS Overall incidence of melanoma in Canada increased by 67 % from 1992 to 2006 (p < 0.0001). The increase in incidence was greater for melanoma in situ compared with invasive melanoma (136 % versus 52 % [p < 0.0001]). Incidence was positively correlated with higher income quintiles; the incidence rates among patients in the lowest income quintiles were 67 % of that for the highest income quintiles (p < 0.0001). DISCUSSION A wide variety of explanations have been postulated for an increased incidence in melanoma among persons of higher SES, including access to and awareness of screening, more access to vacations in sunny climates, and increased leisure time. Variations in incidence of melanoma by urban vs. rural location and province may indicate differences in access to dermatologists across Canada. CONCLUSIONS Melanoma incidence is increasing in Canada and is higher among people in high SES groups. This rise is likely due to a combination of factors including a true rise in incidence due to increases in sun exposure, and also an increased detection rate, particularly in those who are more aware of the disease and have access to resources for detection.
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Affiliation(s)
- Stephanie E Johnson-Obaseki
- Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, S3 - 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.
| | - Varant Labajian
- Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, S3 - 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.
| | - Martin J Corsten
- Department of Otolaryngology - Head and Neck Surgery, Aurora Health Care, Aurora St. Luke's Medical Center, 2801 W. Kinnickinnic River Parkway, Suite 630, Milwaukee, WI, 53215, USA.
| | - James T McDonald
- Department of Economics, University of New Brunswick, PO Box 4400, Fredericton, NB, E3B6C4, Canada.
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Hamilton W, Stapley S, Campbell C, Lyratzopoulos G, Rubin G, Neal RD. For which cancers might patients benefit most from expedited symptomatic diagnosis? Construction of a ranking order by a modified Delphi technique. BMC Cancer 2015; 15:820. [PMID: 26514369 PMCID: PMC4627396 DOI: 10.1186/s12885-015-1865-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 10/27/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND This study aimed to answer the question 'for which cancers, in a symptomatic patient, does expediting the diagnosis provide an improvement in mortality and/or morbidity?' METHODS An initial ranking was constructed from previous work identifying 'avoidable deaths' for 21 common cancers in the UK. In a two-round modified Delphi exercise, 22 experts, all experienced across multiple cancers, used an evidence pack summarising recent relevant publications and their own experience to adjust this ranking. Participants also answered on a Likert scale whether they anticipated mortality or morbidity benefits for each cancer from expedited diagnosis. RESULTS Substantial changes in ranking occurred in the Delphi exercise. Finally, expedited diagnosis was judged to provide the greatest mortality benefit in breast cancer, uterine cancer and melanoma, and least in brain and pancreatic cancers. Three cancers, prostate, brain and pancreas, attracted a median answer of 'disagree' to whether they expected mortality benefits from expedited diagnosis of symptomatic cancer. CONCLUSIONS Our results can guide future research, with emphasis given to studying interventions to improve symptomatic diagnosis of those cancers ranked highly. In contrast, research efforts for cancers with the lowest rankings could be re-directed towards alternative avenues more likely to yield benefit, such as screening or treatment.
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Affiliation(s)
- Willie Hamilton
- University of Exeter, College House, St Luke's Campus, Exeter, EX2 4TE, UK.
| | - Sally Stapley
- University of Exeter, College House, St Luke's Campus, Exeter, EX2 4TE, UK.
| | - Christine Campbell
- Centre for Population Health Sciences, The University of Edinburgh, Medical Quad, Teviot Place, Edinburgh, EH8 9AG, UK.
| | - Georgios Lyratzopoulos
- Cambridge Centre for Health Services Research, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB2 0SR, UK.
| | - Greg Rubin
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - Richard D Neal
- School of Medicine, Pharmacy and Health, University of Durham, Wolfson Research Institute, Queen's Campus, Stockton on Tees, TS17 6BH, UK.
