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Wall J, Gadsby‐Davis K, Mistry K, Levell NJ, Venables ZC. Impact of the COVID-19 pandemic on international cutaneous squamous cell carcinoma incidence: A systematic review and meta-analysis. SKIN HEALTH AND DISEASE 2024; 4:e405. [PMID: 39104659 PMCID: PMC11297431 DOI: 10.1002/ski2.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 05/09/2024] [Accepted: 06/04/2024] [Indexed: 08/07/2024]
Abstract
Background Non-melanoma skin cancer (NMSC) is the most common cancer globally in white ethinicity populations, and cutaneous squamous cell carcinoma (cSCC) is the second most common subtype. The COVID-19 pandemic severely impacted public and private healthcare systems. Many studies have reported reduced cancer diagnoses during the pandemic. The impact of the COVID-19 pandemic on global cSCC and NMSC incidence is poorly reported. Objectives The aim was to conduct a systematic review and meta-analysis to assess the impact of the COVID-19 pandemic on global cSCC and NMSC incidence rates, compared with 2019 incidence rates. Two primary outcome measures were used: crude incidence rate ratios (CIRR) and age-standardised incidence rate ratios (ASIRR). Methods A structured search was undertaken on 23 March 2023 using grey literature and four electronic databases: MEDLINE, CINAHL, EMBASE and Web of Science. Studies published before January 2020 were excluded. A quality assessment was undertaken using A. Lomas quality assessment tool. CIRR outcomes were synthesised in a meta-analysis, while ASIRR outcomes were narratively synthesised. Results Fourteen cancer registries were included, capturing data from 13 countries across Europe. Variation was observed in NMSC and cSCC incidence across the cancer registries. Pooled cSCC crude incidence rates in 2020 were equal to crude incidence rates in 2019 (cSCC-CIRR 1.00 (95% confidence interval (CI) 0.94-1.06). In 2021, the pooled result indicated a non-significant 8% increase in cSCC crude incidence rates, compared with 2019 (cSCC-CIRR 1.08 (95% CI 0.98-1.19). Significant reductions were reported in NMSC incidence across all meta-analyses in 2020 and 2021 compared with 2019. Heterogeneity was observed across most pooled estimates (I 2>75%). Conclusion There was a lack of high quality data on cSCC incidence rates recorded during the pandemic outside of Europe. The COVID-19 pandemic resulted in no significant changes in cSCC incidence across Europe. By contrast, NMSC incidence fell across Europe following the pandemic. Significant reductions in pooled NMSC incidence rates may reflect a delay in basal cell carcinoma presentation, diagnosis and treatment. Although annual incidence rates for cSCC were not affected by the pandemic, delays in treatment may still have occurred, which may result in poorer outcomes yet to be fully understood.
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Affiliation(s)
- James Wall
- University of East AngliaNorwich Medical SchoolNorwichUK
| | | | - Khaylen Mistry
- University of East AngliaNorwich Medical SchoolNorwichUK
- DermatologyNorfolk and Norwich University Hospitals NHS Foundation TrustNorwichUK
| | - Nick J. Levell
- University of East AngliaNorwich Medical SchoolNorwichUK
- DermatologyNorfolk and Norwich University Hospitals NHS Foundation TrustNorwichUK
| | - Zoe C. Venables
- University of East AngliaNorwich Medical SchoolNorwichUK
- DermatologyNorfolk and Norwich University Hospitals NHS Foundation TrustNorwichUK
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Yapijakis C, Gintoni I, Charalampidou S, Angelopoulou A, Papakosta V, Vassiliou S, Chrousos GP. Angiotensinogen, Angiotensin-Converting Enzyme, and Chymase Gene Polymorphisms as Biomarkers for Basal Cell Carcinoma Susceptibility. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1423:175-180. [PMID: 37525041 DOI: 10.1007/978-3-031-31978-5_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
INTRODUCTION The intake of angiotensin-converting enzyme (ACE) inhibitors and specific antagonists of angiotensin II receptors, widely used as antihypertensive drugs, significantly reduces the risk of developing basal cell carcinoma (BCC), highlighting the possible tumorigenic role of angiotensin II (AngII). We present here the investigated genetic association between the development of BCC and functional DNA polymorphisms M235T, I/D, and A1903G in the genes of angiotensinogen (AGT), angiotensin-converting enzyme (ACE), and chymase (CMA1), which mediate AngII production levels. METHODS DNA samples of 203 unrelated Greeks were studied, including 100 patients with BCC and 103 matched healthy controls. RESULTS The MT genotype of the AGT-M235T polymorphism was significantly more prevalent in the patient group (78.0%) versus the healthy control group (28.3%; p < 0.001). The DD genotype of the ACE-I/D polymorphism was also increased in BCC patients (72.8%) compared to controls (46.2%; p = 0.001). The heterozygous AG genotype of CMA1-A1903G was significantly more frequent in the BCC group (86%) than in the healthy controls (50.5%; p < 0.001). CONCLUSIONS The MT, DD, and AG genotypes of the AGT- M235T, ACE-I/D, and CMA1-A1903G polymorphisms, respectively, were significantly increased in frequency within the group of cancer patients compared to the healthy controls. All three genotypes correspond to increased enzyme levels or activity and result in increased levels of AngII; therefore, they may be potentially utilized as reliable biomarkers associated with an individual's increased risk for BCC development.
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Affiliation(s)
- Christos Yapijakis
- Unit of Orofacial Genetics, 1st Department of Pediatrics, National Kapodistrian University of Athens, "Hagia Sophia" Children's Hospital, Athens, Greece.
- Department of Molecular Genetics, Cephalogenetics Center, Athens, Greece.
- University Research Institute for the Study of Genetic and Malignant Disorders in Childhood, Choremion Laboratory, "Aghia Sophia" Children's Hospital, Athens, Greece.
