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Trepanowski N, Hathaway CA, Chang MS, Hay JL, Samatham R, Geller AC, Swetter SM, Tworoger SS, Kanetsky PA, Leachman SA, Hartman RI. Influence of the COVID-19 pandemic on sun habits of patients with melanoma: a cross-sectional study. Arch Dermatol Res 2024; 316:221. [PMID: 38787523 DOI: 10.1007/s00403-024-02952-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/04/2023] [Accepted: 04/26/2024] [Indexed: 05/25/2024]
Affiliation(s)
- Nicole Trepanowski
- Boston University School of Medicine, Boston, MA, USA
- Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Avenue, Boston, MA, USA
| | - Cassandra A Hathaway
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Michael S Chang
- Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Avenue, Boston, MA, USA
| | - Jennifer L Hay
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ravi Samatham
- Department of Dermatology at Oregon Health & Science University, Portland, OR, USA
| | - Alan C Geller
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Susan M Swetter
- Department of Dermatology/Pigmented Lesion and Melanoma Program, Stanford University Medical Center and Cancer Institute, Palo Alto, CA, USA
- Dermatology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Shelley S Tworoger
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Peter A Kanetsky
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Sancy A Leachman
- Department of Dermatology at Oregon Health & Science University, Portland, OR, USA
- Knight Cancer Institute at Oregon Health & Science University, Portland, OR, USA
| | - Rebecca I Hartman
- Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Avenue, Boston, MA, USA.
- Department of Dermatology, VA Integrated Service Network (VISN-1), Jamaica Plain, Boston, MA, USA.
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2
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Manne S, Heckman CJ, Frederick S, Schaefer AA, Studts CR, Khavjou O, Honeycutt A, Berger A, Liu H. A Digital Intervention to Improve Skin Self-Examination Among Survivors of Melanoma: Protocol for a Type-1 Hybrid Effectiveness-Implementation Randomized Trial. JMIR Res Protoc 2024; 13:e52689. [PMID: 38345836 PMCID: PMC10897801 DOI: 10.2196/52689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/26/2023] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND Although melanoma survival rates have improved in recent years, survivors remain at risk of recurrence, second primary cancers, and keratinocyte carcinomas. The National Comprehensive Cancer Network recommends skin examinations by a physician every 3 to 12 months. Regular thorough skin self-examinations (SSEs) are recommended for survivors of melanoma to promote the detection of earlier-stage, thinner melanomas, which are associated with improved survival and lower treatment costs. Despite their importance, less than a quarter of survivors of melanoma engage in SSEs. OBJECTIVE Previously, our team developed and evaluated a web-based, fully automated intervention called mySmartSkin (MSS) that successfully improved SSE among survivors of melanoma. Enhancements were proposed to improve engagement with and outcomes of MSS. The purpose of this paper is to describe the rationale and methodology for a type-1 hybrid effectiveness-implementation randomized trial evaluating the enhanced MSS versus control and exploring implementation outcomes and contextual factors. METHODS This study will recruit from state cancer registries and social media 300 individuals diagnosed with cutaneous malignant melanoma between 3 months and 5 years after surgery who are currently cancer free. Participants will be randomly assigned to either enhanced MSS or a noninteractive educational web page. Surveys will be collected from both arms at baseline and at 3, 6, 12, and 18 months to assess measures of intervention engagement, barriers, self-efficacy, habit, and SSE. The primary outcome is thorough SSE. The secondary outcomes are the diagnosis of new or recurrent melanomas and sun protection practices. RESULTS Multilevel modeling will be used to examine whether there are significant differences in survivor outcomes between MSS and the noninteractive web page over time. Mixed methods will evaluate reach, adoption, implementation (including costs), and potential for maintenance of MSS, as well as contextual factors relevant to those outcomes and future scale-up. CONCLUSIONS This trial has the potential to improve outcomes in survivors of melanoma. If MSS is effective, the results could guide its implementation in oncology care and nonprofit organizations focused on skin cancers. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/52689.
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Affiliation(s)
- Sharon Manne
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | - Carolyn J Heckman
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | - Sara Frederick
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | - Alexis A Schaefer
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | - Christina R Studts
- University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Olga Khavjou
- RTI International, Research Triangle Park, NC, United States
| | | | - Adam Berger
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | - Hao Liu
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
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3
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Domínguez Bueso DL, González Ruiz LM, Mondragón Márquez LI, Liu JJ. Skin cancer survivorship and sun protection behaviors in the United States. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2024; 40:e12933. [PMID: 38288776 DOI: 10.1111/phpp.12933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 11/08/2023] [Accepted: 11/12/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Skin cancer survivors are more vulnerable to subsequent skin cancers and other malignancies, but previous studies have not examined in detail their sun protection behavior prevalence by sociodemographic factors. We aimed to understand the sociodemographic disparities in the prevalence of three important types of sun protection behaviors: using sunscreen, seeking shade, and wearing protective clothing, among skin cancer survivors and those without skin cancer history. METHODS We used the 2015 U.S. National Health Interview Survey to analyze 29,523 participants, of which 772 were skin cancer survivors and 28,751 were those without skin cancer history. We assessed overall and specific sun protection behavior prevalence based on using sunscreen, seeking shade, and wearing protective clothing. Weighted Poisson regression was used to estimate prevalence ratios. RESULTS Melanoma and nonmelanoma skin cancer survivors had similar overall sun protection behavior (p > .05). Among all skin cancer survivors, 36.0% infrequently used sunscreen, 50.2% infrequently wore protective clothing, 47.8% infrequently sought shade, and 30.0% lacked frequent overall sun protection, which significantly differed from those without skin cancer history (p < .0001). The prevalence of frequent overall sun protection behavior was lower for those who were younger at survey, males, less educated, single or never married, or lived in poverty, regardless of their skin cancer history (p < .01). CONCLUSIONS By identifying subpopulations with higher prevalence of infrequent sun protection among those with or without skin cancer history, our findings may encourage efforts to reduce sociodemographic disparities in sun protection behaviors and promote primary and tertiary skin cancer prevention.