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Gardner KH, Hill DE, Wright AC, Brewer JD, Arpey CJ, Otley CC, Roenigk RK, Baum CL. Upstaging From Melanoma in Situ to Invasive Melanoma on the Head and Neck After Complete Surgical Resection. Dermatol Surg 2015; 41:1122-5. [PMID: 26356849 DOI: 10.1097/dss.0000000000000466] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Melanoma in situ (MIS) diagnosed from a subtotal biopsy may be upstaged to invasive melanoma after resection. The frequency of this phenomenon is markedly variable. OBJECTIVE To quantify the rate of upstaging MIS on the head and neck after resection at this institution, characterize the location of the invasive component relative to the clinically evident lesion, and determine the rate of upstaging with time. MATERIALS AND METHODS The authors retrospectively reviewed clinical records of adult patients with a preoperative diagnosis of MIS on the head and neck from January 1994 to August 2012. Patient and tumor characteristics were recorded. RESULTS In total, 624 patients met the inclusion criteria and 24 (4%) were upstaged after resection. Four patients had invasive disease beyond the clinically evident lesion. The annual percentage of upstaged lesions seemed to show an increasing trend with time. CONCLUSION Upstaging of MIS on the head and neck occurs at a relatively low rate that may be increasing with time. Invasive components of lentigo maligna melanoma may exist beyond the clinically evident margins. Histological examination of the maximal amount of the surgical specimen is paramount for optimal staging and treatment of MIS.
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Affiliation(s)
- Kevin H Gardner
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
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Paris J, Bhat V, Thombs B. Is Adult Attention-Deficit Hyperactivity Disorder Being Overdiagnosed? CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2015; 60:324-8. [PMID: 26175391 PMCID: PMC4500182 DOI: 10.1177/070674371506000705] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 08/01/2014] [Indexed: 01/19/2023]
Abstract
This review offers a perspective on the question as to whether attention-deficit hyperactivity disorder (ADHD) is being overdiagnosed in adults. Considering underlying causes as well as consequences, we conclude that the diagnosis of adult ADHD should be made cautiously, making use of multiple sources of information, including self-report, clinical interviews, collateral information, childhood documentation, and neuropsychological testing. Routine screening with symptom checklists is insufficient, and stimulant response is diagnostically uninformative. The causes of overdiagnosis may include changes in diagnostic thresholds, poor diagnostic practices, and advertising by the pharmaceutical industry. Overdiagnosis leads to overtreatment, and dramatic increases in prescriptions for adult ADHD during the last decade should arouse concern.
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Affiliation(s)
- Joel Paris
- Research Associate, Institute of Community and Family Psychiatry, Sir Mortimer B Davis Jewish General Hospital, Montreal, Quebec; Professor, Department of Psychiatry, McGill University, Montreal, Quebec
| | - Venkat Bhat
- Resident, Department of Psychiatry, McGill University, Montreal, Quebec
| | - Brett Thombs
- Research Associate, Institute of Community and Family Psychiatry, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec; Associate Professor, Department of Psychiatry, McGill University, Montreal, Quebec
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Rutherford MJ, Ironmonger L, Ormiston-Smith N, Abel GA, Greenberg DC, Lyratzopoulos G, Lambert PC. Estimating the potential survival gains by eliminating socioeconomic and sex inequalities in stage at diagnosis of melanoma. Br J Cancer 2015; 112 Suppl 1:S116-23. [PMID: 25734390 PMCID: PMC4385984 DOI: 10.1038/bjc.2015.50] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Although inequalities in cancer survival are thought to reflect inequalities in stage at diagnosis, little evidence exists about the size of potential survival gains from eliminating inequalities in stage at diagnosis. METHODS We used data on patients diagnosed with malignant melanoma in the East of England (2006-2010) to estimate the number of deaths that could be postponed by completely eliminating socioeconomic and sex differences in stage at diagnosis after fitting a flexible parametric excess mortality model. RESULTS Stage was a strong predictor of survival. There were pronounced socioeconomic and sex inequalities in the proportion of patients diagnosed at stages III-IV (12 and 8% for least deprived men and women and 25 and 18% for most deprived men and women, respectively). For an annual cohort of 1025 incident cases in the East of England, eliminating sex and deprivation differences in stage at diagnosis would postpone approximately 24 deaths to beyond 5 years from diagnosis. Using appropriate weighting, the equivalent estimate for England would be around 215 deaths, representing 11% of all deaths observed within 5 years from diagnosis in this population. CONCLUSIONS Reducing socioeconomic and sex inequalities in stage at diagnosis would result in substantial reductions in deaths within 5 years of a melanoma diagnosis.