- Department of Oral and Maxillofacial Surgery, School of Medicine, National and Kapodistrian University of Athens, Attikon Hospital, Athens, Greece.
| | - Iphigenia Gintoni
- Unit of Orofacial Genetics, 1st Department of Pediatrics, National Kapodistrian University of Athens, "Hagia Sophia" Children's Hospital, Athens, Greece
- Department of Molecular Genetics, Cephalogenetics Center, Athens, Greece
- University Research Institute for the Study of Genetic and Malignant Disorders in Childhood, Choremion Laboratory, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Sevastiana Charalampidou
- Unit of Orofacial Genetics, 1st Department of Pediatrics, National Kapodistrian University of Athens, "Hagia Sophia" Children's Hospital, Athens, Greece
- Department of Molecular Genetics, Cephalogenetics Center, Athens, Greece
| | - Antonia Angelopoulou
- Unit of Orofacial Genetics, 1st Department of Pediatrics, National Kapodistrian University of Athens, "Hagia Sophia" Children's Hospital, Athens, Greece
- Department of Molecular Genetics, Cephalogenetics Center, Athens, Greece
- University Research Institute for the Study of Genetic and Malignant Disorders in Childhood, Choremion Laboratory, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Veronica Papakosta
- Department of Oral and Maxillofacial Surgery, School of Medicine, National and Kapodistrian University of Athens, Attikon Hospital, Athens, Greece
| | - Stavros Vassiliou
- Department of Oral and Maxillofacial Surgery, School of Medicine, National and Kapodistrian University of Athens, Attikon Hospital, Athens, Greece
| | - George P Chrousos
- University Research Institute for the Study of Genetic and Malignant Disorders in Childhood, Choremion Laboratory, "Aghia Sophia" Children's Hospital, Athens, Greece
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Antihypertensive drugs and the risk of cancer: a critical review of available evidence and perspective. J Hypertens 2021; 38:1005-1015. [PMID: 32371788 DOI: 10.1097/hjh.0000000000002379] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
: The issue of a potential danger of antihypertensive drugs related to cancer susceptibility is currently generating a major debate in the scientific community, concerns in the public and emphasized interest from the media. The present article is a thorough review of what is known on the various classes of antihypertensive drugs concerning the risk of developing different neoplasms and about the suggested pathophysiological mechanisms, whenever available. The main limitations of evidence derived from studies currently available in this setting are also discussed, high-lightening the need for newly developed approaches to generate more accurate recommendations and informed advice for physicians.
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Tokez S, Wakkee M, Louwman M, Noels E, Nijsten T, Hollestein L. Assessment of Cutaneous Squamous Cell Carcinoma (cSCC) In situ Incidence and the Risk of Developing Invasive cSCC in Patients With Prior cSCC In situ vs the General Population in the Netherlands, 1989-2017. JAMA Dermatol 2021; 156:973-981. [PMID: 32609322 DOI: 10.1001/jamadermatol.2020.1988] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance The incidence rates of keratinocyte cancer are increasing globally; however, the incidence rates of cutaneous squamous cell carcinoma (cSCC) in situ and the risk of developing subsequent invasive cSCC remain unknown. Objective To estimate annual population-based age-standardized incidence rates of histopathologically confirmed cSCC in situ stratified by sex, age, and body site and to assess the risk of developing invasive cSCC among patients with cSCC in situ compared with the general population. Design, Setting, and Participants This nationwide epidemiological population-based cohort study used cancer registry data to identify all patients with a first incident of histopathologically confirmed cSCC in situ between January 1, 1989, and December 31, 2017. In addition, all patients with cSCC in situ who subsequently had a first incident of invasive cSCC were identified up to June 11, 2019. Data were analyzed between March 18 and November 12, 2019. Main Outcomes and Measures Age-standardized incidence rates per year for cSCC in situ, standardized to the 2013 edition of the European Standard Population, were calculated by sex, age, and body site. Cumulative risks, standardized incidence ratios, and absolute excess risks were calculated to assess the risk of invasive cSCC in patients with cSCC in situ compared with the general population. Results In this population-based cohort study of 88 754 patients with a first incident of cSCC in situ between January 1, 1989, and December 31, 2017, 58.8% were women; the median age was 75 years (interquartile range [IQR], 67-82 years) for women and 73 years (IQR, 65-80 years) for men. Increasing incidence rates were observed, with the highest incidence rates in 2017 among women in general (71.7 cases per 100 000 person-years) and among men 80 years and older (540.9 cases per 100 000 person-years). The most common body site among women was the face (15.9 cases per 100 000 person-years) and among men was the scalp and/or neck (12.3 cases per 100 000 person-years). After 5 years of follow-up, among patients with cSCC in situ, the cumulative risk of developing an invasive cSCC at any anatomic location was 11.7% (95% CI, 11.6%-11.9%) in men and 6.9% (95% CI, 6.8%-7.0%) in women (P < .001). The standardized incidence ratio was highest in the first year of follow-up among both men (16.6; 95% CI, 15.7-17.5) and women (15.1; 95% CI, 14.2-16.1). Conclusions and Relevance This study reports the first nationwide incidence rates of cSCC in situ to date. The increasing incidence rates of cSCC in situ and the high risk of developing invasive cSCC among patients with cSCC in situ may increase the health care burden associated with precursors of keratinocyte cancer and highlight the need to include cutaneous skin cancer precursor lesions when exploring policies to address skin cancer care.
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Affiliation(s)
- Selin Tokez
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Marlies Wakkee
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Marieke Louwman
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands
| | - Eline Noels
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands.,Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands
| | - Tamar Nijsten
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Loes Hollestein
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands.,Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands
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5
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Urban K, Mehrmal S, Uppal P, Giesey RL, Delost GR. The global burden of skin cancer: A longitudinal analysis from the Global Burden of Disease Study, 1990-2017. JAAD Int 2021; 2:98-108. [PMID: 34409358 PMCID: PMC8362234 DOI: 10.1016/j.jdin.2020.10.013] [Citation(s) in RCA: 121] [Impact Index Per Article: 40.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2020] [Indexed: 12/25/2022] Open
Abstract
Background Despite efforts toward the earlier detection and prevention of skin cancer, the prevalence of skin cancers continues to increase. Identifying trends in skin cancer burdens among populations can lead to impactful and sustainable interventions. Methods We assessed the global trends in skin cancer from 1990 to 2017 in 195 countries worldwide through the Global Burden of Disease Study (GBD) 2017 database. Results The rate of change in skin cancers between 1990 to 2017 varied among countries. Squamous cell carcinomas increased by 310% during this time, the highest among any neoplasm tracked by the GBD. Men experienced greater age-specific prevalence rates of keratinocyte carcinoma across all ages (P < .05). Women had a greater prevalence of melanoma until approximately age 50 years, after which the trend reversed until age 85 years. Men experienced greater age-specific death rates across all ages. The disability-adjusted life years (DALYs) of melanoma and keratinocyte carcinoma increased exponentially with age (P < .05). Conclusion The incidence, prevalence, and DALYs of skin cancers are increasing disproportionately among different demographic groups. As a worldwide epidemiological assessment, the GBD 2017 provides frequently updated measures of the skin cancer burden, which may help to direct resources and allocate funding to close the gap in global skin cancer disparities.
