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Olsen CM, Pandeya N, Neale RE, Law MH, Whiteman DC. Phenotypic and genotypic risk factors for invasive melanoma by sex and body site. Br J Dermatol 2024:ljae297. [PMID: 39026389 DOI: 10.1093/bjd/ljae297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 07/09/2024] [Accepted: 07/18/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Cutaneous melanoma incidence varies consistently across body sites between men and women, but the underlying causes of the differences remain unclear. To date, no prospective studies have examined risk factors for melanoma separately for men and women according to body site. METHODS We compared the association between constitutional, genetic and environmental risk factors for invasive melanoma on different body sites separately for men and women in a population-based prospective cohort study of 17,774 men and 21,070 women aged between 40 and 69 years and residents of Queensland, Australia at baseline in 2011. Participants were followed until December 2021.We examined risk factors including hair colour, tanning ability, naevus density, and proxies for high cumulative sun exposure, all self-reported at baseline. We also examined polygenic risk score (PRS) derived from summary statistics from a melanoma genome-wide association study meta-analysis. RESULTS During a median 10.4 years of follow-up, 455 men and 331 women developed an incident invasive melanoma; the mean age at diagnosis was lower in women than in men (62.6 vs. 65.0, respectively). The most common body site was the trunk in men (45.1%), and the upper (36.8%) and lower limbs (27.4%) in women. High naevus density and proxy measures of high cumulative sun exposure were similarly associated with melanoma at all sites in men and women. In both sexes, high genetic risk was associated with melanoma on all body sites except the head and neck. We observed differences between men and women in the association between PRS and melanoma of the trunk (highest vs. lowest tertile of PRS: HR 2.78, 95% CI 1.64-4.69 for men; 1.55, 95% CI 0.63-3.80 for women), and non-significant but large differences for the lower limbs (HR 5.25, 95% CI 1.80-15.27 for men; 1.75, 95% CI 0.88-3.47 for women). CONCLUSIONS While there are a number of potential explanations for these findings, this raises the possibility that genetic factors other than those related to pigmentation and naevus phenotypes may play a role in the predilection for melanoma to arise on different sites between the sexes.
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Affiliation(s)
- Catherine M Olsen
- Department of Population Health, QIMR Berghofer Medical Research Institute, Queensland, Australia
- Faculty of Medicine, University of Queensland, Queensland, Australia
| | - Nirmala Pandeya
- Department of Population Health, QIMR Berghofer Medical Research Institute, Queensland, Australia
- Faculty of Medicine, University of Queensland, Queensland, Australia
| | - Rachel E Neale
- Department of Population Health, QIMR Berghofer Medical Research Institute, Queensland, Australia
- Faculty of Medicine, University of Queensland, Queensland, Australia
| | - Matthew H Law
- Department of Population Health, QIMR Berghofer Medical Research Institute, Queensland, Australia
- Faculty of Medicine, University of Queensland, Queensland, Australia
- School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - David C Whiteman
- Department of Population Health, QIMR Berghofer Medical Research Institute, Queensland, Australia
- Faculty of Medicine, University of Queensland, Queensland, Australia
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Neale RE, Beedle V, Ebeling PR, Elliott T, Francis D, Girgis CM, Gordon L, Janda M, Jones G, Lucas RM, Mason RS, Monnington PK, Morahan J, Paxton G, Sinclair C, Shumack S, Smith J, Webb AR, Whiteman DC. Balancing the risks and benefits of sun exposure: A revised position statement for Australian adults. Aust N Z J Public Health 2024; 48:100117. [PMID: 38350754 DOI: 10.1016/j.anzjph.2023.100117] [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: 09/03/2023] [Revised: 11/11/2023] [Accepted: 11/21/2023] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE To describe the development of a new position statement regarding balancing the risks and benefits of sun exposure for Australian adults. METHODS We conducted a Sun Exposure Summit in March 2021, with presentations from invited experts and a workshop including representation from academic, clinical, policy, and patient stakeholder organisations. The group considered advice about balancing the risks and benefits of sun exposure for Australian adults and developed a revised consensus position statement. RESULTS The balance of risks and benefits of sun exposure is not the same for everybody. For people at very high risk of skin cancer, the risks of exposure likely outweigh the benefits; sun protection is essential. Conversely, people with deeply pigmented skin are at low risk of skin cancer but at high risk of vitamin D deficiency; routine sun protection is not recommended. For those at intermediate risk of skin cancer, sun protection remains a priority, but individuals may obtain sufficient sun exposure to maintain adequate vitamin D status. CONCLUSIONS The new position statement provides sun exposure advice that explicitly recognises the differing needs of Australia's diverse population. IMPLICATIONS FOR PUBLIC HEALTH Mass communication campaigns should retain the focus on skin cancer prevention. The new position statement will support the delivery of personalised advice.