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Affiliation(s)
- M J Rutherford
- Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK
| | - L Ironmonger
- Statistical Information Team, Cancer Research UK, Angel Building, 407 St John Street, London EC1V 4AD, UK
| | - N Ormiston-Smith
- Statistical Information Team, Cancer Research UK, Angel Building, 407 St John Street, London EC1V 4AD, UK
| | - G A Abel
- Cambridge Centre for Health Services Research, Institute of Public Health, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - D C Greenberg
- Cambridge Centre for Health Services Research, Institute of Public Health, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- National Cancer Registration Service, Public Health England, Eastern Office, Cambridge CB22 3AD, UK
| | - G Lyratzopoulos
- Cambridge Centre for Health Services Research, Institute of Public Health, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Health Behaviour Research Centre, Department of Epedimiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
| | - P C Lambert
- Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm SE-171 77, Sweden
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Bay C, Kejs AMT, Storm HH, Engholm G. Incidence and survival in patients with cutaneous melanoma by morphology, anatomical site and TNM stage: a Danish Population-based Register Study 1989-2011. Cancer Epidemiol 2014; 39:1-7. [PMID: 25468643 DOI: 10.1016/j.canep.2014.10.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 08/28/2014] [Accepted: 10/07/2014] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The incidence of melanoma of the skin has risen in Denmark in recent decades, the increase being steeper from 2004. It is unclear whether this represents a true rise in incidence or whether it is caused by an increased awareness of the condition. METHODS To assess whether the increase was characterised by early-stage melanomas and a higher proportion of melanomas with superficial spreading morphology, we studied all skin melanoma patients registered in the Danish Cancer Register 1989-2011 (n=27,010) and followed up for death through 2013. Trends in age-standardised incidence by sex, subsite and morphology, relative survival, TNM stage distribution and stage-specific relative survival from 2004 were analysed. RESULTS The incidence of melanoma more than doubled over 23 years. A steeper increase from 2004 was driven mainly by superficial spreading tumours, but the proportion of nodular melanomas in patients 50 years of age and over also increased significantly. The largest increase occurred for stage I tumours and for tumours on the trunk. From 1989-1993 to 2009-2011 the 5-year relative survival increased at 12% and 6% points for male and female patients, respectively. INTERPRETATION Greater awareness, and thus lower stage at diagnosis (mediated by a large skin cancer prevention campaign from 2007), might explain part of the increase, but the increase in nodular melanoma also points to a genuine increase in the risk of melanoma.
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Affiliation(s)
- Christiane Bay
- The Danish Cancer Society, Department of Cancer Prevention & Documentation, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | | | - Hans H Storm
- The Danish Cancer Society, Department of Cancer Prevention & Documentation, Denmark.
| | - Gerda Engholm
- The Danish Cancer Society, Department of Cancer Prevention & Documentation, Denmark.
