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De Pinto G, Mignozzi S, La Vecchia C, Levi F, Negri E, Santucci C. Global trends in cutaneous malignant melanoma incidence and mortality. Melanoma Res 2024; 34:265-275. [PMID: 38391175 PMCID: PMC11045545 DOI: 10.1097/cmr.0000000000000959] [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: 12/07/2023] [Accepted: 02/02/2024] [Indexed: 02/24/2024]
Abstract
Mortality from cutaneous malignant melanoma (CMM) increased in the past, but trends have been favorable in more recent years in many high-income countries. However, incidence has been increasing in several countries. We provided an up-to-date overview of mortality trends from CMM. We analyzed death certification data from the WHO in selected countries worldwide from 1980 to the most recent available calendar years. We also reported incidence data derived from Cancer Incidence in Five Continents from 1990 to 2012. Separate analyses were performed for young adults aged 20-44 and middle-aged adults aged 45-64 years. Mortality from CMM in all age groups showed a favorable pattern in the majority of the countries considered. Mortality trends declined by 40 to 50% in Australia over the last decades, confirming the importance of prevention measures. Considering young adults aged 20-44, Australia, New Zealand and Northern Europe reported the highest death rates for both sexes (>0.90/100 000 in men and >0.60/100 000 in women) while Japan, the Philippines, and Latin America the lowest ones (<0.50/100 000 and <0.35/100 000 in men and women, respectively). Incidence trends were stable or upward in most countries, with higher rates among women. Our study highlights a global reduction of CMM mortality over the last three decades. The increasing awareness of risk factors, mainly related to UV exposure, along with early diagnosis and progress in treatment for advanced disease played pivotal roles in reducing CMM mortality, particularly in Australia.
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Affiliation(s)
- Giuseppe De Pinto
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Silvia Mignozzi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Fabio Levi
- Department of Epidemiology and Health Services Research, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Eva Negri
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Claudia Santucci
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Brănișteanu DE, Porumb-Andrese E, Stărică A, Munteanu AC, Toader MP, Zemba M, Porumb V, Cozmin M, Moraru AD, Nicolescu AC, Brănișteanu DC. Differences and Similarities in Epidemiology and Risk Factors for Cutaneous and Uveal Melanoma. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050943. [PMID: 37241175 DOI: 10.3390/medicina59050943] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 04/17/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
Both cutaneous melanoma (CM) and uveal melanoma (UM) represent important causes of morbidity and mortality. In this review, we evaluate the available knowledge on the differences and similarities between cutaneous melanoma and uveal melanoma, focusing on the epidemiological aspects and risk factors. Uveal melanoma is a rare condition but is the most prevalent primary intra-ocular malignant tumor in adults. Cutaneous melanoma, on the other hand, is significantly more common. While the frequency of cutaneous melanoma has increased in the last decades worldwide, the incidence of uveal melanoma has remained stable. Although both tumors arise from melanocytes, they are very distinct entities biologically, with complex and varied etiologies. Both conditions are encountered more frequently by individuals with a fair phenotype. ultraviolet-radiation is an important, well-documented risk factor for the development of CM, but has shown not to be of specific risk in UM. Although cutaneous and ocular melanomas seem to be inherited independently, there are reported cases of concomitant primary tumors in the same patient.
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Affiliation(s)
- Daciana Elena Brănișteanu
- Dermatology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
- Railway Clinical Hospital, 700506 Iasi, Romania
| | - Elena Porumb-Andrese
- Dermatology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
- Railway Clinical Hospital, 700506 Iasi, Romania
| | - Alexandra Stărică
- Dermatology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
- Railway Clinical Hospital, 700506 Iasi, Romania
| | - Anca Catalina Munteanu
- Dermatology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
- Railway Clinical Hospital, 700506 Iasi, Romania
| | | | - Mihail Zemba
- Ophthalmology Department, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Vlad Porumb
- Department Surgery, 'Grigore T. Popa' University of Medicine and Pharmacy, 700111 Iasi, Romania
| | - Mihai Cozmin
- Clinical Department, Apollonia University of Iasi, 700511 Iasi, Romania
| | - Andreea Dana Moraru
- Ophthalmology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alin Codruț Nicolescu
- Roma Medical Center for Diagnosis and Treatment, 011773 Bucharest, Romania
- "Agrippa Ionescu" Emergency Clinical Hospital, 011773 Bucharest, Romania
| | - Daniel Constantin Brănișteanu
- Railway Clinical Hospital, 700506 Iasi, Romania
- Ophthalmology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
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Kwitko S, Marafon SB, Simao MF, Giacomini F, Marinho DR. Conjunctival melanoma following cornea transplant from a cancer donor: A case report. Am J Ophthalmol Case Rep 2023; 29:101809. [PMID: 36793795 PMCID: PMC9923179 DOI: 10.1016/j.ajoc.2023.101809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/22/2022] [Accepted: 01/24/2023] [Indexed: 01/30/2023] Open
Abstract
Purpose Conjunctival melanoma is a rare ocular tumor. We report a case of ocular conjunctival melanoma during topical immunosuppression, after a corneal transplant from a donor with metastatic melanoma. Observation A 59-year-old white male presented with a progressive nonpigmented conjunctival lesion in his right eye. He had previously undergone two penetrating keratoplasties, and he was being treated with topical immunosuppression with 0.03% tacrolimus (Ophthalmos Pharma; Sao Paulo, SP/Brazil). The histopathology evaluation revealed the nodule to be a conjunctival epithelioid melanoma. The donor's death cause was disseminated melanoma. Conclusion and importance The correlation between cancer and systemic immunosuppression after a solid organ transplant is widely known. The local influence, however, has not been reported. In this case, a causal relationship was not established. The correlation between conjunctival melanoma, exposure to topical tacrolimus immunosuppressive therapy, and the malignance characteristic of donor cornea should be better evaluated.