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Affiliation(s)
- Rachel E Neale
- QIMR Berghofer Medical Research Institute, Brisbane, Australia; University of Queensland, Brisbane, Australia.
| | | | - Peter R Ebeling
- Monash University, Melbourne, Australia; Healthy Bones Australia, Australia
| | - Thomas Elliott
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | - Christian M Girgis
- University of Sydney, Sydney, Australia; Australa and New Zealand Bone and Mineral Society, Australia
| | - Louisa Gordon
- QIMR Berghofer Medical Research Institute, Brisbane, Australia; University of Queensland, Brisbane, Australia
| | | | - Graeme Jones
- Australa and New Zealand Bone and Mineral Society, Australia; University of Tasmania, Hobart, Australia
| | | | - Rebecca S Mason
- University of Sydney, Sydney, Australia; Healthy Bones Australia, Australia
| | | | | | | | | | | | - Jane Smith
- Royal Australian College of General Practitioners, Australia
| | - Ann R Webb
- University of Manchester, Manchester, United Kingdom
| | - David C Whiteman
- QIMR Berghofer Medical Research Institute, Brisbane, Australia; University of Queensland, Brisbane, Australia
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Wang S, Chen J, Jin Z, Xing Y, Wang R. Natural hair color and skin cancers: A two-sample Mendelian randomization study. Gene 2024; 893:147940. [PMID: 37907182 DOI: 10.1016/j.gene.2023.147940] [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: 09/12/2023] [Revised: 10/16/2023] [Accepted: 10/27/2023] [Indexed: 11/02/2023]
Abstract
Previous observational studies have indicated an association between hair color and the risk of melanoma and keratinocyte skin cancer (KSC); however, different hair colors show inconsistent effects on skin cancers. Here, we conducted a two-sample Mendelian randomization (MR) study to evaluate the causal relationship between natural hair color and skin cancers by using 211 single nucleotide polymorphisms as genetic instruments from a genome-wide meta-analysis of 360,270 individuals of European ancestry. Light hair colors (red, blonde, and light brown) were associated with high levels of cutaneous melanoma (CM) and KSC (CM-inverse variance weighted [IVW] odds ratio [OR]-red: 1.034, 95% confidence interval [CI]: 1.025-1.044, P < 0.001; OR-blonde: 1.008, 95% CI: 1.003-1.014, P = 0.003; OR-light brown: 1.006, 95% CI: 1.002-1.011, P = 0.009; KSC-IVW OR-red: 1.078, 95% CI: 1.053-1.103, P < 0.001; OR-blonde: 1.024, 95% CI: 1.009-1.040, P = 0.002; OR-light brown: 1.018, 95% CI: 1.004-1.033, P = 0.01). However, dark brown hair showed an inverse causal relationship with skin cancers (CM IVW OR: 0.987, 95% CI: 0.984-0.990, P < 0.001; KSC IVW OR: 0.979, 95% CI: 0.970-0.988, P < 0.001). Black hair was associated with a decreased risk of KSC (IVW OR: 0.954, 95% CI: 0.913-0.997, P = 0.036) but showed no causal relationship with CM. The present study provides strong MR evidence of a causal association between hair color and skin cancer. Secondary MR analyses enhances result robustness by replicating findings, exploring gender-specific effects, and providing a more comprehensive understanding of the complex relationship between hair color and skin cancers. More large-scale MR studies or randomized controlled trials are required to further investigate the mechanisms of the association between hair color and skin cancers.