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Affiliation(s)
- Katelyn Urban
- Lake Erie College of Osteopathic Medicine, Greensburg, Pennsylvania
| | - Sino Mehrmal
- Department of Internal Medicine, Alameda Health System–Highland Hospital, Oakland, California
| | - Prabhdeep Uppal
- Departments of Emergency Medicine and Family Medicine, Christiana Care Health System, Newark, Delaware
| | - Rachel L. Giesey
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Gregory R. Delost
- Lake Erie College of Osteopathic Medicine, Greensburg, Pennsylvania
- Apex Dermatology and Skin Surgery Center, Mayfield Heights, Ohio
- Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania
- Correspondence to: Gregory R. Delost, DO, Apex Dermatology and Skin Surgery Center, 5800 Landerbrook Dr Suite #250, Mayfield Heights, OH 44124.
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Dacus D, Riforgiate E, Wallace NA. β-HPV 8E6 combined with TERT expression promotes long-term proliferation and genome instability after cytokinesis failure. Virology 2020; 549:32-38. [PMID: 32818730 PMCID: PMC11381111 DOI: 10.1016/j.virol.2020.07.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 11/25/2022]
Abstract
Human papillomavirus (HPV) is a family of viruses divided into five genera: alpha, beta, gamma, mu, and nu. There is an ongoing discussion about whether beta genus HPVs (β-HPVs) contribute to cutaneous squamous cell carcinoma (cSCC). The data presented here add to this conversation by determining how a β-HPV E6 protein (β-HPV 8E6) alters the cellular response to cytokinesis failure. Specifically, cells were observed after cytokinesis failure was induced by dihydrocytochalasin B (H2CB). β-HPV 8E6 attenuated the immediate toxicity associated with H2CB but did not promote long-term proliferation after H2CB. Immortalization by telomerase reverse transcriptase (TERT) activation also rarely allowed cells to sustain proliferation after H2CB exposure. In contrast, TERT expression combined with β-HPV 8E6 expression allowed cells to proliferate for months following cytokinesis failure. However, this continued proliferation comes with genome destabilizing consequences. Cells that survived H2CB-induced cytokinesis failure suffered from changes in ploidy.
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Affiliation(s)
- Dalton Dacus
- Division of Biology, Kansas State University, Manhattan, KS, USA
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Treff NR, Eccles J, Marin D, Messick E, Lello L, Gerber J, Xu J, Tellier LC. Preimplantation Genetic Testing for Polygenic Disease Relative Risk Reduction: Evaluation of Genomic Index Performance in 11,883 Adult Sibling Pairs. Genes (Basel) 2020; 11:E648. [PMID: 32545548 PMCID: PMC7349610 DOI: 10.3390/genes11060648] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/18/2020] [Accepted: 06/10/2020] [Indexed: 01/08/2023] Open
Abstract
Preimplantation genetic testing for polygenic disease risk (PGT-P) represents a new tool to aid in embryo selection. Previous studies demonstrated the ability to obtain necessary genotypes in the embryo with accuracy equivalent to in adults. When applied to select adult siblings with known type I diabetes status, a reduction in disease incidence of 45-72% compared to random selection was achieved. This study extends analysis to 11,883 sibling pairs to evaluate clinical utility of embryo selection with PGT-P. Results demonstrate simultaneous relative risk reduction of all diseases tested in parallel, which included diabetes, cancer, and heart disease, and indicate applicability beyond patients with a known family history of disease.
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Affiliation(s)
- Nathan R. Treff
- Genomic Prediction Inc. 675 US Highway One, North Brunswick, NJ 08902, USA; (J.E.); (D.M.); (E.M.); (L.L.); (J.X.); (L.C.A.M.T.)
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers University-Robert Wood Johnson Medical School, New Brunswick, NJ 08903, USA
| | - Jennifer Eccles
- Genomic Prediction Inc. 675 US Highway One, North Brunswick, NJ 08902, USA; (J.E.); (D.M.); (E.M.); (L.L.); (J.X.); (L.C.A.M.T.)
| | - Diego Marin
- Genomic Prediction Inc. 675 US Highway One, North Brunswick, NJ 08902, USA; (J.E.); (D.M.); (E.M.); (L.L.); (J.X.); (L.C.A.M.T.)
| | - Edward Messick
- Genomic Prediction Inc. 675 US Highway One, North Brunswick, NJ 08902, USA; (J.E.); (D.M.); (E.M.); (L.L.); (J.X.); (L.C.A.M.T.)
| | - Louis Lello
- Genomic Prediction Inc. 675 US Highway One, North Brunswick, NJ 08902, USA; (J.E.); (D.M.); (E.M.); (L.L.); (J.X.); (L.C.A.M.T.)
- Department of Physics and Astronomy, Hannah Administration Building, Michigan State University, 426 Auditorium Rd., East Lansing, MI 48824, USA
| | - Jessalyn Gerber
- Department of Genetics, Rutgers University, Piscataway, NJ 08854, USA;
| | - Jia Xu
- Genomic Prediction Inc. 675 US Highway One, North Brunswick, NJ 08902, USA; (J.E.); (D.M.); (E.M.); (L.L.); (J.X.); (L.C.A.M.T.)
| | - Laurent C.A.M. Tellier
- Genomic Prediction Inc. 675 US Highway One, North Brunswick, NJ 08902, USA; (J.E.); (D.M.); (E.M.); (L.L.); (J.X.); (L.C.A.M.T.)