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Affiliation(s)
- Sergio Kwitko
- Ophthalmology Department of Hospital de Clinicas de Porto Alegre, 2350 Ramiro Barcelos St, Room 17 B1, Porto Alegre, RS, 90035-007, Brazil
- Oftalmocentro, 724 Doutor Nilo Pecanha Avenue, Room 404, Porto Alegre, RS, 90470-000, Brazil
| | - Samara Barbara Marafon
- Ophthalmology Department of Hospital de Clinicas de Porto Alegre, 2350 Ramiro Barcelos St, Room 17 B1, Porto Alegre, RS, 90035-007, Brazil
- Oftalmocentro, 724 Doutor Nilo Pecanha Avenue, Room 404, Porto Alegre, RS, 90470-000, Brazil
| | - Mariana Fernandez Simao
- Ophthalmology Department of Hospital de Clinicas de Porto Alegre, 2350 Ramiro Barcelos St, Room 17 B1, Porto Alegre, RS, 90035-007, Brazil
| | - Fernanda Giacomini
- School of Medicine, University of Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Diane Ruschel Marinho
- Ophthalmology Department of Hospital de Clinicas de Porto Alegre, 2350 Ramiro Barcelos St, Room 17 B1, Porto Alegre, RS, 90035-007, Brazil
- Oftalmocentro, 724 Doutor Nilo Pecanha Avenue, Room 404, Porto Alegre, RS, 90470-000, Brazil
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Immunomodulatory, Anticancer, and Antimicrobial Effects of Rice Bran Grown in Iraq: An In Vitro and In Vivo Study. Pharmaceuticals (Basel) 2022; 15:ph15121502. [PMID: 36558953 PMCID: PMC9782048 DOI: 10.3390/ph15121502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 11/26/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022] Open
Abstract
Emerging evidence supports the role of rice bran in cancer prevention. Studies were conducted on multiple rice cultivars. However, limited studies were conducted on rice cultivars in the Middle East. In this study, rice bran growing in Iraq (O. sativa ssp. Japonica, cultivars: Amber Barka) was evaluated for its effect on preventing cancer and stimulating the immune system. Rice bran was collected from local mills in Al-Najaf (south of Iraq). Several solvent extracts (ethanol, methanol, n-hexane, and water) were prepared by maceration. MTT assay was used to measure the antiproliferative effects of extracts against a panel of cancer cell lines. The ability of each extract to induce apoptosis and inhibit angiogenesis was measured using standard ELISA kits. The effect of extracts on the immune system was evaluated using a lymphocyte proliferation assay, a pinocytic activity assay, a phagocytic activity assay, and a Th1/Th2 cytokine detection kit. A microbroth dilution method was used to detect the antimicrobial activity of each extract against different microbial strains. LC-MS analysis was used to detect the phytochemical composition of extracts, while DPPH assay was used to determine the antioxidant activity. For the in vivo study, rice bran was added to mouse fodder at 10% and 20%. Mice were treated for two weeks using mouse fodder supplemented with rice bran. In the third week of the experiment, EMT6/P breast cancer cells (1 × 10⁶ cells/mL) were injected subcutaneously into the abdominal area of each mouse. The dimensions of the grown tumors were measured after 14 days of tumor inoculation. A microbroth dilution method was used to evaluate the antimicrobial activity of rice bran extracts against three bacterial strains. The highest antiproliferative activity was observed in ethanol and n-hexane extracts. Ethanol and methanol extract showed the highest activity to induce apoptosis and inhibit angiogenesis. Both extracts were also effective to enhance immunity by activating lymphocytes and phagocytes proliferation with modulations of cytokine levels. The incorporation of rice bran in mice food caused a 20% regression in tumor development and growth compared with the negative control. All extracts exhibited limited antimicrobial activity against tested microorganisms. Methanol extract showed antioxidant activity with an IC50 value of 114 µg/mL. LC-MS analysis revealed the presence of multiple phytochemicals in rice bran including apiin, ferulic acid, and succinic acid. Rice bran is a rich source of active phytochemicals that may inhibit cancer and stimulate the immune system. Rice bran's biological activities could be due to the presence of multiple synergistically active phytochemicals. Further studies are needed to understand the exact mechanisms of action of rice bran.
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Jacoub K, Al-Eisawi Z. ABO blood group and skin cancers. Clin Hemorheol Microcirc 2021; 81:359-371. [PMID: 34974432 DOI: 10.3233/ch-211290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Beside the role of ABO group in immunohaematology, there is accumulating evidence that the ABO blood group also plays a key role in various human disorders. The interest in blood groups and their association with disease stems from the awareness that blood group antigens are incredibly important components in the process of cell maturation and control. Studies have indicated a link between cancer and the ABO blood group. The appearance or disappearance of blood type antigens is now considered a hallmark of malignancy in many common cancers. Several tumour markers are in fact known blood group antigens. The aim of this review is to describe the history and possible functions of the ABO group and then summarize the association between blood groups and skin cancers.