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Affiliation(s)
- Shiting Wang
- Nanjing University of Chinese Medicine, Nanjing, China; Department of Oncology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
| | - Jiaqi Chen
- Nanjing University of Chinese Medicine, Nanjing, China; Department of Oncology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
| | - Zhichao Jin
- Department of Oncology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
| | - Ying Xing
- Nanjing University of Chinese Medicine, Nanjing, China; Department of Oncology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
| | - Ruiping Wang
- Department of Oncology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
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Ingold N, Zhu G, Duffy DL, Mothershaw A, Martin NG, MacGregor S, Law MH. Counting nevi on the outer arm provides an accurate and feasible alternative to total body nevus count. J Eur Acad Dermatol Venereol 2023; 37:e1302-e1304. [PMID: 37328921 PMCID: PMC10615689 DOI: 10.1111/jdv.19279] [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: 02/21/2023] [Accepted: 06/12/2023] [Indexed: 06/18/2023]
Affiliation(s)
- N Ingold
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - G Zhu
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - D L Duffy
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - A Mothershaw
- Frazer Institute, University of Queensland, Dermatology Research Centre, Brisbane, Queensland, Australia
| | - N G Martin
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - S MacGregor
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - M H Law
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
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Wong CK, Dite GS, Spaeth E, Murphy NM, Allman R. Melanoma risk prediction based on a polygenic risk score and clinical risk factors. Melanoma Res 2023; 33:293-299. [PMID: 37096571 PMCID: PMC10309112 DOI: 10.1097/cmr.0000000000000896] [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: 12/28/2022] [Accepted: 03/30/2023] [Indexed: 04/26/2023]
Abstract
Melanoma is one of the most commonly diagnosed cancers in the Western world: third in Australia, fifth in the USA and sixth in the European Union. Predicting an individual's personal risk of developing melanoma may aid them in undertaking effective risk reduction measures. The objective of this study was to use the UK Biobank to predict the 10-year risk of melanoma using a newly developed polygenic risk score (PRS) and an existing clinical risk model. We developed the PRS using a matched case-control training dataset ( N = 16 434) in which age and sex were controlled by design. The combined risk score was developed using a cohort development dataset ( N = 54 799) and its performance was tested using a cohort testing dataset ( N = 54 798). Our PRS comprises 68 single-nucleotide polymorphisms and had an area under the receiver operating characteristic curve of 0.639 [95% confidence interval (CI) = 0.618-0.661]. In the cohort testing data, the hazard ratio per SD of the combined risk score was 1.332 (95% CI = 1.263-1.406). Harrell's C-index was 0.685 (95% CI = 0.654-0.715). Overall, the standardized incidence ratio was 1.193 (95% CI = 1.067-1.335). By combining a PRS and a clinical risk score, we have developed a risk prediction model that performs well in terms of discrimination and calibration. At an individual level, information on the 10-year risk of melanoma can motivate people to take risk-reduction action. At the population level, risk stratification can allow more effective population-level screening strategies to be implemented.