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Affiliation(s)
| | - Liza M González Ruiz
- International Health Program, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | | | - Jason J Liu
- International Health Program, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
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4
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Challapalli SD, Shetty KR, Bui Q, Osazuwa-Peters N, Adjei Boakye E. Sun protective behaviors among adolescents and young adults in the United States. J Natl Med Assoc 2023; 115:353-361. [PMID: 37142483 DOI: 10.1016/j.jnma.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/05/2023] [Accepted: 04/11/2023] [Indexed: 05/06/2023]
Abstract
PURPOSE We described sun protective behaviors in adolescents and young adults (AYA) compared to older adults. METHODS We used data from the 2013-2018 National Health and Nutrition Examination Survey, a nationally representative samples of the civilian, noninstitutionalized US population (10,710 respondents aged between 20 and 59 and without a history of skin cancer diagnoses). The primary exposure for the study was age group: aged 20-39 defined as AYA and aged 40-59 as adults. The outcome variable was sun protective behaviors: stay in the shade, wear a long-sleeved shirt, use sunscreen, at least one of the three; and all three measures. Multivariable logistic regression models were used to assess association between age group and sun protective behaviors adjusting for sociodemographic factors. RESULTS Overall, 51.3% of respondents were AYA, 76.1% reported staying in the shade, 50.9% using sunscreen, 33.3% wearing long-sleeved clothes, 88.1% engaging in one of the three behaviors, and 17.1% engaging in all three behaviors. In the adjusted models, the odds of engaging in all three behaviors among AYAs was 28% (aOR: 0.72, 95% CI: 0.62-0.83) lower than adult respondents. Compared to adults, AYAs were 22% less likely to wear long sleeved clothes (aOR: 0.78, 95% CI: 0.70-0.87). There were no significant differences in the odds of engaging in at least one sun protective behavior, using sunscreen, and staying in the shade between AYAs and adults. CONCLUSIONS More targeted interventions need to be implemented to decrease the risk of skin cancer in the AYA population.
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Affiliation(s)
- Sai D Challapalli
- Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School, Houston, Texas, USA
| | - Kunal R Shetty
- Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School, Houston, Texas, USA
| | - Quoc Bui
- Division of Biostatistics, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Nosayaba Osazuwa-Peters
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina, USA; Duke Cancer Institute, Duke University, Durham, North Carolina, USA
| | - Eric Adjei Boakye
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan, USA; Department of Otolaryngology - Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, USA.
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5
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Vogel RI, Luo X, Brown K, Jewett P, Dona AC, Nagler RH, Ahmed RL, Martinson BC, Lazovich D. A UVR-sensor wearable device intervention to reduce sun exposure in melanoma survivors: Results from a randomized controlled trial. PLoS One 2023; 18:e0281480. [PMID: 36763627 PMCID: PMC9916644 DOI: 10.1371/journal.pone.0281480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 12/12/2022] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Melanoma survivors are at increased risk of developing a second primary melanoma; however, some report sub-optimal sun behaviors and sunburns. We tested the effectiveness of a wearable device with ultraviolet radiation (UVR)-sensing technology to improve sun behaviors and reduce sunburns in cutaneous melanoma survivors. MATERIALS AND METHODS We conducted a randomized controlled trial using Shade 2, a commercially available wrist device that measures UVR. The intervention group received the device and mobile application notifications about their exposure and prompts to use sunscreen. The control group received the device and a separate research mobile application without information about their exposure or notifications. Participants wore the device for 12 weeks and self-reported sun behaviors before, during, and after the intervention. The primary outcome was a composite score of sun protection behaviors at week 12. RESULTS 386 participants were randomized (186 control, 182 intervention). Most were female and 5+ years past their first melanoma diagnosis. The average age was 56 years. Most (93%) completed the study, though 40% experienced device issues. No meaningful differences were observed in self-reported sun protection behaviors at week 12 (controls 3.0±0.5 vs. intervention 2.9±0.5, p = 0.06), any sunburn during the intervention period (controls 14.4% vs. intervention 12.7%, p = 0.75), or average daily objective UVR exposure (controls median 87 vs. intervention 83 J/m2, p = 0.43). CONCLUSION Wearing a device that measured and alerted melanoma survivors to UVR exposure did not result in different sun behaviors, exposure, or sunburns relative to controls. The technology needs refinement before further attempts to assess the effectiveness of self-monitoring UVR exposure. CLINICAL TRIALS REGISTRATION NCT03927742.