- Department of Physics and Astronomy, Hannah Administration Building, Michigan State University, 426 Auditorium Rd., East Lansing, MI 48824, USA
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Teepen JC, Kok JL, Kremer LC, Tissing WJE, van den Heuvel-Eibrink MM, Loonen JJ, Bresters D, van der Pal HJ, Versluys B, van Dulmen-den Broeder E, Nijsten T, Hauptmann M, Hollema N, Dolsma WV, van Leeuwen FE, Ronckers CM. Long-Term Risk of Skin Cancer Among Childhood Cancer Survivors: A DCOG-LATER Cohort Study. J Natl Cancer Inst 2020; 111:845-853. [PMID: 30802904 DOI: 10.1093/jnci/djy212] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/14/2018] [Accepted: 11/19/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Skin cancer is common after radiotherapy among childhood cancer survivors (CCSs). We studied risks and risk factors for subsequent skin cancers, with emphasis on radiation dose, exposed skin surface area, and chemotherapeutic agents. METHODS The DCOG-LATER cohort study includes 5-year Dutch CCSs diagnosed 1963-2001. Subsequent skin cancers were identified from record linkages with the Netherlands Cancer Registry and Dutch Pathology Registry. Incidence rates were compared with general population rates. Multivariable Cox regression models were used, applying a novel method of case-control sampling enabling use of tumor location in cohort analyses. All statistical tests were two-sided. RESULTS Among 5843 CCSs, 259 developed 1061 basal cell carcinomas (BCCs) (standardized incidence ratio [SIR] = 29.8, 95% confidence interval [CI] = 26.3 to 33.6; excess absolute risk per 10 000 person-years (EAR) = 24.6), 20 had melanoma (SIR = 2.3, 95% CI = 1.4 to 3.5; EAR = 1.1), and 10 had squamous cell carcinoma (SIR = 7.5, 95% CI = 3.6 to 13.8; EAR = 0.8). Cumulative incidence of BCC 40 years after childhood cancer was 19.1% (95% CI = 16.6 to 21.8%) after radiotherapy vs 0.6% expected based on general population rates. After a first BCC, 46.7% had more BCCs later. BCC risk was associated with any radiotherapy to the skin compartment of interest (hazard ratio [HR] = 14.32, 95% CI = 10.10 to 20.29) and with estimated percentage in-field skin surface area (26-75%: HR = 1.99, 95% CI = 1.24 to 3.20; 76-100%: HR = 2.16, 95% CI = 1.33 to 3.53, vs 1-25% exposed; Ptrend among exposed = .002), but not with prescribed radiation dose and likelihood of sun-exposed skin-area. Of all chemotherapy groups examined, only vinca alkaloids increased BCC risk (HR = 1.54, 95% CI = 1.04 to 2.27). CONCLUSION CCSs have a strongly, 30-fold increased BCC risk. BCC risk appears to increase with increasing skin surface area exposed. This knowledge underscores the need for awareness by survivors and their health care providers.
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Affiliation(s)
- Jop C Teepen
- See the Notes section for the full list of authors' affiliations
| | - Judith L Kok
- See the Notes section for the full list of authors' affiliations
| | | | - Wim J E Tissing
- See the Notes section for the full list of authors' affiliations
| | | | | | - Dorine Bresters
- See the Notes section for the full list of authors' affiliations
| | | | | | | | - Tamar Nijsten
- See the Notes section for the full list of authors' affiliations
| | | | - Nynke Hollema
- See the Notes section for the full list of authors' affiliations
| | - Wil V Dolsma
- See the Notes section for the full list of authors' affiliations
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Tokez S, Alblas M, Nijsten T, Pardo LM, Wakkee M. Predicting keratinocyte carcinoma in patients with actinic keratosis: development and internal validation of a multivariable risk-prediction model. Br J Dermatol 2020; 183:495-502. [PMID: 31856292 PMCID: PMC7496285 DOI: 10.1111/bjd.18810] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Patients with actinic keratosis (AK) are at increased risk for developing keratinocyte carcinoma (KC) but predictive factors and their risk rates are unknown. OBJECTIVES To develop and internally validate a prediction model to calculate the absolute risk of a first KC in patients with AK. METHODS The risk-prediction model was based on the prospective population-based Rotterdam Study cohort. We hereto analysed the data of participants with at least one AK lesion at cohort baseline using a multivariable Cox proportional hazards model and included 13 a priori defined candidate predictor variables considering phenotypic, genetic and lifestyle risk factors. KCs were identified by linkage of the data with the Dutch Pathology Registry. RESULTS Of the 1169 AK participants at baseline, 176 (15·1%) developed a KC after a median follow-up of 1·8 years. The final model with significant predictors was obtained after backward stepwise selection and comprised the presence of four to nine AKs [hazard ratio (HR) 1·68, 95% confidence interval (CI) 1·17-2·42], 10 or more AKs (HR 2·44, 95% CI 1·65-3·61), AK localization on the upper extremities (HR 0·75, 95% CI 0·52-1·08) or elsewhere except the head (HR 1·40, 95% CI 0·98-2·01) and coffee consumption (HR 0·92, 95% CI 0·84-1·01). Evaluation of the discriminative ability of the model showed a bootstrap validated concordance index (c-index) of 0·60. CONCLUSIONS We showed that the risk of KC in patients with AK can be calculated with the use of four easily assessable predictor variables. Given the c-index, extension of the model with additional, currently unknown predictor variables is desirable. Linked Comment: Kim et al. Br J Dermatol 2020; 183:415-416.