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Affiliation(s)
| | | | - Erika Spaeth
- Phenogen Sciences Inc., Charlotte, North Carolina, USA
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Olsen CM, Pandeya N, Dusingize JC, Neale RE, MacGregor S, Law MH, Whiteman DC. Risk Factors Associated With First and Second Primary Melanomas in a High-Incidence Population. JAMA Dermatol 2023; 159:37-46. [PMID: 36416830 PMCID: PMC9685542 DOI: 10.1001/jamadermatol.2022.4975] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/23/2022] [Indexed: 11/24/2022]
Abstract
Importance An increasing number of people develop more than 1 primary melanoma, yet to date, no population-based prospective cohort studies have reported on risk factors for developing first vs second primary melanomas. Objective To compare the clinical characteristics of first and second melanomas and then to estimate the relative risks of developing 1 vs multiple melanomas associated with demographic, phenotypic, sun exposure, and genetic factors. Design, Setting, and Participants This population-based prospective cohort study included men and women aged 40 to 69 years recruited in 2011 and followed up until December 2018 in Queensland, Australia. Data analysis was performed from February to July 2022. Exposures Self-reported information about demographic, phenotypic, and sun exposure measures captured using a survey completed at baseline, and polygenic risk score for melanoma. Main Outcomes and Measures Incident first or second primary melanoma diagnosis, and histologic and clinical characteristics thereof. The Wei-Lin-Weissfeld model for recurrent events was used to estimate the association of each factor with the risks of first and second primary melanoma. Results A total of 38 845 patients (mean [SD] age at baseline, 56.1 [8.2] years; 17 775 men and 21 070 women) were included in the study. During a median follow-up period of 7.4 years, 1212 (3.1%) participants had a single primary melanoma diagnosis, and 245 (0.6%) had a second primary melanoma diagnosis. Second melanomas were more likely than first melanomas to be in situ; for invasive tumors, second melanomas were more likely to be thin (ie, ≤1 mm) than first melanomas. Having many moles at age 21 years (self-reported using visual scoring tool) was more strongly associated with second (hazard ratio [HR], 6.36; 95% CI, 3.77-10.75) than first primary melanoma (HR, 3.46; 95% CI, 2.72-4.40) (P value for difference between the HRs = .01). A high genetic predisposition (ie, polygenic risk score in tertile 3) was also more strongly associated with second (HR, 3.28; 95% CI, 2.06-5.23) than first melanoma (HR, 2.06; 95% CI, 1.71-2.49; P = .03). Second melanomas were more strongly associated with a history of multiple skin cancer excisions (HR, 2.63; 95% CI, 1.80-3.83) than first melanomas (HR, 1.86; 95% CI, 1.61-2.16; P = .05). For all other phenotypic characteristics and sun exposure measures, similarly elevated associations with first vs second melanomas were observed. Conclusions and Relevance Findings of this cohort study suggest that within the general population, the presence of many nevi and having a high genetic predisposition to melanoma were associated with the highest risks of developing second primary melanomas.
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Affiliation(s)
- Catherine M. Olsen
- Departments of Population Health and Computational Biology, QIMR Berghofer Medical Research Institute, Queensland, Australia
- Faculty of Medicine, University of Queensland, Queensland, Australia
| | - Nirmala Pandeya
- Departments of Population Health and Computational Biology, QIMR Berghofer Medical Research Institute, Queensland, Australia
- Faculty of Medicine, University of Queensland, Queensland, Australia
| | - Jean Claude Dusingize
- Departments of Population Health and Computational Biology, QIMR Berghofer Medical Research Institute, Queensland, Australia
| | - Rachel E. Neale
- Departments of Population Health and Computational Biology, QIMR Berghofer Medical Research Institute, Queensland, Australia
- Faculty of Medicine, University of Queensland, Queensland, Australia
| | - Stuart MacGregor
- Departments of Population Health and Computational Biology, QIMR Berghofer Medical Research Institute, Queensland, Australia
| | - Matthew H. Law
- Departments of Population Health and Computational Biology, QIMR Berghofer Medical Research Institute, Queensland, Australia
- Faculty of Health, Queensland University of Technology, Queensland, Australia