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Affiliation(s)
- Rachel Isaksson Vogel
- Department of Obstetrics, Gynecology and Women’s Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, Minnesota, United States of America
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
- * E-mail:
| | - Xianghua Luo
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Katherine Brown
- Department of Obstetrics, Gynecology and Women’s Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Patricia Jewett
- Department of Obstetrics, Gynecology and Women’s Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, Minnesota, United States of America
- Department of Medicine, Division of Hematology and Oncology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Allison C. Dona
- Medical School, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Rebekah H. Nagler
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
- Hubbard School of Journalism & Mass Communication, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Rehana L. Ahmed
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Brian C. Martinson
- HealthPartners Institute, Bloomington, Minnesota, United States of America
- Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health System, Minneapolis, Minnesota, United States of America
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - DeAnn Lazovich
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
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Mueller AM, Goessinger EV, Cerminara SE, Kostner L, Amaral M, Huber SM, Passweg LP, Moreno LG, Bodenmann D, Kunz M, Levesque MP, Maul JT, Cheng PF, Navarini AA, Maul LV. Educational level-dependent melanoma awareness in a high-risk population in Switzerland. Front Oncol 2023; 13:1174542. [PMID: 37207151 PMCID: PMC10189064 DOI: 10.3389/fonc.2023.1174542] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 04/13/2023] [Indexed: 05/21/2023] Open
Abstract
Introduction The worldwide incidence of melanoma has been increasing rapidly in recent decades with Switzerland having one of the highest rates in Europe. Ultraviolet (UV) radiation is one of the main risk factors for skin cancer. Our objective was to investigate UV protective behavior and melanoma awareness in a high-risk cohort for melanoma. Methods In this prospective monocentric study, we assessed general melanoma awareness and UV protection habits in at-risk patients (≥100 nevi, ≥5 dysplastic nevi, known CDKN2A mutation, and/or positive family history) and melanoma patients using questionnaires. Results Between 01/2021 and 03/ 2022, a total of 269 patients (53.5% at-risk patients, 46.5% melanoma patients) were included. We observed a significant trend toward using a higher sun protection factor (SPF) in melanoma patients compared with at-risk patients (SPF 50+: 48% [n=60] vs. 26% [n=37]; p=0.0016). Those with a college or university degree used a high SPF significantly more often than patients with lower education levels (p=0.0007). However, higher educational levels correlated with increased annual sun exposure (p=0.041). Neither a positive family history for melanoma, nor gender or Fitzpatrick skin type influenced sun protection behavior. An age of ≥ 50 years presented as a significant risk factor for melanoma development with an odd's ratio of 2.32. Study participation resulted in improved sun protection behavior with 51% reporting more frequent sunscreen use after study inclusion. Discussion UV protection remains a critical factor in melanoma prevention. We suggest that melanoma awareness should continue to be raised through public skin cancer prevention campaigns with a particular focus on individuals with low levels of education.
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Affiliation(s)
- Alina Miriam Mueller
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Elisabeth Victoria Goessinger
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Sara Elisa Cerminara
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Lisa Kostner
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Margarida Amaral
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | | | | | | | | | - Michael Kunz
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | - Mitchell Paul Levesque
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Julia-Tatjana Maul
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Phil Fang Cheng
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - Alexander Andreas Navarini
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Lara Valeska Maul
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
- *Correspondence: Lara Valeska Maul,
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Rojas KD, Perez ME, Marchetti MA, Nichols AJ, Penedo FJ, Jaimes N. Skin Cancer: Primary, Secondary, and Tertiary Prevention. Part II. J Am Acad Dermatol 2022; 87:271-288. [DOI: 10.1016/j.jaad.2022.01.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/12/2022] [Accepted: 01/26/2022] [Indexed: 10/19/2022]
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8
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Manne SL, Heckman CJ, Kashy DA, Ritterband LM, Thorndike FP, Lozada C, Coups EJ. Randomized controlled trial of the mySmartSkin web-based intervention to promote skin self-examination and sun protection among individuals diagnosed with melanoma. Transl Behav Med 2021; 11:1461-1472. [PMID: 33904921 DOI: 10.1093/tbm/ibaa103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Adherence to regular, thorough skin self-examination (SSE) and consistent sun protection behaviors among melanoma survivors is relatively low. This study reports on the impact of an online intervention, called mySmartSkin (MSS), on engagement in SSE and sun protection behaviors among melanoma survivors, as well as the mediators of the intervention effects. The intervention was compared with usual care (UC), and primary outcomes were assessed at 24 and 48 weeks. Short-term outcomes were also evaluated at 8 weeks postbaseline. Results demonstrate a significant effect on SSE and sun protection. At all three follow-up assessments, the proportion of participants reporting conducting a thorough SSE in the time since the previous assessment was significantly greater in MSS than in UC. In addition, both multivariate and univariate analyses indicated that engagement in sun protection behaviors was significantly higher in MSS than UC at 24 weeks, but the effect on sun protection at 48 weeks was significant only in multivariate analyses. Beneficial effects of MSS were significantly mediated by knowledge about melanoma and characteristics of suspicious lesions, as well as self-efficacy. Participant engagement in MSS was satisfactory, with approximately two-thirds of participants completing at least two of the three core components. Content was rated as highly trusted, easy to understand, easy to navigate, and helpful. In conclusion, MSS illustrated significant and durable effects on SSE and mixed results on sun protection. Future studies should consider ways to further enhance treatment effects and engagement in MSS.
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Affiliation(s)
- Sharon L Manne
- Department of Medicine, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Carolyn J Heckman
- Department of Medicine, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Deborah A Kashy
- Michigan State University, Department of Psychology, East Lansing, MI, USA
| | - Lee M Ritterband
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Center for Behavioral Health & Technology, Charlottesville, VA, USA
| | - Frances P Thorndike
- Department of Psychiatry and Neurobehavioral Sciences, Pear Therapeutics, Boston, MA, USA
| | - Carolina Lozada
- Department of Medicine, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
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Heckman CJ, Manne SL, Kashy DA, Bhurosy T, Ritterband L, Coups EJ. Correlates of sun protection behaviors among melanoma survivors. BMC Public Health 2021; 21:882. [PMID: 33962615 PMCID: PMC8105954 DOI: 10.1186/s12889-021-10951-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 04/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The study objective was to assess potential correlates of sun protection behaviors among melanoma survivors. METHODS Participants were 441 melanoma survivors recruited from three health centers and a state cancer registry in the United States. Sun protection behaviors (sunscreen, shade, protective shirts, and hats) were assessed through an online survey, as were potential correlates (demographic, melanoma risk, knowledge and beliefs, psychological and social influence factors). Hierarchical multiple regression analyses were conducted. RESULTS Correlates of sun protection behaviors included education, skin cancer risk factors, melanoma knowledge and beliefs, melanoma worry and distress, physician recommendation for sun protection, injunctive norms, and pro-protection beliefs (e.g., perceived barriers, self-efficacy). CONCLUSIONS Future efforts to improve sun safety among melanoma survivors may benefit from targeting individuals with lower education levels, and addressing sun protection social influence, barriers, and self-efficacy.