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Akhbari P, Whitehouse A, Boyne JR. Long non-coding RNAs drive metastatic progression in melanoma (Review). Int J Oncol 2014; 45:2181-6. [PMID: 25269471 DOI: 10.3892/ijo.2014.2691] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 08/21/2014] [Indexed: 11/06/2022] Open
Abstract
Metastatic melanoma is the leading cause of skin-cancer related deaths and while in recent years some progress has been made with targeted therapies, there remains an urgent unmet need for novel therapeutic treatments and reliable diagnostic, prognostic and predictive biomarkers. The emergence of next generation sequencing (NGS) has seen a growing appreciation for the role played by non-coding genomic transcripts in regulating gene expression and by extension impacting on disease progression. The long non-coding RNAs (lncRNAs) represent the most enigmatic of these new regulatory molecules. Our understanding of how lncRNAs regulate biological functions and their importance to disease aetiology, while still limited, is rapidly improving, in particular with regards to their role in cancer. Herein we review the identification of several lncRNAs shown to impact on melanoma disease progression and discuss how these molecules are operating at the molecular level.
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Affiliation(s)
- Pouria Akhbari
- Centre for Skin Sciences, University of Bradford, Bradford, UK
| | - Adrian Whitehouse
- School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds, UK
| | - James R Boyne
- Centre for Skin Sciences, University of Bradford, Bradford, UK
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Stefansson H, Tryggvadottir L, Olafsdottir E, Mooney E, Olafsson J, Sigurgeirsson B, Jonasson J. Cutaneous melanoma in
I
celand: changing
B
reslow's tumour thickness. J Eur Acad Dermatol Venereol 2014; 29:346-352. [DOI: 10.1111/jdv.12552] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 04/14/2014] [Indexed: 11/29/2022]
Affiliation(s)
- H. Stefansson
- Faculty of Medicine University of Iceland Reykjavik Iceland
- Department of Medicine Landspitali – The National University Hospital of Iceland Reykjavik Iceland
- The Icelandic Cancer Registry Reykjavik Iceland
| | - L. Tryggvadottir
- Faculty of Medicine University of Iceland Reykjavik Iceland
- The Icelandic Cancer Registry Reykjavik Iceland
| | | | - E. Mooney
- Dermatology Laekning Reykjavik Iceland
| | - J.H. Olafsson
- Dermatology Hudlaeknastodin Reykjavik Iceland
- Faculty of Medicine Section of Dermatology University of Iceland Reykjavik Iceland
| | - B. Sigurgeirsson
- Dermatology Hudlaeknastodin Reykjavik Iceland
- Faculty of Medicine Section of Dermatology University of Iceland Reykjavik Iceland
| | - J.G. Jonasson
- Faculty of Medicine University of Iceland Reykjavik Iceland
- The Icelandic Cancer Registry Reykjavik Iceland
- Department of Pathology Landspitali – The National University Hospital of Iceland Reykjavik Iceland
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Weyers W. Confusion-specimen mix-up in dermatopathology and measures to prevent and detect it. Dermatol Pract Concept 2014; 4:27-42. [PMID: 24520511 PMCID: PMC3919837 DOI: 10.5826/dpc.0401a04] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 10/14/2013] [Indexed: 11/23/2022] Open
Abstract
Maintaining patient identity throughout the biopsy pathway is critical for the practice of dermatology and dermatopathology. From the biopsy procedure to the acquisition of the pathology report, a specimen may pass through the hands of more than twenty individuals in several workplaces. The risk of a mix-up is considerable and may account for more serious mistakes than diagnostic errors. To prevent specimen mix-up, work processes should be standardized and automated wherever possible, e.g., by strict order in the operating room and in the laboratory and by adoption of a bar code system to identify specimens and corresponding request forms. Mutual control of clinicians, technicians, histopathologists, and secretaries, both simultaneously and downstream, is essential to detect errors. The most vulnerable steps of the biopsy pathway, namely, labeling of specimens and request forms and accessioning of biopsy specimens in the laboratory, should be carried out by two persons simultaneously. In preceding work steps, clues must be provided that allow a mix-up to be detected later on, such as information about clinical diagnosis, biopsy technique, and biopsy site by the clinician, and a sketch of the specimen by the technician grossing it. Awareness of the danger of specimen mix-up is essential for preventing and detecting it. The awareness can be heightened by documentation of any error in the biopsy pathway. In case of suspicion, a mix-up of specimens from different patients can be confirmed by DNA analysis.