- School of Biomedical Sciences, University of Queensland, Queensland, Australia
| | - David C. Whiteman
- Departments of Population Health and Computational Biology, QIMR Berghofer Medical Research Institute, Queensland, Australia
- Faculty of Medicine, University of Queensland, Queensland, Australia
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Sanjida S, Betz-Stablein B, Atkinson V, Janda M, Barsoum R, Edwards HA, Chiu F, Tran MC, Soyer HP, Schaider H. In-Depth Characterisation of Real-World Advanced Melanoma Patients Receiving Immunotherapies and/or Targeted Therapies: A Case Series. Cancers (Basel) 2022; 14:cancers14112801. [PMID: 35681781 PMCID: PMC9179437 DOI: 10.3390/cancers14112801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 06/02/2022] [Indexed: 12/04/2022] Open
Abstract
Immunotherapies and targeted therapies have shown significant benefits for melanoma survival in the clinical trial setting. Much less is known about the characteristics and associated outcomes of those receiving such therapies in real-world settings. This study describes the characteristics of patients with advanced melanoma receiving immuno- and/or targeted therapies in a real-world setting. This prospective cohort study enrolled participants aged >18 years, diagnosed with advanced melanoma and currently undergoing immuno- and/or targeted therapies outside a clinical trial for follow-up with three-dimensional (3D) total-body imaging. Participants (n = 41) had a mean age of 62 years (range 29−86), 26 (63%) were male and the majority (n = 26, 63%) had ≥2 comorbidities. After a median of 39 months (range 1−52) follow-up, 59% (n = 24/41) of participants were alive. Despite multiple co-morbidities, the survival of participants with advanced melanoma treated using immuno- and/or targeted therapies was similar or better in our real-world setting compared to those treated in clinical trials using similar therapies. Larger studies powered to evaluate phenotypic and socio-economic characteristics, as well as specific comorbidities associated with survival in a real-world setting, are required to help determine those who will most benefit from immuno- and/or targeted therapies.
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Affiliation(s)
- Saira Sanjida
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Woolloongabba, QLD 4102, Australia; (S.S.); (M.J.)
- The University of Queensland Diamantina Institute, Dermatology Research Centre, The University of Queensland, Woolloongabba, QLD 4102, Australia; (R.B.); (H.A.E.); (F.C.); (M.C.T.); (H.P.S.); (H.S.)
| | - Brigid Betz-Stablein
- The University of Queensland Diamantina Institute, Dermatology Research Centre, The University of Queensland, Woolloongabba, QLD 4102, Australia; (R.B.); (H.A.E.); (F.C.); (M.C.T.); (H.P.S.); (H.S.)
- Correspondence: ; Tel.: +61-7-34437399
| | - Victoria Atkinson
- Cancer Care Services, Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia;
| | - Monika Janda
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Woolloongabba, QLD 4102, Australia; (S.S.); (M.J.)
| | - Ramez Barsoum
- The University of Queensland Diamantina Institute, Dermatology Research Centre, The University of Queensland, Woolloongabba, QLD 4102, Australia; (R.B.); (H.A.E.); (F.C.); (M.C.T.); (H.P.S.); (H.S.)
| | - Harrison Aljian Edwards
- The University of Queensland Diamantina Institute, Dermatology Research Centre, The University of Queensland, Woolloongabba, QLD 4102, Australia; (R.B.); (H.A.E.); (F.C.); (M.C.T.); (H.P.S.); (H.S.)
| | - Frank Chiu
- The University of Queensland Diamantina Institute, Dermatology Research Centre, The University of Queensland, Woolloongabba, QLD 4102, Australia; (R.B.); (H.A.E.); (F.C.); (M.C.T.); (H.P.S.); (H.S.)
| | - My Co Tran
- The University of Queensland Diamantina Institute, Dermatology Research Centre, The University of Queensland, Woolloongabba, QLD 4102, Australia; (R.B.); (H.A.E.); (F.C.); (M.C.T.); (H.P.S.); (H.S.)
| | - H Peter Soyer
- The University of Queensland Diamantina Institute, Dermatology Research Centre, The University of Queensland, Woolloongabba, QLD 4102, Australia; (R.B.); (H.A.E.); (F.C.); (M.C.T.); (H.P.S.); (H.S.)
- Dermatology Department, Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia
| | - Helmut Schaider
- The University of Queensland Diamantina Institute, Dermatology Research Centre, The University of Queensland, Woolloongabba, QLD 4102, Australia; (R.B.); (H.A.E.); (F.C.); (M.C.T.); (H.P.S.); (H.S.)