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Affiliation(s)
- Khaldun Jacoub
- Faculty of Applied Medical Sciences, Department of Medical Laboratory Sciences, The Hashemite University, Jordan
| | - Zaynab Al-Eisawi
- Faculty of Applied Medical Sciences, Department of Medical Laboratory Sciences, The Hashemite University, Jordan
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6
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Bennett HG, Dahl LA, Furness J, Kemp-Smith K, Climstein M. Skin cancer and sun protective behaviours in water-based sports: A scoping review. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2021; 38:197-214. [PMID: 34582598 DOI: 10.1111/phpp.12737] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/11/2021] [Accepted: 09/26/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Individuals who participate in outdoor sports are subject to an increased risk of developing skin cancer. To date, there has been no review examining skin cancer and sun protective behaviours specific to outdoor, water-based sports. Therefore, this scoping reviews objectives were to (a) summarize volume and type of the scientific literature available relating to skin cancer, (b) examine current sun protective behaviours and (c) identify knowledge gaps to inform future research. METHOD A scoping review was conducted to address the objectives following the PRISMA guidelines. Seven databases were searched; identified studies were screened based on title, abstract and full text for outdoor water-based sports, which examined skin cancer and/or sun protective behaviours. Data were extracted, synthesized and critically appraised using a modified AXIS tool. Percentage frequencies were calculated, and key results were placed in tabular or graphical presentation. RESULTS Nine cross-sectional studies were identified, all defined as low-level evidence. A combined sample of 4377 participants across six countries and five water-based sports showed BCC (71%) was the most common skin cancer, followed by melanoma (18%) and SCC (10%). The head (41%) and upper limbs (27%) were the most common location. CONCLUSION This review highlights the minimal research available and demonstrates those in water-based sports are at high risk of developing skin cancer. Due to difficulty adhering to sun protective behaviours, the most prevalent location is the upper body. Included studies were of low-level evidence, providing opportunity for future research to expand upon the gaps in the current literature.
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Affiliation(s)
- Hannah Grace Bennett
- Water Based Research Unit, Faculty of Health Science, Institute of Health and Sport, Bond University, Robina, Queensland, Australia
| | - Lillian Arabella Dahl
- Water Based Research Unit, Faculty of Health Science, Institute of Health and Sport, Bond University, Robina, Queensland, Australia
| | - James Furness
- Water Based Research Unit, Faculty of Health Science, Institute of Health and Sport, Bond University, Robina, Queensland, Australia
| | - Kevin Kemp-Smith
- Water Based Research Unit, Faculty of Health Science, Institute of Health and Sport, Bond University, Robina, Queensland, Australia
| | - Mike Climstein
- Water Based Research Unit, Faculty of Health Science, Institute of Health and Sport, Bond University, Robina, Queensland, Australia.,Clinical Exercise Physiology, School of Health and Human Sciences, Southern Cross University, Bilinga, Queensland, Australia.,Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, University of Sydney, Sydney, New South Wales, Australia
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Vidovic D, Simms GA, Pasternak S, Walsh M, Peltekian K, Stein J, Helyer LK, Giacomantonio CA. Case Report: Combined Intra-Lesional IL-2 and Topical Imiquimod Safely and Effectively Clears Multi-Focal, High Grade Cutaneous Squamous Cell Cancer in a Combined Liver and Kidney Transplant Patient. Front Immunol 2021; 12:678028. [PMID: 34122442 PMCID: PMC8190543 DOI: 10.3389/fimmu.2021.678028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/07/2021] [Indexed: 01/04/2023] Open
Abstract
Cutaneous squamous cell carcinoma (cSCC) is the second most common non-melanoma skin cancer worldwide, with ever increasing incidence and mortality. While most patients can be treated successfully with surgical excision, cryotherapy, or radiation therapy, there exist a subset of patients with aggressive cSCC who lack adequate therapies. Among these patients are solid organ transplant recipients who due to their immunosuppression, develop cSCC at a dramatically increased rate compared to the normal population. The enhanced ability of the tumor to effectively undergo immune escape in these patients leads to more aggressive tumors with a propensity to recur and metastasize. Herein, we present a case of aggressive, multi-focal cSCC in a double organ transplant recipient to frame our discussion and current understanding of the immunobiology of cSCC. We consider factors that contribute to the significantly increased incidence of cSCC in the context of immunosuppression in this patient population. Finally, we briefly review current literature describing experience with localized therapies for cSCC and present a strong argument and rationale for consideration of an IL-2 based intra-lesional treatment strategy for cSCC, particularly in this immunosuppressed patient population.
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Affiliation(s)
- Dejan Vidovic
- Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Gordon A. Simms
- Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Sylvia Pasternak
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Mark Walsh
- Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Kevork Peltekian
- Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - John Stein
- Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Lucy K. Helyer
- Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Carman A. Giacomantonio
- Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
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D'Souza C, Kramadhari N, Skalkos E, Dutton T, Bailey J. Sun safety knowledge, practices and attitudes in rural Australian farmers: a cross-sectional study in Western New South Wales. BMC Public Health 2021; 21:731. [PMID: 33858398 PMCID: PMC8051022 DOI: 10.1186/s12889-021-10777-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 04/06/2021] [Indexed: 12/14/2022] Open
Abstract
Background Rates of skin cancer in Australia are amongst the highest in the world, with Western New South Wales (NSW) exhibiting very high prevalence. There is a large proportion of outdoor workers, including farmers, in Western NSW who have high levels of sun exposure and hence are at greater risk of developing skin cancer. Aims To characterise the current sun safety practices of farmers in Western NSW and explore their knowledge, attitudes and perceived barriers towards sun safety and its implementation. Methods A cross-sectional survey study was conducted using a self-directed questionnaire. Participants were recruited at field days held in Western NSW and through surveys distributed at general practices, local stores and online. Eligibility criteria were aged 18 years and over and currently working on a farm in the study region. Results Of the 144 participants, 89 (61.8%) were male with a mean age of 49 years. Knowledge of sun safety was relatively high with most questions answered correctly by greater than 80% of participants. Risk of developing skin cancer was underestimated in 58 (40.3%) participants. Of all participants, 89 (62.2%) identified one or more barriers to practicing sun safety. The most common barrier was forgetfulness in 62 (43.4%) participants. The identification of barriers was significantly associated with reduced engagement of sun safety practices (p = 0.009). Conclusions Knowledge of sun safety among farmers was high. There was, however, underestimation of risk of developing skin cancer. Addressing perceived barriers to implementing sun safety could improve sun safety practices in this cohort.