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Affiliation(s)
- S Tokez
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - M Alblas
- Department of Public Health, Erasmus MC University Medical Centre, Rotterdam, the Netherlands
| | - T Nijsten
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - L M Pardo
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - M Wakkee
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
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10
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Noels EC, Hollestein LM, van Egmond S, Lugtenberg M, van Nistelrooij LPJ, Bindels PJE, van der Lei J, Stern RS, Nijsten T, Wakkee M. Healthcare utilization and management of actinic keratosis in primary and secondary care: a complementary database analysis. Br J Dermatol 2019; 181:544-553. [PMID: 30636037 PMCID: PMC6850060 DOI: 10.1111/bjd.17632] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2019] [Indexed: 12/25/2022]
Abstract
Background The high prevalence of actinic keratosis (AK) requires the optimal use of healthcare resources. Objectives To gain insight in to the healthcare utilization of people with AK in a population‐based cohort, and the management of AK in a primary and secondary care setting. Methods A retrospective cohort study using three complementary data sources was conducted to describe the use of care, diagnosis, treatment and follow‐up of patients with AK in the Netherlands. Data sources consisted of a population‐based cohort study (Rotterdam Study), routine general practitioner (GP) records (Integrated Primary Care Information) and nationwide claims data (DRG Information System). Results In the population‐based cohort (Rotterdam Study), 69% (918 of 1322) of participants diagnosed with AK during a skin‐screening visit had no previous AK‐related visit in their GP record. This proportion was 50% for participants with extensive AK (i.e. ≥ 10 AKs; n = 270). Cryotherapy was the most used AK treatment by both GPs (78%) and dermatologists (41–56%). Topical agents were the second most used treatment by dermatologists (13–21%) but were rarely applied in primary care (2%). During the first AK‐related GP visit, 31% (171 of 554) were referred to a dermatologist, and the likelihood of being referred was comparable between low‐ and high‐risk patients, which is inconsistent with the Dutch general practitioner guidelines for ‘suspicious skin lesions’ from 2017. Annually, 40 000 new claims representing 13% of all dermatology claims were labelled as cutaneous premalignancy. Extensive follow‐up rates (56%) in secondary care were registered, while only 18% received a claim for a subsequent cutaneous malignancy in 5 years. Conclusions AK management seems to diverge from guidelines in both primary and secondary care. Underutilization of field treatments, inappropriate treatments and high referral rates without proper risk stratification in primary care, combined with extensive follow‐up in secondary care result in the inefficient use of healthcare resources and overburdening in secondary care. Efforts directed to better risk differentiation and guideline adherence may prove useful in increasing the efficiency in AK management. What's already known about this topic? The prevalence of actinic keratosis (AK) is high and, in particular, multiple AKs are a strong skin cancer predictor. The high prevalence of AK requires optimal use of healthcare resources. Nevertheless, (population based) AK healthcare utilization and management data are very rare.
What does this study add? Although AK‐related care already consumes substantial resources, about 70% of the AK population has never received care. Primary care AK management demonstrated underutilization of topical therapies and high referral rates without proper risk stratification, while in secondary care the extensive follow‐up schedules were applied. This inefficient use of healthcare resources highlights the need for better harmonization and risk stratification to increase the efficiency of AK care.
Linked Comment: https://doi.org/10.1111/bjd.17862. https://doi.org/10.1111/bjd.18269 available online https://www.bjdonline.com/article/
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Affiliation(s)
- E C Noels
- Department of Dermatology, Erasmus University Medical Centre, Rotterdam, the Netherlands.,Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands
| | - L M Hollestein
- Department of Dermatology, Erasmus University Medical Centre, Rotterdam, the Netherlands.,Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands
| | - S van Egmond
- Department of Dermatology, Erasmus University Medical Centre, Rotterdam, the Netherlands.,Department of Public Health, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - M Lugtenberg
- Department of Dermatology, Erasmus University Medical Centre, Rotterdam, the Netherlands.,Department of Public Health, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | | | - P J E Bindels
- Department of General Practice, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - J van der Lei
- Department of Medical Informatics, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - R S Stern
- Department of Dermatology, Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, MA, U.S.A
| | - T Nijsten
- Department of Dermatology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - M Wakkee
- Department of Dermatology, Erasmus University Medical Centre, Rotterdam, the Netherlands
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11
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Verkouteren JAC, Pardo LM, Uitterlinden AG, Nijsten T. Non-genetic and genetic predictors of a superficial first basal cell carcinoma. J Eur Acad Dermatol Venereol 2019; 33:533-540. [PMID: 30520188 PMCID: PMC6593991 DOI: 10.1111/jdv.15389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 11/09/2018] [Indexed: 01/08/2023]
Abstract
Background Several observational studies have suggested differences in the risk factor profile between patients with superficial basal cell carcinomas (BCCs) and non‐superficial BCCs. Objective To test the reproducibility of previous study findings and to find new genetic and non‐genetic predictors for patients with a superficial first BCC. Methods A total of 14.628 participants of northwestern European descent aged 45 years or older from a prospective population‐based cohort study (Rotterdam Study) were linked with the Dutch Pathology Registry (PALGA) of whom 1528 were identified as BCC patients. After exclusion, 948 eligible BCC patients remained for further non‐genetic analyses and 1014 for genetic analyses. We included 11 phenotypic, environmental and tumour‐specific characteristics, and 20 candidate single nucleotide polymorphisms (SNP) as potential predictors for patients with a superficial first BCC. We performed binary logistic multivariable regression analyses. Results We found that patients with a superficial first BCC were significantly younger, almost two times more often female and 12–18 times more likely to have their BCC on the trunk or extremities than patients with a non‐superficial first BCC. One SNP (rs12203592), mapped to IRF4, looked promising (OR 1.83, 95% CI 1.13–2.97, P‐value <0.05), but after adjustment for multiple testing, no significant differences in genetic make‐up between superficial BCC and non‐superficial BCC patients were found. Conclusion We conclude that patients with a superficial BCC differ from non‐superficial BCC patients with respect to environmental factors (tumour localization as a proxy for UVR exposure) and phenotypic characteristics (age and sex), but we found no difference in genotype. As superficial BCC patients develop their first BCCs at a younger age, they could be at higher lifetime risk for subsequent skin cancers and therefore be an important group for secondary prevention. Linked article: This article is commented on G. Argenziano et. al., p. 461 in this issue. To view this article visit
https://doi.org/10.1111/jdv.15486.
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Affiliation(s)
- J A C Verkouteren
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - L M Pardo
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - A G Uitterlinden
- Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - T Nijsten
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
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12
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Voiculescu VM, Lisievici CV, Lupu M, Vajaitu C, Draghici CC, Popa AV, Solomon I, Sebe TI, Constantin MM, Caruntu C. Mediators of Inflammation in Topical Therapy of Skin Cancers. Mediators Inflamm 2019; 2019:8369690. [PMID: 30766448 PMCID: PMC6350587 DOI: 10.1155/2019/8369690] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 09/28/2018] [Accepted: 11/26/2018] [Indexed: 12/24/2022] Open
Abstract
Taking into consideration that the immune system plays a very important role in the development of melanoma and non-melanoma skin cancers, which have a high prevalence in immunosuppressed patients and after prolonged ultraviolet radiation, the interest in developing novel therapies, in particular targeting the inflammation in cancer, has increased in the past years. The latest data suggest that therapies such as imiquimod (IMQ), ingenol mebutate (IM), 5-fluorouracil (5-FU), retinoids, and nonsteroidal anti-inflammatory drugs (NSAIDs) have been used with success in the topical treatment of some cancers. Herein, we review the topical treatment targeting the inflammation in skin cancer and the mechanisms involved in these processes. Currently, various associations have shown a superior success rate than monotherapy, such as systemic acitretin and topical IMQ, topical 5-FU with tretinoin cream, or IMQ with checkpoint inhibitor cytotoxic T lymphocyte antigen 4. Novel therapies targeting Toll-like receptor-7 (TLR-7) with higher selectivity than IMQ are also of great interest.