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Affiliation(s)
- Carolyn J Heckman
- Rutgers, The State University of New Jersey, 195 Little Albany St., New Brunswick, NJ, 08901, USA.
| | - Sharon L Manne
- Rutgers, The State University of New Jersey, 195 Little Albany St., New Brunswick, NJ, 08901, USA
| | | | - Trishnee Bhurosy
- Rutgers, The State University of New Jersey, 195 Little Albany St., New Brunswick, NJ, 08901, USA
| | | | - Elliot J Coups
- Rutgers, The State University of New Jersey, 195 Little Albany St., New Brunswick, NJ, 08901, USA
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10
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Looking for Sunshine: Genetic Predisposition to Sun Seeking in 265,000 Individuals of European Ancestry. J Invest Dermatol 2021; 141:779-786. [DOI: 10.1016/j.jid.2020.08.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 07/04/2020] [Accepted: 08/05/2020] [Indexed: 11/23/2022]
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11
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Sun Protective Clothing and Sun Avoidance: The Most Critical Components of Photoprotection in Patients With Melanoma. Dermatol Surg 2021; 47:333-337. [PMID: 32991331 DOI: 10.1097/dss.0000000000002794] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Ultraviolet radiation is the main modifiable risk factor for melanoma which can be reduced by avoiding excess sun exposure. OBJECTIVE We sought to explore (1) sun protective practices, (2) effectiveness of these sun protective practices, and (3) vitamin D supplementation in patients with melanoma. METHODS Using the National Health Interview Survey, the authors conducted a cross-sectional analysis to investigate sun protective behaviors and sunburns among adults with melanoma compared with those without skin cancer. We calculated adjusted odds ratio (aOR), 95% confidence interval (95% CI), and p-values using logistic regression. RESULTS Patients with melanoma reported increased use of sun avoidance, shade, sunscreen, long sleeves, and hats, but had similar sunburn rates compared with those without skin cancer. Only sun avoidance and long sleeves were associated with decreased odds of sunburn. Patients with melanoma also reported decreased vitamin D supplementation. CONCLUSION Although it is reassuring that patients with melanoma practice sun protective behaviors, this does not always translate into reduced sunburns. Physicians should emphasize the importance of photoprotection, especially sun avoidance and sun protective clothing, to reduce future melanoma risk.
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12
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Sun X, Zhang N, Yin C, Zhu B, Li X. Ultraviolet Radiation and Melanomagenesis: From Mechanism to Immunotherapy. Front Oncol 2020; 10:951. [PMID: 32714859 PMCID: PMC7343965 DOI: 10.3389/fonc.2020.00951] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 05/14/2020] [Indexed: 12/13/2022] Open
Abstract
Melanoma is the deadliest form of skin cancer, and nearly 90% of melanomas are believed to be caused by ultraviolet radiation (UVR), mainly from sunlight. UVR induces DNA damage, forming products such as cyclobutane pyrimidine dimers (CPD) and 6-4-pyrimidone photoproducts (6-4PP) in a wavelength-dependent manner and causes oxidative DNA damage. These DNA lesions lead to DNA mutations and contribute to the formation of melanoma. In this review, we discuss the protective role of melanocytes against UV-induced DNA damage and how genetic variations, including those in p53 and melanocortin-1 receptor (MC1R), or epigenetic histone modifications in melanocytes result in a tendency toward melanoma. We also provide a summary of prevention and treatment strategies against melanoma, including the most recent immunotherapies. Collectively, this work contributes to the understanding of the molecular pathogenesis of UV-induced melanoma.
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Affiliation(s)
- Xiaoying Sun
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Na Zhang
- Department of Cardiology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chengqian Yin
- Department of Dermatology, Cutaneous Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Bo Zhu
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Xin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
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13
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von Schuckmann LA, Wilson LF, Hughes MCB, Beesley VL, Janda M, van der Pols JC, Smithers BM, Khosrotehrani K, Green AC. Sun protection behavior after diagnosis of high-risk primary melanoma and risk of a subsequent primary. J Am Acad Dermatol 2019; 80:139-148.e4. [DOI: 10.1016/j.jaad.2018.06.068] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 06/06/2018] [Accepted: 06/26/2018] [Indexed: 10/27/2022]
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14
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Green AC, Hughes MCB, von Schuckmann LA, Khosrotehrani K, Smithers BM. Clustering of prevention behaviours in patients with high-risk primary melanoma. Psychooncology 2017; 27:1442-1449. [PMID: 29044793 DOI: 10.1002/pon.4565] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 09/13/2017] [Accepted: 10/04/2017] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Because melanoma patients are at high risk of further disease, we aimed to study their melanoma prevention behaviours. METHODS In a large cohort of patients newly diagnosed with high-risk melanoma in Queensland, Australia, we assessed clustering of preventive behaviours using latent class analysis. We assessed associated factors with prevalence proportion ratios (PPRs) and 95% confidence intervals (CIs) estimated by Poisson regression and also if preventive behaviour was associated with better tumour prognosis at diagnosis. RESULTS Among 789 primary melanoma patients (57% male; 21% with previous melanoma), we identified 4 different behaviour clusters: "no/ low prevention" (34% of cohort), "sun protection only" (25%), "skin checks only" (25%), and "sun protection and skin checks" (17%). Prevalence of clusters differed between males and females and also the component behaviours. Preventive behaviours were associated with having skin that burned and past cutaneous cancer, and for males, combined sun protective and skin checking behaviour was associated with higher education and non-smoking. In patients with no past history of cutaneous cancer, males in the "skin checks only" cluster had significantly reduced chances of a thick (poor prognosis) melanoma (PPR = 0.79, 95% CI 0.68, 0.91) and females in the "sun protection and skin checks" cluster were significantly less likely to have an ulcerated melanoma (PPR = 0.85, 95% CI 0.74, 0.98) compared with the "no/ low prevention" cluster. CONCLUSION These findings allow tailoring of preventive advice to melanoma patients to reduce their risk of future primary and recurrent disease.