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Affiliation(s)
- Charmaine D'Souza
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, PO Box 9008, Bathurst, NSW, 2795, Australia
| | - Nikitha Kramadhari
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, PO Box 9008, Bathurst, NSW, 2795, Australia
| | - Elizabeth Skalkos
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, PO Box 9008, Bathurst, NSW, 2795, Australia
| | - Tegan Dutton
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, PO Box 9008, Bathurst, NSW, 2795, Australia
| | - Jannine Bailey
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, PO Box 9008, Bathurst, NSW, 2795, Australia.
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Morgado-Águila C, Rey-Sánchez P, Gil-Fernández G, Costa-Fernández MC, Rodríguez-Velasco FJ. Vitamin D Receptor Polymorphisms and Non-Melanoma Skin Cancer Risk: A Case-Control Study. J Clin Med 2020; 9:jcm9123819. [PMID: 33255834 PMCID: PMC7759998 DOI: 10.3390/jcm9123819] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 11/20/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022] Open
Abstract
Exposure to sunlight is the major source of vitamin D and the main environmental cause of non-melanocytic skin cancers. Vitamin D, partly mediated through the vitamin D receptor (VDR), has potential therapeutic applications in skin cancer. The aim of this study was to investigate the association of BsmI and ApaI VDR polymorphisms among patients with non-melanoma cancers and controls. An observational case-control study was conducted in a sample of 154 subjects. We observed no significant effects between these polymorphisms and skin cancer risk. When stratified for gender, GG and AG BsmI polymorphisms significantly increased the risk of basal cell carcinomas in males. In relation to ApaI, all three polymorphisms significantly increased the risk of basal cell carcinoma in males. When stratified for age, we found that being 70 years of age or younger was a protective factor against both skin cancers. Being a female and 70 years old or younger was a protective factor for basal cell carcinoma. A comparison of the frequencies of the VDR genotypes in patients older than 70 years vs. 70 years or younger also revealed age-dependent variations in patients with non-melanoma skin cancer. Our study suggests a role for VDR polymorphisms in non-melanoma skin cancer development.
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Affiliation(s)
- Carolina Morgado-Águila
- Department of Plastic and Reconstructive Surgery, Cáceres University Hospital Complex, Cáceres, 10001 Extremadura, Spain;
| | - Purificación Rey-Sánchez
- Department of Nursing, Faculty of Nursing and Occupational Therapy, University of Extremadura, Cáceres, 10003 Extremadura, Spain;
- Correspondence: (P.R.-S.); (G.G.-F.); (F.J.R.-V.); Tel.: +34-927-251-234 (P.R.-S.); +34-924-286-674 (G.G.-F.); +34-924-289-839 (F.J.R.-V.)
| | - Guadalupe Gil-Fernández
- Department of Nursing, Faculty of Medicine, University of Extremadura, Badajoz, 06006 Extremadura, Spain
- Correspondence: (P.R.-S.); (G.G.-F.); (F.J.R.-V.); Tel.: +34-927-251-234 (P.R.-S.); +34-924-286-674 (G.G.-F.); +34-924-289-839 (F.J.R.-V.)
| | - María Carmen Costa-Fernández
- Department of Nursing, Faculty of Nursing and Occupational Therapy, University of Extremadura, Cáceres, 10003 Extremadura, Spain;
| | - Francisco José Rodríguez-Velasco
- Department of Nursing, Faculty of Medicine, University of Extremadura, Badajoz, 06006 Extremadura, Spain
- Correspondence: (P.R.-S.); (G.G.-F.); (F.J.R.-V.); Tel.: +34-927-251-234 (P.R.-S.); +34-924-286-674 (G.G.-F.); +34-924-289-839 (F.J.R.-V.)
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Thompson MJW, Jones G, Balogun SA, Aitken DA. Skin Photosensitivity is Associated with 25-Hydroxyvitamin D and BMD but not Fractures Independent of Melanin Density in Older Caucasian Adults. Calcif Tissue Int 2020; 107:335-344. [PMID: 32696106 DOI: 10.1007/s00223-020-00728-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 07/10/2020] [Indexed: 11/24/2022]
Abstract
Whether skin photosensitivity modulates sun exposure behaviours, consequent vitamin D status and skeletal health outcomes independently of constitutive pigmentation have not been systematically investigated. 1072 community-dwelling adults aged 50-80 years had skin photosensitivity quantified by questionnaire and melanin density by spectrophotometry. Bone mineral density (BMD), falls risk and 25-hydroxyvitamin D (25OHD) were measured using DXA, short form physiological profile assessment and radioimmunoassay, respectively. Sun exposure and symptomatic fractures were assessed by questionnaire. Participants were followed up at 2.5 (n = 879), 5 (n = 767) and 10 (n = 571) years. Higher resistance to sunburn and greater ability to tan were associated with reduced sun protection behaviours (RR 0.87, p < 0.001 & RR 0.88, p < 0.001), higher lifetime discretionary sun exposure in summer (RR 1.05, p = 0.001 & RR 1.07, p = 0.001) and winter (RR 1.07, p = 0.001 & RR 1.08, p = 0.02) and fewer lifetime sunburns (RR 0.86, p < 0.001 & RR 0.91, p = 0.001). Higher resistance to sunburn was associated with lower total body (β = - 0.006, p = 0.047) and femoral neck (β = - 0.006, p = 0.038) BMD, but paradoxically, fewer prevalent fractures (RR 0.94, p = 0.042). Greater ability to tan was associated with higher 25OHD (β = 1.43, p = 0.04), lumbar spine (β = 0.014, p = 0.046) and total body (β = 0.013, p = 0.006) BMD, but not fracture or falls risk. These associations were independent of constitutive melanin density. Cutaneous photosensitivity was associated with sun exposure behaviours, cutaneous sequelae and, consequently, 25OHD and BMD in older Caucasian adults independent of constitutive melanin density. There was no consistent association with fracture outcomes, suggesting environmental factors are at least as important.