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Affiliation(s)
- Vlad Mihai Voiculescu
- Department of Dermatology, “ELIAS” University Emergency Hospital, Bucharest, Romania
- Carol Davila University of Medicine and Pharmacy Bucharest, Romania, Bucharest, Romania
| | | | - Mihai Lupu
- Carol Davila University of Medicine and Pharmacy Bucharest, Romania, Bucharest, Romania
- Dermatology Clinic, MedAs Medical Center, Bucharest, Romania
| | - Cristina Vajaitu
- Department of Dermatology, “ELIAS” University Emergency Hospital, Bucharest, Romania
| | | | | | - Iulia Solomon
- Department of Dermatology, “ELIAS” University Emergency Hospital, Bucharest, Romania
| | - Teona Ioana Sebe
- Carol Davila University of Medicine and Pharmacy Bucharest, Romania, Bucharest, Romania
- The Clinic of Plastic Surgery Reconstructive Microsurgery, Emergency Hospital Bucharest, Romania
| | - Maria Magdalena Constantin
- Carol Davila University of Medicine and Pharmacy Bucharest, Romania, Bucharest, Romania
- 2nd Department of Dermatology, “Colentina” Clinical Hospital, Bucharest, Romania
| | - Constantin Caruntu
- Carol Davila University of Medicine and Pharmacy Bucharest, Romania, Bucharest, Romania
- Department of Dermatology, Prof. “N Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, Bucharest, Romania
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13
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Gandini S, Palli D, Spadola G, Bendinelli B, Cocorocchio E, Stanganelli I, Miligi L, Masala G, Caini S. Anti-hypertensive drugs and skin cancer risk: a review of the literature and meta-analysis. Crit Rev Oncol Hematol 2018; 122:1-9. [PMID: 29458778 DOI: 10.1016/j.critrevonc.2017.12.003] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 10/04/2017] [Accepted: 12/06/2017] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Several anti-hypertensive drugs have photosensitizing properties, however it remains unclear whether long-term users of these drugs are also at increased risk of skin malignancies. We conducted a literature review and meta-analysis on the association between use of anti-hypertensive drugs and the risk of cutaneous melanoma and non-melanoma skin cancer (NMSC). METHODS We searched PubMed, EMBASE, Google Scholar and the Cochrane Library, and included observational and experimental epidemiological studies published until February 28th, 2017. We calculated summary relative risk (SRR) and 95% confidence intervals (95% CI) through random effect models to estimate the risk of skin malignancies among users of the following classes of anti-hypertensive drugs: thiazide diuretics, angiotensin converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB), calcium channel blockers (CCB) and β-blockers. We conducted sub-group and sensitivity analysis to explore causes of between-studies heterogeneity, and assessed publication bias using a funnel-plot based approach. RESULTS Nineteen independent studies were included in the meta-analysis. CCB users were at increased skin cancer risk (SRR 1.14, 95% CI 1.07-1.21), and β-blockers users were at increased risk of developing cutaneous melanoma (SRR 1.21, 95% CI 1.05-1.40), with acceptable between-studies heterogeneity (I2 < 50%). There was no association between thiazide diuretics, ACEi or ARB use and skin cancer risk. We found no evidence of publication bias affecting the results. CONCLUSION Family doctors and clinicians should inform their patients about the increased risk of skin cancer associated with the use of CCB and β-blockers and instruct them to perform periodic skin self-examination. Further studies are warranted to elucidate the observed associations.
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Affiliation(s)
- Sara Gandini
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
| | - Domenico Palli
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - Giuseppe Spadola
- Division of Melanoma and Muscolo-Cutaneous Sarcoma, European Institute of Oncology, Milan, Italy
| | - Benedetta Bendinelli
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - Emilia Cocorocchio
- Division of Melanoma and Muscolo-Cutaneous Sarcoma, European Institute of Oncology, Milan, Italy
| | - Ignazio Stanganelli
- Skin Cancer Unit, IRCCS-IRST Scientific Institute of Romagna for the Study and Treatment of Cancer, Meldola, Italy
| | - Lucia Miligi
- Environmental and Occupational Epidemiology Branch, Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - Giovanna Masala
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - Saverio Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy.