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Affiliation(s)
- Adèle C Green
- Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia.,CRUK Manchester Institute, and Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Maria Celia B Hughes
- Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia
| | - Lena A von Schuckmann
- Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia.,School of Public Health, The University of Queensland, Brisbane, Australia
| | - Kiarash Khosrotehrani
- Experimental Dermatology Group, The University of Queensland Diamantina Institute, Brisbane, Qld, Australia
| | - B Mark Smithers
- Queensland Melanoma Project, Discipline of Surgery, The University of Queensland, Brisbane, Qld, Australia
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15
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Abstract
The goal of this study was to identify a relevant and inclusive list of quality of life issues among long-term survivors of melanoma. Individuals diagnosed with stage I-III cutaneous melanoma and had survived 1-5 years, ages 18-65 years at diagnosis, were recruited. Five focus groups were conducted with 33 participants in total. Discussions centered on participants' experiences at diagnosis, as well as ongoing physical, emotional, and social concerns, and behavioral changes since diagnosis. The majority of participants reported shock, fear, and feeling overwhelmed at the time of diagnosis. Some reported lingering physical concerns, including pain, numbness, and lymphedema, while a few reported no lasting issues. Emotional concerns were common, with most reporting anxiety. Several also noted feeling lonely and isolated. Social concerns included alteration of activities to avoid sun exposure, issues with family communication, and frustration with the lack of appreciation of the seriousness of melanoma by others. Finally, while many participants reported changes to their sun exposure and UV-protection behaviors, some reported little to no change. The shared experiences among participants in this study confirm the unique nature of melanoma and the need for interventions designed to improve the health and quality of life of melanoma survivors.
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16
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Vogel RI, Strayer LG, Engelman L, Nelson HH, Blaes AH, Anderson KE, Lazovich D. Sun Exposure and Protection Behaviors among Long-term Melanoma Survivors and Population Controls. Cancer Epidemiol Biomarkers Prev 2017; 26:607-613. [PMID: 28254810 DOI: 10.1158/1055-9965.epi-16-0854] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 11/30/2016] [Accepted: 11/30/2016] [Indexed: 01/21/2023] Open
Abstract
Introduction: Melanoma is considered a generally preventable cancer, with excessive ultraviolet radiation (UVR) exposure being a strong causal factor. UVR exposure following a melanoma diagnosis can be modified to reduce risk of second primary melanomas. The goal of this study was to compare measures of UVR exposure and protection behaviors between long-term melanoma survivors and controls.Methods: Participants from a previously conducted case-control study were recruited for a cross-sectional survey. Melanoma cases were 25 to 59 years old at diagnosis; controls were age and sex matched. Participants were asked about UVR exposure and protection measures used in the past year, and comparisons between melanoma survivors and controls were conducted using logistic regression models, adjusting for potential confounders.Results: A total of 724 (62.0%) long-term melanoma survivors and 660 (59.9%) controls completed the follow-up survey. Melanoma survivors were significantly less likely to report high sun exposure on a typical weekday [OR, 0.72 (0.55-0.94)], sunburns [OR, 0.40 (0.30-0.53)], or indoor tanning [OR, 0.20 (0.09-0.44)] than controls; however, high sun exposure on a typical weekend day was similar. Report of optimal sun protection behaviors was higher in melanoma survivors compared with controls. However, a few melanoma survivors reported indoor tanning, 10% reported intentionally seeking sun to tan, and 20% reported sunburns.Conclusions: Although long-term melanoma survivors reported healthier UVR exposure and protection behaviors compared with controls, a sizeable proportion still reported elevated sun exposure, sunburns, and suboptimal UVR protection behaviors.Impact: Opportunities remain for improving sun protection to reduce future melanoma risk among melanoma survivors. Cancer Epidemiol Biomarkers Prev; 26(4); 607-13. ©2017 AACR.