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Affiliation(s)
- M J W Thompson
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, TAS, 7000, Australia.
| | - G Jones
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, TAS, 7000, Australia
| | - S A Balogun
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, TAS, 7000, Australia
| | - D A Aitken
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, TAS, 7000, Australia
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Ultraviolet Radiation Exposure: Some Observations and Considerations, Focusing on Some Italian Experiences, on Cancer Risk, and Primary Prevention. ENVIRONMENTS 2020. [DOI: 10.3390/environments7020010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Solar ultraviolet radiation may cause acute and chronic health effects on the skin, eyes, and also on the immune system. Actinic keratosis, non-melanoma skin cancers, and malignant melanoma are the main long-term adverse skin effects. In the white population, the most common type of cancer worldwide is skin cancer, and the incidence of this cancer has increased during the last decades. The most important risk factor responsible for this trend seems to be Ultraviolet Radiation (UVR). IARC has classified UVR as being carcinogenic to humans. UV radiation exposure is ubiquitous; to study skin cancer risk, it is important to take into account the fact that UV exposure may occur both for occupational activities but also during vacation or recreational activities. Furthermore, exposure to artificial UVR such as those emitted by artificial devices, classified by IARC as carcinogenic to humans, is also to be considered. Due to the prominent role of UVR, primary prevention of skin cancer is very suitable, because when following specific rules this risk factor can be reduced. The incidence rate of skin cancer is higher in people with fair skin. Outdoor workers exposed to solar UVR are at risk of developing skin cancer, particularly non-melanoma skin cancers, and welders exposed to artificial UVR are at risk of developing ocular melanoma. A specific project on solar UVR risk in outdoor workers in Tuscany, Italy, has shown that outdoor workers had an unsatisfactory sun protection behaviour. The project demonstrates the complexity of studying UVR exposure and recommended the need for prevention programs. Risk increases with increasing ambient solar radiation and with unsafe behaviours in the sun or when using artificial UVR (e.g., sunbeds). Effective prevention strategies have to be adopted both for the outdoor workers and for the general population exposed to UVR. A standardized program of proven efficacy, such as that implemented in Australia, should also be implemented in other countries. All these strategies could contribute to the aim of decreasing the morbidity and mortality of cancers associated with this exposure. The aim of this paper is to provide an overview of UVR exposure risk, particularly occupational risk, and to give some elements to understand the complexity of the relation between UVR exposure and cancer risk, as well as to outline primary prevention measures, focusing also on Italian experiences that could be useful for providing additional elements of knowledge on this topic.
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Little MP, Linet MS, Kimlin MG, Lee T, Tatalovich Z, Sigurdson AJ, Cahoon EK. Cumulative solar ultraviolet radiation exposure and basal cell carcinoma of the skin in a nationwide US cohort using satellite and ground-based measures. Environ Health 2019; 18:114. [PMID: 31881891 PMCID: PMC6935112 DOI: 10.1186/s12940-019-0536-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 10/18/2019] [Indexed: 05/05/2023]
Abstract
BACKGROUND Basal cell carcinoma of the skin (BCC) is the most common cancer in populations of European ancestry. Although consistently linked with basal cell carcinoma of the skin in case-control studies, few prospective cohort studies have evaluated the shape of the exposure-response of basal cell carcinoma associated with cumulative radiant solar ultraviolet exposure (UVR). METHODS We followed 63,912 white cancer-free US radiologic technologists from entry (1983-1998) to exit (2003-2005) with known ultraviolet irradiance at up to 5 residential locations. Using generalized-additive and relative risk models we analyzed the exposure-response of basal cell carcinomas associated with ambient cumulative ultraviolet radiant exposure using ground-based National Solar Radiation database Average Daily Total Global data and satellite-based National Aeronautics and Space Administration Total Ozone Mapping Spectrometer data. RESULTS There were 2151 technologists with an incident primary basal cell carcinoma. Risk of basal cell carcinoma rose with increasing cumulative ultraviolet radiation exposure using both measures, such that 1 MJ cm- 2 increased basal cell carcinoma risk by 8.48 (95% CI 5.22, 11.09, p < 0.001) and by 10.15 (95% CI 6.67, 13.10, p < 0.001) per 10,000 persons per year using the Average Daily Total Global and Total Ozone Mapping Spectrometer ultraviolet data, respectively; relative risk was likewise elevated. There was some evidence of upward curvature in the cumulative ultraviolet exposure response using both exposure measures with a greater increase in risk of basal cell carcinoma at higher levels of ultraviolet radiation exposure, but less evidence for curvature in relative risk. There are indications of substantial variation of relative risk with time after exposure and age at exposure, so that risk is highest for the period 10-14 years after ultraviolet radiation exposure and for those exposed under the age of 25. CONCLUSIONS We observed increases in risk of basal cell carcinoma and a similar exposure-response for ground-based and satellite ultraviolet radiation measures. Our observations suggest that interventions should concentrate on persons with higher levels of ultraviolet radiation exposure.
