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Leachman SA, Latour E, Detweiler-Bedell B, Detweiler-Bedell JB, Zell A, Wenzel E, Stoos E, Nelson JH, Wiedrick J, Berry EG, Lange J, Etzioni R, Lapidus JA. Melanoma literacy among the general population of three western US states. Pigment Cell Melanoma Res 2023; 36:481-500. [PMID: 37574711 DOI: 10.1111/pcmr.13106] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/10/2023] [Accepted: 06/06/2023] [Indexed: 08/15/2023]
Abstract
Melanoma is a significant cause of cancer death, despite being detectable without specialized or invasive technologies. Understanding barriers to preventive behaviors such as skin self-examination (SSE) could help to define interventions for increasing the frequency of early detection. To determine melanoma knowledge and beliefs across three high-incidence US states, 15,000 surveys were sent to a population-representative sample. We aimed to assess (1) melanoma literacy (i.e., knowledge about melanoma risks, attitudes, and preventive behaviors) and (2) self-reported SSE and its association with melanoma literacy, self-efficacy, and belief in the benefits of SSE. Of 2326 respondents, only 21.2% provided responses indicating high knowledge of melanoma, and 62.8% reported performing an SSE at any time in their lives. Only 38.3% and 7.3% reported being "fairly" or "very" confident about doing SSE, respectively. SSE performance among respondents was most strongly associated with higher melanoma knowledge, higher self-efficacy, and personal history of melanoma. Melanoma literacy among survey respondents was modest, with greater literacy associated with a higher likelihood of reported preventive behavior. This assessment establishes a baseline and provides guidance for public health campaigns designed to increase prevention and early detection of this lethal cancer.
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Affiliation(s)
- Sancy A Leachman
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA
- Melanoma & Skin Cancer Program, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Emile Latour
- Biostatistics Shared Resource, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA
| | | | | | - Adrienne Zell
- Oregon Clinical and Translational Research Institute (OCTRI), Oregon Health & Science University, Portland, Oregon, USA
| | - Elizabeth Wenzel
- Oregon Clinical and Translational Research Institute (OCTRI), Oregon Health & Science University, Portland, Oregon, USA
| | - Elizabeth Stoos
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA
- Melanoma & Skin Cancer Program, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Jacob H Nelson
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA
| | - Jack Wiedrick
- Biostatistics and Design Program, Oregon Health & Science University, Portland, Oregon, USA
- Oregon Health & Science University-Portland State University (OHSU-PSU) School of Public Health, Portland, Oregon, USA
| | - Elizabeth G Berry
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA
- Melanoma & Skin Cancer Program, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Jane Lange
- Melanoma & Skin Cancer Program, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA
- Center for Early Detection Advanced Research, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Ruth Etzioni
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Group Health Research Institute, Seattle, Washington, USA
| | - Jodi A Lapidus
- Oregon Clinical and Translational Research Institute (OCTRI), Oregon Health & Science University, Portland, Oregon, USA
- Biostatistics and Design Program, Oregon Health & Science University, Portland, Oregon, USA
- Oregon Health & Science University-Portland State University (OHSU-PSU) School of Public Health, Portland, Oregon, USA
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Ahimbisibwe A, Valberg M, Green AC, Ghiasvand R, Rueegg CS, Rimal R, Weiderpass E, Sandanger TM, Robsahm TE, Veierød MB. Nevus Count, Pigmentary Characteristics, and Melanoma-specific Mortality among Norwegian Women with Melanoma >1.0 mm Thick. Acta Derm Venereol 2023; 103:adv4403. [PMID: 37014267 PMCID: PMC10108620 DOI: 10.2340/actadv.v103.4403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 01/24/2023] [Indexed: 04/05/2023] Open
Abstract
Little is known about if and how nevi and pigmentation are associated with melanoma-specific mortality. However, increased melanoma awareness in people with lighter pigmentation and many nevi may result in earlier diagnosis of thinner less-lethal tumors. The aim of this study was to investigate associations between nevus count (asymmetrical > 5 mm and small symmetrical), pigmentary characteristics (hair colour, eye colour, skin colour, freckling, pigmentary score), and melanoma-specific mortality in subjects with melanomas > 1 mm. Data from the Norwegian Women and Cancer cohort, established in 1991, with complete follow-up of melanoma patients until 2018 through the Cancer Registry of Norway, were used to estimate hazard ratios with 95% confidence intervals for the associations between nevus count, pigmentary characteristics, and melanoma-specific mortality, stratified by tumor thickness using Cox regression. Estimated hazard ratios consistently indicated a higher risk of melanoma death for those with darker vs lighter pigmentary characteristics in patients with tumors > 1.0-2.0 mm and > 2.0 mm thick (e.g. pigmentary score hazard ratio 1.25, 95% confidence interval (0.74-2.13)). Among women with melanomas > 1.0 mm thick, lighter pigmentation and asymmetrical nevi may be associated with lower melanoma-specific mortality, suggesting that factors that increase the risk of melanoma may also be associated with decreased risk of death from melanoma.