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Affiliation(s)
- Rachel Isaksson Vogel
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, Minnesota. .,Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Lori G Strayer
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Leah Engelman
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Heather H Nelson
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.,Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Anne H Blaes
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.,Division of Hematology and Oncology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Kristin E Anderson
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.,Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - DeAnn Lazovich
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.,Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
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17
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Li WQ, E McGeary J, Cho E, Flint A, Wu S, Ascherio A, Rimm E, Field A, A Qureshi A. Indoor tanning bed use and risk of food addiction based on the modified Yale Food Addiction Scale. J Biomed Res 2017; 31:31-39. [PMID: 28808183 PMCID: PMC5274510 DOI: 10.7555/jbr.31.20160098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
The popularity of indoor tanning may be partly attributed to the addictive characteristics of tanning for some individuals. We aimed to determine the association between frequent indoor tanning, which we view as a surrogate for tanning addiction, and food addiction. A total of 67,910 women were included from the Nurses’ Health Study II. In 2005, we collected information on indoor tanning during high school/college and age 25-35 years, and calculated the average use of indoor tanning during these periods. Food addiction was defined as ≥3 clinically significant symptoms plus clinically significant impairment or distress, assessed in 2009 using a modified version of the Yale Food Addiction Scale. Totally 23.3% (15,822) of the participants reported indoor tanning at high school/college or age 25-35 years. A total of 5,557 (8.2%) women met the criteria for food addiction. We observed a dose–response relationship between frequency of indoor tanning and the likelihood of food addiction (Ptrend < 0.0001), independent of depression, BMI, and other confounders. Compared with never indoor tanners, the odds ratio (95% confidence interval) of food addiction was 1.07 (0.99-1.17) for average indoor tanning 1-2 times/year, 1.25 (1.09-1.43) for 3-5 times/year, 1.34 (1.14-1.56) for 6-11 times/year, 1.61 (1.35-1.91) for 12-23 times/year, and 2.98 (1.95-4.57) for 24 or more times/year. Frequent indoor tanning before or at early adulthood is associated with prevalence of food addiction at middle age. Our data support the addictive property of frequent indoor tanning, which may guide intervention strategies to curb indoor tanning and prevent skin cancer.
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Affiliation(s)
- Wen-Qing Li
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI 02903, United States.,Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02903, United States
| | - John E McGeary
- Providence VA Medical Center, Providence, RI 02908, United States.,Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI 02903, United States
| | - Eunyoung Cho
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI 02903, United States.,Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02903, United States.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women
| | - Alan Flint
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, United States.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Shaowei Wu
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI 02903, United States.,Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100083, China
| | - Alberto Ascherio
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, United States.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Eric Rimm
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, United States.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Alison Field
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02903, United States;Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, United States;Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States;Division of Adolescent Medicine, Boston Children's Hospital, Boston, MA 02115, United States
| | - Abrar A Qureshi
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI 02903, United States.,Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02903, United States;Providence VA Medical Center, Providence, RI 02908, United States.,Department of Dermatology, Rhode Island Hospital, Providence, RI 02903, United States
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18
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Rodríguez VM, Berwick M, Hay JL. Communication about melanoma and risk reduction after melanoma diagnosis. Psychooncology 2016; 26:2142-2148. [PMID: 27862570 DOI: 10.1002/pon.4315] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 10/21/2016] [Accepted: 11/11/2016] [Indexed: 01/16/2023]
Abstract
BACKGROUND Melanoma patients are advised to perform regular risk-reduction practices, including sun protection as well as skin self-examinations (SSEs) and physician-led examinations. Melanoma-specific communication regarding family risk and screening may promote such behaviors. To this end, associations between patients' melanoma-specific communication and risk reduction were examined. METHODS Melanoma patients (N = 169) drawn from a population-based cancer registry reported their current risk-reduction practices, perceived risk of future melanoma, and communication with physicians and relatives about melanoma risk and screening. RESULTS Patients were, on average, 56 years old and 6.7 years' post diagnosis; 51% were male, 93% reported "fair/very fair" skin color, 75% completed at least some college, and 22% reported a family history of melanoma. Patients reported varying levels of regular (always/nearly always) sun protection: sunscreen use (79%), shade seeking (60%), hat use (54%), and long-sleeve shirt use (30%). Only 28% performed thorough SSE regularly, whereas 92% reported undergoing physician-led skin examinations within the past year. Participants who were female, younger, and had a higher perceived risk of future melanoma were more likely to report past communication. In adjusted analyses, communication remained uniquely associated with increased sunscreen use and SSE. CONCLUSIONS Encouraging melanoma patients to have a more active role in discussions concerning melanoma risk and screening with relatives and physicians alike may be a useful strategy to promote 2 key risk-reduction practices post melanoma diagnosis and treatment. Future research is needed to identify additional strategies to improve comprehensive risk reduction in long-term melanoma patients.
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Affiliation(s)
- Vivian M Rodríguez
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marianne Berwick
- Department of Internal Medicine and Dermatology, University of New Mexico, Albuquerque, NM, USA
| | - Jennifer L Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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19
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Novel Gene Expression Profile of Women with Intrinsic Skin Youthfulness by Whole Transcriptome Sequencing. PLoS One 2016; 11:e0165913. [PMID: 27829007 PMCID: PMC5102383 DOI: 10.1371/journal.pone.0165913] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 10/19/2016] [Indexed: 01/23/2023] Open
Abstract
While much is known about genes that promote aging, little is known about genes that protect against or prevent aging, particularly in human skin. The main objective of this study was to perform an unbiased, whole transcriptome search for genes that associate with intrinsic skin youthfulness. To accomplish this, healthy women (n = 122) of European descent, ages 18–89 years with Fitzpatrick skin type I/II were examined for facial skin aging parameters and clinical covariates, including smoking and ultraviolet exposure. Skin youthfulness was defined as the top 10% of individuals whose assessed skin aging features were most discrepant with their chronological ages. Skin biopsies from sun-protected inner arm were subjected to 3’-end sequencing for expression quantification, with results verified by quantitative reverse transcriptase-polymerase chain reaction. Unbiased clustering revealed gene expression signatures characteristic of older women with skin youthfulness (n = 12) compared to older women without skin youthfulness (n = 33), after accounting for gene expression changes associated with chronological age alone. Gene set analysis was performed using Genomica open-access software. This study identified a novel set of candidate skin youthfulness genes demonstrating differences between SY and non-SY group, including pleckstrin homology like domain family A member 1 (PHLDA1) (p = 2.4x10-5), a follicle stem cell marker, and hyaluronan synthase 2-anti-sense 1 (HAS2-AS1) (p = 0.00105), a non-coding RNA that is part of the hyaluronan synthesis pathway. We show that immunologic gene sets are the most significantly altered in skin youthfulness (with the most significant gene set p = 2.4x10-5), suggesting the immune system plays an important role in skin youthfulness, a finding that has not previously been recognized. These results are a valuable resource from which multiple future studies may be undertaken to better understand the mechanisms that promote skin youthfulness in humans.