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Abstract
The incidence, mortality, and survival rates of melanoma vary significantly across Europe, likely related to persistent inequalities between European countries in the areas of skin cancer early detection, case registration, and prevention. To enhance the planning of prevention strategies for skin cancer in Europe, we solicited the direct opinion of European experts in the field of dermato-oncology on the main obstacles, needs, and priorities for the reduction of the skin cancer burden on this continent. We surveyed European dermatologists with leading positions in European and international organizations active in skin cancer prevention by means of written, single-choice and multiple-choice questionnaires. Fifty-two dermatologists from 32 European countries completed the survey (response rate 80%). Fewer respondents in Eastern Europe compared with Western Europe reported the presence of governmental (12 vs. 46%) or nongovernmental (35 vs. 65%) initiatives for skin cancer prevention. Most respondents in Eastern (73%) and Western Europe (69%) reported the existence of national cancer registries, but the confidence in the accuracy of melanoma registration was low. Public and professional education for early detection were top priorities for skin cancer campaigns across Europe and the perceived obstacles were similar in both regions: the lack of a national program of public education, insufficient public authority initiatives, and insufficient training of physicians on skin cancer. Our survey highlighted several areas requiring intervention for skin cancer prevention and found that the main issues and obstacles appear to be similar across Europe, creating the premise for coordinated, pan-European action.
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Bangash HK, Romegialli A, Dadras SS. What's new in prognostication of melanoma in the dermatopathology laboratory? Clin Dermatol 2013; 31:317-23. [PMID: 23608451 DOI: 10.1016/j.clindermatol.2012.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
With the advent of genetic and epigenetic research, molecular techniques could someday be used to discriminate nevus from melanoma so that ambiguous melanocytic lesions could be more accurately classified or that prognostication could be improved in melanoma patients. That promised day might be closer than realized. The last 20 years of research in cytogenetic and genetic alterations in melanoma have culminated in defined chromosomal lesions discriminating benign from malignant melanocytic tumors. Exploiting these differences, fluorescence in situ hybridization (FISH) can reproducibly discriminate unequivocal melanomas from melanocytic nevi with high sensitivity and specificity. The discriminating power of FISH in melanocytic tumors with ambiguous histopathology is questionable, however, because there is no standard definition of "malignancy." Additional FISH studies on ambiguous cases are needed through international collaborations where large collections of such cases are shared and the "proof of malignancy" is established by adequate clinical follow-up. This contribution reviews the diagnostic utility of DNA-based FISH technology as it compares the diagnostic accuracy in melanocytic tumors with unambiguous vs ambiguous histopathology. The melanoma epigenome is further characterized through research into various activities of small interfering RNAs, such as microRNAs, providing the pathway for the application of microRNA-based strategies that could be the basis for future diagnostic biomarkers and molecular therapies in melanoma.
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Affiliation(s)
- Haider K Bangash
- Department of Internal Medicine, University of Connecticut Health Center, Farmington, CT 06032, USA
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Cribados: una propuesta de racionalización. GACETA SANITARIA 2013; 27:372-3. [DOI: 10.1016/j.gaceta.2013.03.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Revised: 02/26/2013] [Accepted: 03/19/2013] [Indexed: 11/18/2022]
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Malignant melanoma: epidemiologic aspects, diagnostic and therapeutic approach. Wien Med Wochenschr 2013; 163:354-8. [PMID: 23715934 DOI: 10.1007/s10354-013-0207-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 04/23/2013] [Indexed: 10/26/2022]
Abstract
In faired skinned population the incidence of melanoma is rapidly increasing. Beside environmental factors (UV-exposure) certainly other reasons for the observed "melanoma epidemic" have to be discussed. For diagnostic procedure classical histopathology is accompanied by immunohistochemistry and more recently molecular techniques. For therapy new modalities are available which-after many years of frustrating search for new drugs-are now able to prolong both disease/progression free and overall survival.