- Dermatology Department, Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia
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Sargen MR, Tucker MA. Genotypic vs Phenotypic Risk Assessment for Melanoma. J Natl Cancer Inst 2021; 113:1279-1280. [PMID: 33837776 PMCID: PMC11186435 DOI: 10.1093/jnci/djab077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Michael R Sargen
- Affiliations of authors:Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA
| | - Margaret A Tucker
- Affiliations of authors:Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA
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Etiologies of Melanoma Development and Prevention Measures: A Review of the Current Evidence. Cancers (Basel) 2021; 13:cancers13194914. [PMID: 34638397 PMCID: PMC8508267 DOI: 10.3390/cancers13194914] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 12/14/2022] Open
Abstract
Simple Summary Melanoma constitutes a major public health risk, with the rates of diagnosis increasing on a yearly basis. Monitoring for risk factors and preventing dangerous behaviors that increase melanoma risk, such as tanning, are important measures for melanoma prevention. Additionally, assessing the effectiveness of various methods to prevent sun exposure and sunburns—which can lead to melanoma—is important to help identify ways to reduce the development of melanoma. We summarize the recent evidence regarding the heritable and behavioral risks underlying melanoma, as well as the current methods used to reduce the risk of developing melanoma and to improve the diagnosis of this disease. Abstract (1) Melanoma is the most aggressive dermatologic malignancy, with an estimated 106,110 new cases to be diagnosed in 2021. The annual incidence rates continue to climb, which underscores the critical importance of improving the methods to prevent this disease. The interventions to assist with melanoma prevention vary and typically include measures such as UV avoidance and the use of protective clothing, sunscreen, and other chemopreventive agents. However, the evidence is mixed surrounding the use of these and other interventions. This review discusses the heritable etiologies underlying melanoma development before delving into the data surrounding the preventive methods highlighted above. (2) A comprehensive literature review was performed to identify the clinical trials, observational studies, and meta-analyses pertinent to melanoma prevention and incidence. Online resources were queried to identify epidemiologic and clinical trial information. (3) Evidence exists to support population-wide screening programs, the proper use of sunscreen, and community-targeted measures in the prevention of melanoma. Clinical evidence for the majority of the proposed preventive chemotherapeutics is presently minimal but continues to evolve. (4) Further study of these chemotherapeutics, as well as improvement of techniques in artificial intelligence and imaging techniques for melanoma screening, is warranted for continued improvement of melanoma prevention.
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Regional variability of melanoma incidence and prevalence in Hungary. Epidemiological impact of ambient UV radiation and socioeconomic factors. Eur J Cancer Prev 2021; 31:377-384. [PMID: 34545023 DOI: 10.1097/cej.0000000000000716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The incidence of cutaneous melanoma has risen faster than almost any other type of cancer in the last 50 years. Ultraviolet (UV) radiation and genetic susceptibility are the most important risk factors. OBJECTIVE We aimed to determine the epidemiologic indicators of melanoma in Hungary, a country with an estimated population of 9.8 million and an area of 93 030 km2. METHODS Anonymized patient records from the National Health Insurance Fund Management covering the entire population were used to determine the incidence and prevalence of melanoma in the counties of Hungary from 2013 to 2017. Altogether 20 030 melanoma cases were identified for inclusion in this study. RESULTS The prevalence of melanoma increased over the investigated period and was significantly higher among women than men. The incidence of melanoma stagnated during this period and the incidence rate was the highest among the elderly. Interestingly, the incidence was higher in males in the elderly population, while the incidence was higher in females in the younger (<60 years) population. Geographical variations in ambient UV radiation did not show statistically significant correlation with the regional variability of epidemiologic indicators, probably due to small differences in the number of bright sunshine hours per year between regions. Although Hungary is a relatively small country, we observed regional heterogeneity in socioeconomic factors. Notably, a significant and strong negative correlation was found between single-person household rates and melanoma prevalence. CONCLUSION In addition to ambient UV radiation, melanoma incidence and prevalence appear to be related to age, gender and socioeconomic factors.