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20
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Nahar VK, Allison Ford M, Brodell RT, Boyas JF, Jacks SK, Biviji-Sharma R, Haskins MA, Bass MA. Skin cancer prevention practices among malignant melanoma survivors: a systematic review. J Cancer Res Clin Oncol 2015; 142:1273-83. [PMID: 26642962 DOI: 10.1007/s00432-015-2086-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 11/21/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE This systematic review was conducted to evaluate and summarize the existing literature on prevalence of ultraviolet radiation (UVR) exposure, sun protection, and screening behaviors among individuals diagnosed with malignant melanoma (MM). METHODS The search was performed in PubMed, CINAHL, PsycINFO, ScienceDirect, EMBASE, and ERIC from inception of each database through July 2014. Studies were included if (1) individuals diagnosed with MM were the primary sample, (2) measured UVR exposure, primary and secondary preventive behaviors, (3) original research communication that constitutes an entire set of empirical data, (4) observational design, and (5) English peer-reviewed. Studies were excluded if (1) all of the inclusion criteria were not met and (2) duplicates, conference abstracts, editorials, news, letters to the editor, comments, reviews, feature articles, white papers, and guidelines. RESULTS The search resulted in 255 articles that were screened for relevance; however, only 15 articles met all of the inclusion criteria. Most of the studies were cross-sectional (n = 10), used self-administered surveys (n = 8), and were conducted in North America (n = 10). The sample sizes ranged considerably, but were mostly Caucasian (n = 6) and included a higher proportion of women (n = 8). Evidence demonstrated that individuals with MM still engaged in sunbathing, indoor tanning, and reported sunburns. Moreover, survivors reported inadequate levels of both sun protection and skin self-examinations. CONCLUSIONS The findings highlight the need for intensifying intervention strategies to reduce the risk of new primary MMs in this group. Future research should increase in rigor and include more diverse populations and regions.
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Affiliation(s)
- Vinayak K Nahar
- Department of Health, Exercise Science and Recreation Management, The University of Mississippi, 215 Turner Center, PO Box 1848, University, MS, 38677, USA. .,Department of Dermatology, University of Mississippi Medical Center, 2500 N., State St., Jackson, MS, 39216, USA.
| | - M Allison Ford
- Department of Health, Exercise Science and Recreation Management, The University of Mississippi, 215 Turner Center, PO Box 1848, University, MS, 38677, USA
| | - Robert T Brodell
- Department of Dermatology, University of Mississippi Medical Center, 2500 N., State St., Jackson, MS, 39216, USA.,Department of Pathology, University of Mississippi Medical Center, 2500 N., State St., Jackson, MS, 39216, USA.,Department of Dermatology, University of Rochester School of Medicine and Dentistry, Rochester, NY, 14642, USA
| | - Javier F Boyas
- Department of Social Work, University of Mississippi, 208 Longstreet Hall, PO Box 1848, Oxford, MS, 38677, USA
| | - Stephanie K Jacks
- Department of Dermatology, University of Mississippi Medical Center, 2500 N., State St., Jackson, MS, 39216, USA
| | - Rizwana Biviji-Sharma
- Department of Health Policy and Management, Richard M. Fairbanks School of Public Health, Indiana University, IUPUI, 714 N. Senate Ave, Suite 250, Indianapolis, IN, 46202, USA
| | - Mary A Haskins
- Department of Health, Exercise Science and Recreation Management, The University of Mississippi, 215 Turner Center, PO Box 1848, University, MS, 38677, USA
| | - Martha A Bass
- Department of Health, Exercise Science and Recreation Management, The University of Mississippi, 215 Turner Center, PO Box 1848, University, MS, 38677, USA
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21
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Sassolas B, Grange F, Touboul C, Lebbe C, Saiag P, Mortier L, Lhomel C, Robert C. Sun exposure profile in the French population. Results of the EDIFICE Melanoma survey. J Eur Acad Dermatol Venereol 2015; 29 Suppl 2:6-10. [DOI: 10.1111/jdv.12895] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 10/22/2014] [Indexed: 11/29/2022]
Affiliation(s)
- B. Sassolas
- Department of Internal medicine and Respiratory Diseases; Hôpital Cavale Blanche; Brest France
| | - F. Grange
- Department of Dermatology; Robert Debré University Hospital; Reims France
| | | | - C. Lebbe
- Department of Dermatology; Hôpital Saint-Louis; Paris Diderot University, Inserm U976; Paris France
| | - P. Saiag
- Department of Dermatology; Hôpital Ambroise Paré; Boulogne-Billancourt France
| | - L. Mortier
- Department of Dermatology; Hôpital Claude Huriez; Lille France
| | | | - C. Robert
- Department of Dermatology; Institut Gustave Roussy; Villejuif France
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22
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Abstract
Melanoma, the deadliest form of skin cancer, is an aggressive disease that is rising in incidence. Although melanoma is a historically treatment-resistant malignancy, in recent years unprecedented breakthroughs in targeted therapies and immunotherapies have revolutionized the standard of care for patients with advanced disease. Here, we provide an overview of recent developments in our understanding of melanoma risk factors, genomics, and molecular pathogenesis and how these insights have driven advances in melanoma treatment. In addition, we review benefits and limitations of current therapies and look ahead to continued progress in melanoma prevention and therapy. Remarkable achievements in the field have already produced a paradigm shift in melanoma treatment: Metastatic melanoma, once considered incurable, can now be treated with potentially curative rather than palliative intent.