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Affiliation(s)
- Ashley Ahimbisibwe
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, University of Oslo, Oslo, Norway.
| | - Morten Valberg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Adele C Green
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Australia; Cancer Research UK Manchester Institute, University of Manchester, Manchester, UK
| | - Reza Ghiasvand
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway; Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Corina S Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Raju Rimal
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, University of Oslo, Oslo, Norway
| | | | - Torkjel M Sandanger
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Trude E Robsahm
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Marit B Veierød
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, University of Oslo, Oslo, Norway
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Abstract
Variants in the Melanocortin 1 Receptor (MC1R) gene have been associated with an increased risk of melanoma, but the role in nevus count is unclear. We investigated if specific MC1R gene variants or the number of MC1R gene variants and phenotypical features were associated with nevus count. A total of 494 participants of the 'Leiden skin cancer study' were included and the MC1R gene coding sequence was analysed by single-strand conformation polymorphism analysis followed by sequencing of unknown variants. The association between MC1R gene variants and nevus count and the association between age, gender and phenotypical features and nevus count were studied using the Chi-square test. Study of nine frequently occurring MC1R gene variants in participants without skin cancer (n = 203) showed that the 'r' Val60Leu variant was significantly associated with high nevus count (>50 nevi) (P = 0.017). This association was very strong among women (P < 0.001), but not present among men. Having one or two MC1R variants in general did not show a significant difference in the nevus count. Hair colour, skin type, eye colour and age were not significantly associated with nevus count, whereas gender showed a significant association (P = 0.008), with the highest nevus counts in female. The Val60Leu variant of the MC1R gene could be a promising candidate as an independent predictor of high nevus count, particularly in women. This information about the genetic makeup could promote personalized follow-up strategies and might help to prevent skin cancer in the future.
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Lee KJ, Janda M, Stark MS, Sturm RA, Soyer HP. On Naevi and Melanomas: Two Sides of the Same Coin? Front Med (Lausanne) 2021; 8:635316. [PMID: 33681261 PMCID: PMC7933521 DOI: 10.3389/fmed.2021.635316] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/01/2021] [Indexed: 12/13/2022] Open
Abstract
Benign naevi are closely linked to melanoma, as risk factors, simulators, or sites of melanoma formation. There is a heavy genetic overlap between the two lesions, a shared environmental influence of ultraviolet radiation, and many similar cellular features, yet naevi remain locally situated while melanomas spread from their primary site and may progress systemically to distal organs. Untangling the overlapping contributors and predictors of naevi and melanoma is an ongoing area of research and should eventually lead to more personalized prevention and treatment strategies, through the development of melanoma risk stratification tools and early detection of evolving melanomas. This will be achieved through a range of complementary strategies: risk-adjusted primary prevention counseling; the use of lesion imaging technologies such as sequential 3D total body photography and consumer-performed lesion imaging; artificial intelligence deep phenotyping and clinical assistance; a better understanding of genetic drivers of malignancy, risk variants, clinical genetics, and polygenic effects; and the interplay between genetics, phenotype and the environment.
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Affiliation(s)
- Katie J Lee
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Monika Janda
- Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia
| | - Mitchell S Stark
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Richard A Sturm
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
| | - H Peter Soyer
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia.,Department of Dermatology, Princess Alexandra Hospital, Brisbane, QLD, Australia
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Duffy D, Lee K, Jagirdar K, Pflugfelder A, Stark M, McMeniman E, Soyer H, Sturm R. High naevus count and
MC
1R
red hair alleles contribute synergistically to increased melanoma risk. Br J Dermatol 2019; 181:1009-1016. [DOI: 10.1111/bjd.17833] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2019] [Indexed: 12/20/2022]
Affiliation(s)
- D.L. Duffy
- Dermatology Research Centre The University of Queensland Diamantina Institute The University of Queensland Brisbane Qld Australia
- QIMR Berghofer Medical Research Institute Brisbane Qld Australia
| | - K.J. Lee
- Dermatology Research Centre The University of Queensland Diamantina Institute The University of Queensland Brisbane Qld Australia