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14
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Schmitt J, Haufe E, Trautmann F, Schulze HJ, Elsner P, Drexler H, Bauer A, Letzel S, John S, Fartasch M, Brüning T, Seidler A, Dugas-Breit S, Gina M, Weistenhöfer W, Bachmann K, Bruhn I, Lang B, Bonness S, Allam J, Grobe W, Stange T, Westerhausen S, Knuschke P, Wittlich M, Diepgen T. Is ultraviolet exposure acquired at work the most important risk factor for cutaneous squamous cell carcinoma? Results of the population-based case-control study FB-181. Br J Dermatol 2018; 178:462-472. [DOI: 10.1111/bjd.15906] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2017] [Indexed: 12/24/2022]
Affiliation(s)
- J. Schmitt
- Center of Evidence-based Healthcare; Medical Faculty Carl Gustav Carus; University Hospital; Technical University Dresden; Germany
- Institute and Outpatient Clinics of Occupational and Social Medicine; Medical Faculty Carl Gustav Carus; Technical University Dresden; Germany
| | - E. Haufe
- Center of Evidence-based Healthcare; Medical Faculty Carl Gustav Carus; University Hospital; Technical University Dresden; Germany
- Institute and Outpatient Clinics of Occupational and Social Medicine; Medical Faculty Carl Gustav Carus; Technical University Dresden; Germany
| | - F. Trautmann
- Center of Evidence-based Healthcare; Medical Faculty Carl Gustav Carus; University Hospital; Technical University Dresden; Germany
| | - H.-J. Schulze
- Department of Dermatology; Dermatological Radiotherapy and Dermatohistopathology; Special Clinics Hornheide; Münster Germany
| | - P. Elsner
- Department of Dermatology; University Hospital Jena; Jena Germany
| | - H. Drexler
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine; Friedrich-Alexander-University Erlangen-Nuernberg; Nuernberg Germany
| | - A. Bauer
- Department of Dermatology - University Allergy Center; Medical Faculty Carl Gustav Carus; Technical University Dresden; Germany
| | - S. Letzel
- Institute of Occupational, Social and Environmental Medicine; Johannes-Gutenberg University Mainz; Mainz Germany
| | - S.M. John
- Department of Dermatology; Environmental Health and Health Theory; University of Osnabrueck; Osnabrueck Germany
- Institute of Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm); University of Osnabrück; Osnabrück Germany
| | - M. Fartasch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (DGUV); Institute of Ruhr-University Bochum (IPA); Bochum Germany
| | - T. Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (DGUV); Institute of Ruhr-University Bochum (IPA); Bochum Germany
| | - A. Seidler
- Institute and Outpatient Clinics of Occupational and Social Medicine; Medical Faculty Carl Gustav Carus; Technical University Dresden; Germany
| | - S. Dugas-Breit
- Department of Dermatology; Dermatological Radiotherapy and Dermatohistopathology; Special Clinics Hornheide; Münster Germany
| | - M. Gina
- Department of Dermatology; University Hospital Jena; Jena Germany
| | - W. Weistenhöfer
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine; Friedrich-Alexander-University Erlangen-Nuernberg; Nuernberg Germany
| | - K. Bachmann
- Department of Clinical Social Medicine; Occupational and Environmental Dermatology; University of Heidelberg; Heidelberg Germany
| | - I. Bruhn
- Department of Dermatology - University Allergy Center; Medical Faculty Carl Gustav Carus; Technical University Dresden; Germany
| | - B.M. Lang
- Department of Dermatology; University Medical Center; Johannes-Gutenberg University Mainz; Germany
| | - S. Bonness
- Institute of Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm); University of Osnabrück; Osnabrück Germany
- Employer's Liability Insurance Association Clinics Hamburg; Hamburg Germany
| | - J.P. Allam
- Department of Dermatology and Allergy; University Bonn; Bonn Germany
| | - W. Grobe
- Department of Dermatology and Allergy; University Bonn; Bonn Germany
| | - T. Stange
- Center of Evidence-based Healthcare; Medical Faculty Carl Gustav Carus; University Hospital; Technical University Dresden; Germany
| | - S. Westerhausen
- Department of Radiation; Institute of Occupational Health and Safety of the German Social Accident Insurance (DGUV); Sankt Augustin Germany
| | - P. Knuschke
- Department of Dermatology - Experimental Photobiology; University Hospital and Medical Faculty Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - M. Wittlich
- Department of Radiation; Institute of Occupational Health and Safety of the German Social Accident Insurance (DGUV); Sankt Augustin Germany
| | - T.L. Diepgen
- Department of Clinical Social Medicine; Occupational and Environmental Dermatology; University of Heidelberg; Heidelberg Germany
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15
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Smedinga H, Verkouteren JAC, Steyerberg EW, Hofman A, Nijsten T, Vergouwe Y. Occurrence of metachronous basal cell carcinomas: a prognostic model. Br J Dermatol 2017; 177:1113-1121. [PMID: 28664573 DOI: 10.1111/bjd.15771] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND A third of patients with a first basal cell carcinoma (BCC) will develop subsequent (metachronous) BCCs. OBJECTIVES To study the prognostic effect of the number of previous BCC diagnosis dates a patient has experienced to derive a prediction model to assess the risk of metachronous BCCs that may inform individualized decision making on surveillance. METHODS We considered participants of north-western European ancestry from a prospective population-based cohort study (Rotterdam Study). After linkage with the Dutch Pathology Registry, 1077 patients with a first BCC were included. Candidate predictors for metachronous BCCs included patient, lifestyle and tumour characteristics. The prognostic model was developed with Fine and Gray regression analysis to account for competing risk of death. We used bootstrapping to correct for within-patient correlation and statistical optimism in predictive performance. RESULTS Second to fifth BCCs occurred in 293, 122, 58 and 36 patients, with median follow-up times of 3·0, 2·1, 1·7 and 1·8 years after the previous BCC, respectively. The risk of a new BCC was higher for patients with more metachronous BCCs. Having more than one BCC at diagnosis was another strong predictor of metachronous BCCs. Discriminative ability of the model was reasonable with an optimism-corrected c-index of 0·70 at 3 years. CONCLUSIONS The number of previous BCC diagnosis dates was a strong prognostic factor and should be considered when predicting the risk of metachronous BCCs. When the number of previous BCC diagnosis dates is combined with other readily available characteristics into a prognostic model, patients at high risk of a new BCC can be identified.