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Affiliation(s)
- Jennifer A Lo
- Cutaneous Biology Research Center, Department of Dermatology and MGH Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - David E Fisher
- Cutaneous Biology Research Center, Department of Dermatology and MGH Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
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23
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Robinson KC, Fisher DE. Tanning as a substance abuse. Commun Integr Biol 2014; 7:971579. [PMID: 26842945 PMCID: PMC4594601 DOI: 10.4161/cib.29890] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 07/08/2014] [Accepted: 07/11/2014] [Indexed: 12/14/2022] Open
Abstract
While few people would deny the appeal of a day in the sun there are some who seem to
take it too far. In recent years the concept of ‘tanning addiction’ has
become popular and several studies have supported the notion of viewing exposure to UV
radiation as a form of substance abuse. In this article we will review some of the
literature on sun seeking behavior.
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Affiliation(s)
- Kathleen C Robinson
- Cutaneous Biology Research Center; Department of Dermatology and MGH Cancer Center; Massachusetts General Hospital; Harvard Medical School ; Boston, MA USA
| | - David E Fisher
- Cutaneous Biology Research Center; Department of Dermatology and MGH Cancer Center; Massachusetts General Hospital; Harvard Medical School ; Boston, MA USA
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24
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Lau SCM, Chen L, Cheung WY. Protective skin care behaviors in cancer survivors. ACTA ACUST UNITED AC 2014; 21:e531-40. [PMID: 25089104 DOI: 10.3747/co.21.1893] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE Research suggests that physicians neglect preventive care for cancer survivors. A survivor's self-motivation with respect to preventive care is unknown. Using protective skin care as a proxy, our aims were to characterize preventive care in cancer survivors and to identify factors associated with appropriate prevention. METHODS Using data from the 2009 U.S. Health Information National Trends Survey, we compared preventive skin care patterns in cancer survivors and non-cancer patients. Primary endpoints were the use of sunscreens, long-sleeved shirts, hats, and shade. RESULTS We identified 179 early cancer survivors (<5 years), 242 intermediate cancer survivors (5-10 years), 412 long-term cancer survivors (>10 years), and 5951 non-cancer patients. The use of sunscreens (60%), long-sleeved shirts (88%), hats (58%), and shade (68%) was suboptimal. Overall, cancer survivors were not more likely to adhere to preventive care (p = 0.89). A composite score showed a significant difference between the cancer survivor groups (p < 0.01) whereby intermediate survivors reported the best preventive practices. CONCLUSIONS A prior diagnosis of cancer does not appear to increase personal compliance with cancer prevention. Reasons for this poor engagement are not clear. Targeted strategies to increase self-motivation might improve preventive practices in cancer survivors.
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Affiliation(s)
- S C M Lau
- University of British Columbia, Vancouver, BC
| | - L Chen
- BC Cancer Agency, Vancouver, BC
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25
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Rat C, Quereux G, Riviere C, Clouet S, Senand R, Volteau C, Dreno B, Nguyen JM. Targeted melanoma prevention intervention: a cluster randomized controlled trial. Ann Fam Med 2014; 12:21-8. [PMID: 24445100 PMCID: PMC3896535 DOI: 10.1370/afm.1600] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Targeted interventions to reduce the risk and increase the early detection of melanoma have the potential to save lives. We aimed to assess the effect of such an intervention on patient prevention behavior. METHODS We conducted a pilot clustered randomized controlled trial, comparing a targeted screening and education intervention with a conventional information-based campaign in 20 private surgeries in western France. In the intervention group, 10 general practitioners identified patients at elevated risk for melanoma with a validated assessment tool, the Self-Assessment Melanoma Risk Score (SAMScore), examined their skin, and counseled them using information leaflets. In the control group, 10 general practitioners displayed a poster and the leaflets in their waiting room and examined patients' skin at their own discretion. The main outcome measures were sunbathing and skin self-examinations among patients at elevated risk, assessed 5 months later with a questionnaire. RESULTS Analyses were based on 173 patients. Compared with control patients, intervention patients were more likely to remember the campaign (81.4% vs 50.0%, P = .0001) and to correctly identify their elevated risk of melanoma (71.1% vs 42.1%, P = .001). Furthermore, intervention patients had higher levels of prevention behaviors: they were less likely to sunbathe in the summer (24.7% vs 40.8%, P = .048) and more likely to have performed skin self-examinations in the past year (52.6% vs 36.8%, P = .029). The intervention was not associated with any clear adverse effects, although there were trends whereby intervention patients were more likely to worry about melanoma and to consult their general practitioner again about the disease. CONCLUSIONS The combination of use of the SAMScore and general practitioner examination and counseling during consultations is an efficient way to promote patient behaviors that may reduce melanoma risk. Extending the duration of follow-up and demonstrating an impact on morbidity and mortality remain major issues for further research.
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Affiliation(s)
- Cédric Rat
- Department of General Practice, Faculty of Medicine of Nantes, France
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26
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Mayer DK. What's the price of a tan? Clin J Oncol Nurs 2012; 16:337. [PMID: 22842682 DOI: 10.1188/12.cjon.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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