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Abstract
Variants in the Melanocortin 1 Receptor (MC1R) gene have been associated with an increased risk of melanoma, but the role in nevus count is unclear. We investigated if specific MC1R gene variants or the number of MC1R gene variants and phenotypical features were associated with nevus count. A total of 494 participants of the 'Leiden skin cancer study' were included and the MC1R gene coding sequence was analysed by single-strand conformation polymorphism analysis followed by sequencing of unknown variants. The association between MC1R gene variants and nevus count and the association between age, gender and phenotypical features and nevus count were studied using the Chi-square test. Study of nine frequently occurring MC1R gene variants in participants without skin cancer (n = 203) showed that the 'r' Val60Leu variant was significantly associated with high nevus count (>50 nevi) (P = 0.017). This association was very strong among women (P < 0.001), but not present among men. Having one or two MC1R variants in general did not show a significant difference in the nevus count. Hair colour, skin type, eye colour and age were not significantly associated with nevus count, whereas gender showed a significant association (P = 0.008), with the highest nevus counts in female. The Val60Leu variant of the MC1R gene could be a promising candidate as an independent predictor of high nevus count, particularly in women. This information about the genetic makeup could promote personalized follow-up strategies and might help to prevent skin cancer in the future.
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12
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Karapetyan L, Yang X, Wang H, Sander CA, Moyer A, Wilson M, Karunamurthy A, Kirkwood JM. Indoor tanning exposure in association with multiple primary melanoma. Cancer 2021; 127:560-568. [PMID: 33170961 DOI: 10.1002/cncr.33307] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/17/2020] [Accepted: 10/04/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Patients with primary cutaneous melanoma are at increased risk for subsequent new primary melanomas. Indoor tanning is a recognized risk factor for melanoma. This study was aimed at determining the association between indoor tanning and the occurrence of multiple primary melanoma. METHODS This was a retrospective case-control study of cases with multiple primary melanoma and sex-matched controls with single primary melanoma retrieved at a 1:2 ratio from the Biological Sample and Nevus Bank of the Melanoma Center of the University of Pittsburgh Cancer Institute. Logistic regression models were used to examine the association between multiple primary melanoma and risk factors. RESULTS In total, 330 patients (39.1% men) with a median age of 51 years were enrolled. Compared with patients who had a single primary melanoma, patients with multiple melanomas were younger at the diagnosis of their first primary melanoma and were more likely to be discovered at stage 0 or I and to have had indoor tanning exposure, a family history of melanoma, atypical moles, dysplastic nevi, and a Breslow thickness less than 1 mm. Compared with patients' first melanomas, subsequent melanomas were more likely to be thinner or in situ. The estimated probability of the locus for the second primary being the same as that for the first primary melanoma was 34%. In a multivariate analysis after adjustments for age, a family history of melanoma, the presence of atypical and dysplastic nevi, and recreational sun exposure, indoor tanning remained significantly associated with the occurrence of multiple primary melanoma (odds ratio, 2.75; 95% confidence interval, 1.07-7.08; P = .0356). CONCLUSIONS Indoor tanning is associated with an increased risk of second primary melanoma. Subsequent melanomas are more likely to be thin or in situ and to occur in different anatomic locations.
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Affiliation(s)
- Lilit Karapetyan
- Department of Medicine, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Xi Yang
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Hong Wang
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Cindy A Sander
- Department of Medicine, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Ashley Moyer
- Department of Medicine, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Melissa Wilson
- Department of Medicine, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | - John M Kirkwood
- Department of Medicine, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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Genes Determining Nevus Count and Dermoscopic Appearance in Australian Melanoma Cases and Controls. J Invest Dermatol 2019; 140:498-501.e17. [PMID: 31421127 DOI: 10.1016/j.jid.2019.05.032] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 05/13/2019] [Accepted: 05/28/2019] [Indexed: 11/21/2022]
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14
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Cells to Surgery Quiz: May 2019. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.1127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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