| | - K. Jagirdar
- Dermatology Research Centre The University of Queensland Diamantina Institute The University of Queensland Brisbane Qld Australia
| | - A. Pflugfelder
- Dermatology Research Centre The University of Queensland Diamantina Institute The University of Queensland Brisbane Qld Australia
- Department of Dermatology University Medical Center Tübingen Germany
| | - M.S. Stark
- Dermatology Research Centre The University of Queensland Diamantina Institute The University of Queensland Brisbane Qld Australia
| | - E.K. McMeniman
- Dermatology Research Centre The University of Queensland Diamantina Institute The University of Queensland Brisbane Qld Australia
- Department of Dermatology Princess Alexandra Hospital Brisbane Qld Australia
| | - H.P. Soyer
- Dermatology Research Centre The University of Queensland Diamantina Institute The University of Queensland Brisbane Qld Australia
- Department of Dermatology Princess Alexandra Hospital Brisbane Qld Australia
| | - R.A. Sturm
- Dermatology Research Centre The University of Queensland Diamantina Institute The University of Queensland Brisbane Qld Australia
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Aluma-Tenorio MS, Osorio-Ciro JA, Muñoz-Monsalve AM, Jaimes N, Ávila-Álvarez A, Tamayo-Betancur MC. Evaluación de la exposición solar y las medidas de fotoprotección en deportistas del Valle de Aburrá en el 2018. IATREIA 2019. [DOI: 10.17533/udea.iatreia.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Antecedentes: el cáncer de piel es el más común en humanos y su incidencia continúa en aumento. La radiación ultravioleta (RUV) es el principal factor ambiental asociado con este cáncer. Los deportistas presentan un mayor riesgo para desarrollar cáncer de piel; sin embargo en nuestro país, hasta el momento, no se ha estudiado esta población.Objetivo general: describir las conductas de riesgo del cáncer de piel en deportistas del Valle de Aburrá, a través de una encuesta realizada en los centros más importantes de la región.Materiales y métodos: estudio de corte transversal descriptivo; se evaluaron variables sociodemográficas, clínicas y relacionadas con hábitos de fotoprotección. Según el tipo de variable, se usó media y desviación estándar o conteos absolutos y relativos.Resultados: se incluyeron 122 deportistas, la edad promedio del grupo estudiado fue de 20 años, el 56 % de los incluidos fueron hombres. El 74 % de los deportes se realizaban al aire libre, el fútbol fue el deporte más frecuente. El 75 % de los participantes entrenaba cuatro o más veces por semana y el 55 % lo hacía en horas con muy alta RUV. El 27 % de los deportistas reportó de 1 a 3 insolaciones en la infancia. La fotoprotección química se utilizaba con más frecuencia que la física.Conclusiones: este es el primer estudio realizado en Colombia que evidencia la necesidad de mejorar la educación en prevención primaria y secundaria sobre el cáncer de piel en esta población.
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Drugge RJ, Drugge ED. Temporal Image Comparison (Serial Imaging) in Assessing Pigmented Lesions. Dermatol Clin 2017; 35:447-451. [DOI: 10.1016/j.det.2017.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Watts CG, Madronio CM, Morton RL, Goumas C, Armstrong BK, Curtin A, Menzies SW, Mann GJ, Thompson JF, Cust AE. Diagnosis and clinical management of melanoma patients at higher risk of a new primary melanoma: A population-based study in New South Wales, Australia. Australas J Dermatol 2016; 58:278-285. [DOI: 10.1111/ajd.12530] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 06/04/2016] [Indexed: 12/18/2022]
Affiliation(s)
- Caroline G Watts
- Cancer Epidemiology and Prevention Research; Sydney School of Public Health; University of Sydney; Camperdown New South Wales Australia
| | - Christine M Madronio
- Cancer Epidemiology and Prevention Research; Sydney School of Public Health; University of Sydney; Camperdown New South Wales Australia
| | - Rachael L Morton
- NHMRC Clinical Trials Centre; University of Sydney; Camperdown New South Wales Australia
| | - Chris Goumas
- Melanoma Institute Australia; University of Sydney; Sydney New South Wales Australia
| | - Bruce K Armstrong
- Cancer Epidemiology and Prevention Research; Sydney School of Public Health; University of Sydney; Camperdown New South Wales Australia
| | - Austin Curtin
- School of Public Health; Rural Health Northern Rivers; Lismore New South Wales Australia
| | - Scott W Menzies
- Sydney Melanoma Diagnostic Centre; Royal Prince Alfred Hospital; Sydney New South Wales Australia
- Discipline of Dermatology; University of Sydney; Sydney New South Wales Australia
| | - Graham J Mann
- Melanoma Institute Australia; University of Sydney; Sydney New South Wales Australia
- Centre for Cancer Research; Westmead Institute for Medical Research; University of Sydney; Westmead New South Wales Australia
| | - John F Thompson
- Melanoma Institute Australia; University of Sydney; Sydney New South Wales Australia
| | - Anne E Cust
- Cancer Epidemiology and Prevention Research; Sydney School of Public Health; University of Sydney; Camperdown New South Wales Australia
- Melanoma Institute Australia; University of Sydney; Sydney New South Wales Australia
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