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Affiliation(s)
- Mark P Little
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA.
| | - Martha S Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
| | - Michael G Kimlin
- NHMRC Centre for Research Excellence in Sun and Health, University of the Sunshine Coast, Brisbane, Queensland, 4556, Australia
- Cancer Council Queensland, Brisbane, Queensland, Australia
| | - Terrence Lee
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
| | - Zaria Tatalovich
- Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, NIH, DHHS, Bethesda, MD, 20892-9778, USA
| | - Alice J Sigurdson
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
| | - Elizabeth K Cahoon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
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Olsen CM, Pandeya N, Law MH, MacGregor S, Iles MM, Thompson BS, Green AC, Neale RE, Whiteman DC. Does polygenic risk influence associations between sun exposure and melanoma? A prospective cohort analysis. Br J Dermatol 2019; 183:303-310. [PMID: 31747047 DOI: 10.1111/bjd.18703] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND Melanoma develops as the result of complex interactions between sun exposure and genetic factors. However, data on these interactions from prospective studies are scant. OBJECTIVES To quantify the association between ambient and personal ultraviolet exposure and incident melanoma in a large population-based prospective study of men and women residing in a setting of high ambient ultraviolet radiation, and to examine potential gene-environment interactions. METHODS Data were obtained from the QSkin Sun and Health Study, a prospective cohort study of men and women aged 40-69 years, randomly sampled from the Queensland population in 2011. Participants were genotyped and assessed for ultraviolet exposure. RESULTS Among participants with genetic data (n = 15 373), 420 (2·7%) developed cutaneous melanoma (173 invasive, 247 in situ) during a median follow-up time of 4·4 years. Country of birth, age at migration, having > 50 sunburns in childhood or adolescence, and a history of keratinocyte cancer or actinic lesions were significantly associated with melanoma risk. CONCLUSIONS An interaction with polygenic risk was suggested: among people at low polygenic risk, markers of cumulative sun exposure (as measured by actinic damage) were associated with melanoma. In contrast, among people at high polygenic risk, markers of high-level early-life ambient exposure (as measured by place of birth) were associated with melanoma (hazard ratio for born in Australia vs. overseas 3·16, 95% confidence interval 1·39-7·22). These findings suggest interactions between genotype and environment that are consistent with divergent pathways for melanoma development. What's already known about this topic? The relationship between sun exposure and melanoma is complex, and exposure effects are highly modified by host factors and behaviours. The role of genotype on the relationship between ultraviolet radiation exposure and melanoma risk is poorly understood. What does this study add? We found that country of birth, age at migration, sunburns in childhood or adolescence, and history of keratinocyte cancer or actinic lesions were significantly associated with melanoma risk, while other measures of continuous or more intermittent patterns of sun exposure were not. We found evidence for gene-environment interactions that are consistent with divergent pathways for melanoma development. Linked Comment: Cust. Br J Dermatol 2020; 183:205-206. Plain language summary available online.
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Affiliation(s)
- C M Olsen
- Department of Population Health, QIMR Berghofer Medical Research Institute, Queensland, Australia.,Faculty of Medicine, University of Queensland, Queensland, Australia
| | - N Pandeya
- Department of Population Health, QIMR Berghofer Medical Research Institute, Queensland, Australia.,School of Public Health, University of Queensland, Queensland, Australia
| | - M H Law
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Queensland, Australia
| | - S MacGregor
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Queensland, Australia
| | - M M Iles
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, U.K.,Leeds Institute for Data Analytics, University of Leeds, Leeds, U.K
| | - B S Thompson
- Department of Population Health, QIMR Berghofer Medical Research Institute, Queensland, Australia
| | - A C Green
- Department of Population Health, QIMR Berghofer Medical Research Institute, Queensland, Australia.,Cancer Research U.K. Manchester Institute and University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K
| | - R E Neale
- Department of Population Health, QIMR Berghofer Medical Research Institute, Queensland, Australia.,School of Public Health, University of Queensland, Queensland, Australia
| | - D 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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Watts CG, Drummond M, Goumas C, Schmid H, Armstrong BK, Aitken JF, Jenkins MA, Giles GG, Hopper JL, Mann GJ, Cust AE. Sunscreen Use and Melanoma Risk Among Young Australian Adults. JAMA Dermatol 2019; 154:1001-1009. [PMID: 30027280 DOI: 10.1001/jamadermatol.2018.1774] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Importance There are limited data among young adults on sunscreen use during childhood and adulthood and on the association of sunscreen use with melanoma risk. Objective To assess correlates of early-life sunscreen use and the association between sunscreen use and risk of cutaneous melanoma before age 40 years. Design, Setting, and Participants This population-based, case-control family study analyzed Australian Melanoma Family Study data for persons with questionnaire data on sunscreen use collected by interview from 2001 to 2005 across 3 states in Australia, representing two-thirds of the country's population. Case participants (aged 18-39 years) had confirmed first primary melanoma. Siblings of case participants were included, and case participants without a sibling