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Affiliation(s)
- H Smedinga
- Department of Public Health, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - J A C Verkouteren
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - E W Steyerberg
- Department of Public Health, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - A Hofman
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - T Nijsten
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Y Vergouwe
- Department of Public Health, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
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16
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Sanders M, Pardo L, Verkouteren J, Hamann S, Hamer M, Nijsten T. Dermatological screening of a middle-aged and elderly population: the Rotterdam Study. Br J Dermatol 2017; 177:e98-e100. [DOI: 10.1111/bjd.15359] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- M.G.H. Sanders
- Department of Dermatology; Erasmus Medical Center; Rotterdam the Netherlands
| | - L.M. Pardo
- Department of Dermatology; Erasmus Medical Center; Rotterdam the Netherlands
| | - J.A.C. Verkouteren
- Department of Dermatology; Erasmus Medical Center; Rotterdam the Netherlands
| | - S.A.S. Hamann
- Department of Dermatology; Erasmus Medical Center; Rotterdam the Netherlands
| | - M.A. Hamer
- Department of Dermatology; Erasmus Medical Center; Rotterdam the Netherlands
| | - T. Nijsten
- Department of Dermatology; Erasmus Medical Center; Rotterdam the Netherlands
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17
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Williams HC, Bath-Hextall F, Ozolins M, Armstrong SJ, Colver GB, Perkins W, Miller PS. Surgery Versus 5% Imiquimod for Nodular and Superficial Basal Cell Carcinoma: 5-Year Results of the SINS Randomized Controlled Trial. J Invest Dermatol 2017; 137:614-619. [DOI: 10.1016/j.jid.2016.10.019] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 09/27/2016] [Accepted: 10/06/2016] [Indexed: 01/21/2023]
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18
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Verkouteren J, Ramdas K, Wakkee M, Nijsten T. Epidemiology of basal cell carcinoma: scholarly review. Br J Dermatol 2017; 177:359-372. [DOI: 10.1111/bjd.15321] [Citation(s) in RCA: 133] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2016] [Indexed: 12/21/2022]
Affiliation(s)
- J.A.C. Verkouteren
- Department of Dermatology; Erasmus MC Cancer Institute; Burgemeester s'Jacobplein 51 3015 CA Rotterdam the Netherlands
| | - K.H.R. Ramdas
- Department of Dermatology; Erasmus MC Cancer Institute; Burgemeester s'Jacobplein 51 3015 CA Rotterdam the Netherlands
| | - M. Wakkee
- Department of Dermatology; Erasmus MC Cancer Institute; Burgemeester s'Jacobplein 51 3015 CA Rotterdam the Netherlands
| | - T. Nijsten
- Department of Dermatology; Erasmus MC Cancer Institute; Burgemeester s'Jacobplein 51 3015 CA Rotterdam the Netherlands
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19
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Waalboer-Spuij R, Hollestein LM, van de Poll-Franse LV, Nijsten TEC. Histological diagnosis of basal cell carcinoma is not associated with life expectancy in elderly Dutch people: a population-based cohort study. Br J Dermatol 2017; 177:e88-e89. [PMID: 28112793 DOI: 10.1111/bjd.15310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- R Waalboer-Spuij
- Department of Dermatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.,Department of Dermatology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - L M Hollestein
- Department of Dermatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.,Netherlands Comprehensive Cancer Organization (IKNL), Netherlands Cancer Registry, Eindhoven, The Netherlands
| | - L V van de Poll-Franse
- Netherlands Comprehensive Cancer Organization (IKNL), Netherlands Cancer Registry, Eindhoven, The Netherlands.,CoRPS - Centre of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - T E C Nijsten
- Department of Dermatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
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20
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Pardo LM, Li WQ, Hwang SJ, Verkouteren JAC, Hofman A, Uitterlinden AG, Kraft P, Turman C, Han J, Cho E, Murabito JM, Levy D, Qureshi AA, Nijsten T. Genome-Wide Association Studies of Multiple Keratinocyte Cancers. PLoS One 2017; 12:e0169873. [PMID: 28081215 PMCID: PMC5231365 DOI: 10.1371/journal.pone.0169873] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 12/22/2016] [Indexed: 11/18/2022] Open
Abstract
There is strong evidence for a role of environmental risk factors involved in susceptibility to develop multiple keratinocyte cancers (mKCs), but whether genes are also involved in mKCs susceptibility has not been thoroughly investigated. We investigated whether single nucleotide polymorphisms (SNPs) are associated with susceptibility for mKCs. A genome-wide association study (GWAS) of 1,666 cases with mKCs and 1,950 cases with single KC (sKCs; controls) from Harvard cohorts (the Nurses' Health Study [NHS], NHS II, and the Health Professionals Follow-Up Study) and the Framingham Heart Study was carried-out using over 8 million SNPs (stage-1). We sought to replicate the most significant statistical associations (p-value≤ 5.5x10-6) in an independent cohort of 574 mKCs and 872 sKCs from the Rotterdam Study. In the discovery stage, 40 SNPs with suggestive associations (p-value ≤5.5x10-6) were identified, with eight independent SNPs tagging all 40 SNPs. The most significant SNP was located at chromosome 9 (rs7468390; p-value = 3.92x10-7). In stage-2, none of these SNPs replicated and only two of them were associated with mKCs in the same direction in the combined meta-analysis. We tested the associations for 19 previously reported basal cell carcinoma-related SNPs (candidate gene association analysis), and found that rs1805007 (MC1R locus) was significantly associated with risk of mKCs (p-value = 2.80x10-4). Although the suggestive SNPs with susceptibility for mKCs were not replicated, we found that previously identified BCC variants may also be associated with mKC, which the most significant association (rs1805007) located at the MC1R gene.
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Affiliation(s)
- Luba M. Pardo
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Wen-Qing Li
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence Rhode Island, United State of America
- Department of Epidemiology, School of Public Health, Brown University, Rhode Island, United State of America
| | - Shih-Jen Hwang
- National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, United State of America
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institute of Health, Bethesda Maryland MD United State of America
| | | | - Albert Hofman
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United State of America
| | - André G. Uitterlinden
- Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Peter Kraft
- Program in Genetic Epidemiology and Statistical Genetics, Harvard School of Public Health, Boston, MA, United State of America
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United State of America
| | - Constance Turman
- Program in Genetic Epidemiology and Statistical Genetics, Harvard School of Public Health, Boston, MA, United State of America
| | - Jiali Han
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United State of America
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, United State of America
- Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, IN, United State of America
| | - Eunyoung Cho
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence Rhode Island, United State of America
- Department of Epidemiology, School of Public Health, Brown University, Rhode Island, United State of America
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United State of America
| | - Joanne M. Murabito
- National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, United State of America
- Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, United State of America
| | - Daniel Levy
- National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, United State of America
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institute of Health, Bethesda Maryland MD United State of America
| | - Abrar A. Qureshi
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence Rhode Island, United State of America
- Department of Epidemiology, School of Public Health, Brown University, Rhode Island, United State of America
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United State of America
- * E-mail: (TN); (AAQ)
| | - Tamar Nijsten
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
- * E-mail: (TN); (AAQ)
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21
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Verkouteren JA, Smedinga H, Steyerberg EW, Hofman A, Nijsten T. Predicting the Risk of a Second Basal Cell Carcinoma. J Invest Dermatol 2015; 135:2649-2656. [DOI: 10.1038/jid.2015.244] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 05/29/2015] [Accepted: 06/13/2015] [Indexed: 12/31/2022]
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Verkouteren JA, Pardo LM, Uitterlinden AG, Hofman A, Nijsten T. Common Variants Affecting Susceptibility to Develop Multiple Basal Cell Carcinomas. J Invest Dermatol 2015; 135:2135-2138. [DOI: 10.1038/jid.2015.113] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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