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Wong JR, Harris JK, Rodriguez-Galindo C, Johnson KJ. Incidence of childhood and adolescent melanoma in the United States: 1973-2009. Pediatrics 2013; 131:846-54. [PMID: 23589817 PMCID: PMC3639457 DOI: 10.1542/peds.2012-2520] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Childhood and adolescent melanoma is rare but has been increasing. To gain insight into possible reasons underlying this observation, we analyzed trends in melanoma incidence diagnosed between the ages of 0 and 19 years among US whites by gender, stage, age at diagnosis, and primary site. We also investigated incidence trends by UV-B exposure levels. METHODS By using Surveillance, Epidemiology, and End Results (SEER) program data (1973-2009), we calculated age-adjusted incidence rates (IRs), annual percent changes, and 95% confidence intervals for each category of interest. Incidence trends were also evaluated by using joinpoint and local regression models. SEER registries were categorized with respect to low or high UV-B radiation exposure. RESULTS From 1973 through 2009, 1230 children of white race were diagnosed with malignant melanoma. Overall, pediatric melanoma increased by an average of 2% per year (95% confidence interval, 1.4%-2.7%). Girls, 15- to 19-year-olds, and individuals with low UV-B exposure had significantly higher IRs than boys, younger children, and those living in SEER registries categorized as high UV-B. Over the study period, boys experienced increased IRs for melanoma on the face and trunk, and females on the lower limbs and hip. The only decreased incidence trend we observed was among 15- to 19-year-olds in the high UV-B exposure group from 1985 through 2009. Local regression curves indicated similar patterns. CONCLUSIONS These results may help elucidate possible risk factors for adolescent melanoma, but additional individual-level studies will be necessary to determine the reasons for increasing incidence trends.
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Affiliation(s)
- Jeannette R. Wong
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | | | | | - Kimberly J. Johnson
- Brown School and,Department of Pediatrics, School of Medicine, Washington University, St Louis, Missouri; and
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Flohil SC, Seubring I, van Rossum MM, Coebergh JWW, de Vries E, Nijsten T. Trends in Basal Cell Carcinoma Incidence Rates: A 37-Year Dutch Observational Study. J Invest Dermatol 2013. [DOI: 10.1038/jid.2012.431] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Carcoforo P, Raiji MT, Palini GM, Pedriali M, Maestroni U, Soliani G, Detroia A, Zanzi MV, Manna AL, Crompton JG, Langan RC, Stojadinovic A, Avital I. Primary anorectal melanoma: an update. J Cancer 2012. [PMID: 23193431 PMCID: PMC3508425 DOI: 10.7150/jca.5187] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The anorectum is a rare anatomic location for primary melanoma. Mucosal melanoma is a distinct biological and clinical entity from the more common cutaneous melanoma. It portrays worse prognosis than cutaneous melanoma, with distant metastases being the overwhelming cause of morbidity and mortality. Surgery is the treatment of choice, but significant controversy exists over the extent of surgical resection. We present an update on the state of the art of anorectal mucosal melanoma. To illustrate the multimodality approach to anorectal melanoma, we present a typical patient.
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Affiliation(s)
- P Carcoforo
- 1. Section of General Surgery, Department of Surgical, Anaesthesiological and Radiological Sciences, University of Ferrara, Ferrara, Italy
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Vollmer RT. The dynamics of death in melanoma. J Cutan Pathol 2012; 39:1075-82. [DOI: 10.1111/cup.12031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Revised: 02/29/2012] [Accepted: 03/19/2012] [Indexed: 11/28/2022]
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Protein and non-protein biomarkers in melanoma: a critical update. Amino Acids 2012; 43:2203-30. [DOI: 10.1007/s00726-012-1409-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Accepted: 09/24/2012] [Indexed: 12/16/2022]
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70
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Grant WB. Disparities in melanoma incidence rates in Europe. Br J Dermatol 2012; 168:884-5. [PMID: 23013482 DOI: 10.1111/bjd.12054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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