control were excluded. Unrelated controls (aged 18-44 years) were recruited from the electoral roll or were a spouse, partner, or friend nominated by case participants. Data analyses were conducted from October 2017 to February 2018. Exposures Self- and parent-reported sunscreen use, sun exposure, and other candidate risk factors during childhood and adulthood. Main Outcomes and Measures Logistic regression analyses adjusted for potential confounders were used to estimate odds ratios (ORs) for melanoma and for correlates of sunscreen use. Results Participation was 629 of 830 contactable cases (76%) (629 of 1197 overall [53%]), 240 of 570 contactable controls (42%) from the electoral roll (240 of 1068 overall [23%]), and 295 of 371 nominated spouse or friend controls (80%); analysis incuded 603 cases and 1088 controls. The median (interquartile range) age was 32 (28-36) years for 603 cases, 35 (30-38) years for 478 unrelated controls, and 34 (29-38) years for 610 sibling controls. There were more women than men (range, 57%-62%) in all groups, approximately 40% (range, 39%-43%) of participants had a university education, and most participants (range, 58%-73%) had British/northern European ethnicity. Risk of melanoma was less with higher use of sunscreen in childhood (OR for highest vs lowest tertiles, 0.60; 95% CI, 0.42-0.87; P = .02 for trend) and across the lifetime (OR, 0.65; 95% CI, 0.45-0.93; P = .07 for trend). Subgroup analyses suggested that the protective association of sunscreen with melanoma was stronger for people reporting blistering sunburn, receiving a diagnosis of melanoma at a younger age, or having some or many nevi. Total lifetime sun exposure was unrelated to melanoma risk (OR for highest vs lowest tertile, 0.97; 95% CI, 0.66-1.43; P = .94 for trend). By contrast, total sun exposure inversely weighted by sunscreen use (as a measure of sun exposure unprotected by sunscreen) was significantly associated with melanoma risk (OR, 1.80; 95% CI, 1.22-2.65; P = .007 for trend) and appeared stronger for people having lighter pigmentation or some or many nevi or using sunscreen to stay longer in the sun. Regular users of sunscreen were more likely to be female, younger, and of British or northern European ancestry and to have higher educational levels, lighter skin pigmentation, and a stronger history of blistering sunburn. Conclusions and Relevance Our findings provided evidence that regular sunscreen use is significantly associated with reduced risk of cutaneous melanoma among young adults and identified several characteristics associated with less sunscreen use.
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Affiliation(s)
- Caroline G Watts
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia.,Melanoma Institute Australia, Sydney, New South Wales, Australia.,Now with The Kirby Institute, University of New South Wales, Sydney, Australia.,Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Martin Drummond
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia.,Melanoma Institute Australia, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Chris Goumas
- Melanoma Institute Australia, Sydney, New South Wales, Australia
| | - Helen Schmid
- Melanoma Research Group, Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Bruce K Armstrong
- The School of Population Health, The University of Western Australia, Perth, Australia
| | - Joanne F Aitken
- Viertel Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia
| | - Mark A Jenkins
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Graham G Giles
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.,Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Graham J Mann
- Melanoma Institute Australia, Sydney, New South Wales, Australia.,Melanoma Research Group, Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Anne E Cust
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia.,Melanoma Institute Australia, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
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Gandini S, Doré JF, Autier P, Greinert R, Boniol M. Epidemiological evidence of carcinogenicity of sunbed use and of efficacy of preventive measures. J Eur Acad Dermatol Venereol 2019; 33 Suppl 2:57-62. [PMID: 30811691 DOI: 10.1111/jdv.15320] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/20/2018] [Indexed: 11/29/2022]
Abstract
The International Agency for Research on Cancer classified, in July 2009, exposure to artificial tanning devices (sunbeds) as carcinogenic to humans. This classification was based on evidence from epidemiological and experimental animal studies. The present chapter will review these epidemiological evidences. The summary risk estimates from 27 epidemiological studies obtained through a meta-analysis showed an increased risk of melanoma: summary relative risk (SRR) = 1.20 [95% confidence interval (CI) 1.08-1.34]. The risk was higher when exposure took place at younger age (SRR = 1.59; 95% CI 1.36-1.85). The risk was independent of skin sensitivity or population and a dose response was evident. A meta-analysis of 12 studies was conducted for non-melanoma skin cancers and showed a significantly increased risk for basal cell carcinoma (SRR = 1.29; 95% CI 1.08-1.53) and for squamous cell carcinoma (SRR = 1.67; 95% CI 1.29-2.17). As for melanoma, the risk for other skin cancers increased for first exposures at young age. Epidemiological studies have gradually strengthened the evidence for a causal relationship between indoor tanning and skin cancer and they fit with prior knowledge on relationship between UV exposure and skin cancer. Additionally, several case-control studies provided consistent evidence of a positive association between use of sunbed and ocular melanoma, also with greater risk for first exposures at younger age. Preventive measures based on information on risk or by requiring parental authorization for young users proved to be inefficient in several studies. The significant impact of strong actions or total ban, such as performed in Iceland, or a total ban of sunbed use, as in Brazil or Australian states, needs to be further assessed.
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Affiliation(s)
- S Gandini
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | - J-F Doré
- Centre de Recherche en Cancérologie de Lyon, Inserm U1052, Lyon, France
| | - P Autier
- International Prevention Research Institute, Lyon, France
| | - R Greinert
- Department of Molecular Cell biology, Dermatology Center Buxtehude, Elbekliniken Stade/Buxtehude, Klinikum Buxtehude, Buxtehude, Germany
| | - M Boniol
- International Prevention Research Institute, Lyon, France
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Zink A, Schielein M, Wildner M, Rehfuess EA. 'Try to make good hay in the shade - it won't work!' A qualitative interview study on the perspectives of Bavarian farmers regarding primary prevention of skin cancer. Br J Dermatol 2019; 180:1412-1419. [PMID: 30861096 DOI: 10.1111/bjd.17872] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Extensive exposure to solar ultraviolet radiation (UVR) is the main risk factor for keratinocyte carcinoma (KC), making outdoor workers, including farmers, a high-risk population for KC. The use of sun protection is crucial for KC prevention but is not typically implemented by outdoor workers during their daily tasks. OBJECTIVES To explore the attitudes of Bavarian farmers regarding sun-protective measures in their daily work and to understand perceived barriers and unmet needs. METHODS Farmers were recruited through the Bavarian Farmers Association in Bavaria, Southern Germany. Qualitative semi structured interviews were conducted with participants between December 2017 and March 2018. Interviews were recorded, transcribed verbatim and analysed using qualitative content analysis. RESULTS Twenty farmers (11 women, nine men; nine aged 18-30 years, 11 aged > 60 years) participated. Knowledge and awareness of UVR exposure and KC, perceived individual barriers to implementing sun-protective measures, individual experiences and farm life-specific circumstances emerged as key areas influencing the perspectives of farmers regarding the primary prevention of KC. Female farmers tended to take a more positive stance on sun protection, whereas male farmers showed a lower overall interest. CONCLUSIONS Knowledge and awareness of KC and UVR exposure is very limited in Bavarian farmers with serious perceived barriers due to the demands of daily agricultural work. Further qualitative studies are needed to identify intervention options that can increase skin cancer awareness and that can successfully overcome real barriers to implementing sun protection.
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Affiliation(s)
- A Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany
| | - M Schielein
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany
| | - M Wildner
- Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany.,Bavarian Health and Food Safety Authority, Munich, Germany
| | - E A Rehfuess
- Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany
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Holm-Schou ASS, Philipsen PA, Wulf HC. Skin cancer phototype: A new classification directly related to skin cancer and based on responses from 2869 individuals. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2018; 35:116-123. [DOI: 10.1111/phpp.12432] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 08/29/2018] [Accepted: 10/06/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Ann-Sofie Sonne Holm-Schou
- Dermatological Research Department D92; Bispebjerg Hospital; University of Copenhagen; Copenhagen Denmark
| | - Peter Alshede Philipsen
- Dermatological Research Department D92; Bispebjerg Hospital; University of Copenhagen; Copenhagen Denmark
| | - Hans Christian Wulf
- Dermatological Research Department D92; Bispebjerg Hospital; University of Copenhagen; Copenhagen Denmark
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Stump TK, Aspinwall LG, Gray EL, Xu S, Maganti N, Leachman SA, Alshurafa N, Robinson JK. Daily Minutes of Unprotected Sun Exposure (MUSE) Inventory: Measure description and comparisons to UVR sensor and sun protection survey data. Prev Med Rep 2018; 11:305-311. [PMID: 30116702 PMCID: PMC6092553 DOI: 10.1016/j.pmedr.2018.07.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 06/20/2018] [Accepted: 07/21/2018] [Indexed: 12/01/2022] Open
Abstract
One in five US adults will be diagnosed with skin cancer. As most skin cancers are attributable to sun exposure, this risk factor is an important target for research and intervention. Most sun exposure measures assess frequency of specific sun-protection behaviors, which does not account for the use of multiple, potentially overlapping sun-protection methods. In contrast, the Daily Minutes of Unprotected Sun Exposure (MUSE) Inventory assesses sun-protection behavior during self-reported activities, providing several useful metrics, including duration of unprotected sun exposure on 17 body sites, combined to yield an overall MUSE score weighted by percent of body exposed. The present study was conducted July–September 2017, in Chicago, IL USA. For 10 days, participants (39 melanoma survivors; Mage = 58.59, 64.5% female) wore an ultraviolet radiation (UVR) sensor and completed the Daily MUSE Inventory each evening. The Sun Habits Survey was completed at the end of the study. Outdoor time reported in the MUSE Inventory significantly predicted outdoor time recorded by UVR sensors, B = 0.53, p < .001. For all sun-protection behaviors except shade, reports from the Daily MUSE Inventory (i.e., percentage of outdoor time a particular strategy was used) correlated with frequency ratings of the same strategy from the Sun Habits Survey (rs = 0.66–0.75, p < .05). In sum, the Daily MUSE Inventory corresponds with sensor and survey data, and provides a novel metric of unprotected sun exposure that will be useful for evaluating overall extent of sun exposure, including exposure on several smaller body sites that are at high risk for skin cancer.
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Affiliation(s)
- Tammy K Stump
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Dr., Suite 1500, Chicago, IL 60611, USA
| | - Lisa G Aspinwall
- Department of Psychology, University of Utah, 380 S 1530 E, Rm 502, Salt Lake City, UT 84112, USA
| | - Elizabeth L Gray
- Biostatistics Collaboration Center, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Dr., Suite 1400, Chicago, IL 60611, USA
| | - Shuai Xu
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 645 N Michigan Ave, Suite 1050, Chicago, IL 60611, USA.,Center for Bio-Integrated Electronics, Northwestern University, Technological Institute, B390, 2145 Sheridan Road, Evanston, IL 60208, USA
| | - Nenita Maganti
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Sancy A Leachman
- Department of Dermatology, Oregon Health & Science University, 3303 SW Bond Ave, Portland, OR 97239, USA
| | - Nabil Alshurafa
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Dr., Suite 1500, Chicago, IL 60611, USA
| | - June K Robinson
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 645 N Michigan Ave, Suite 1050, Chicago, IL 60611, USA.,Robert H. Lurie Comprehensive Cancer Center, Northwestern University, 676 N. St. Clair, Suite 1200, Chicago, IL 60611, USA
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Levi F, Erler G, Te VC, Randimbison L, La Vecchia C. Trends in Skin Cancer Incidence in Neuchâtel, 1976-98. TUMORI JOURNAL 2018; 87:288-9. [PMID: 11765175 DOI: 10.1177/030089160108700502] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and Background Limited data are available on trends in skin cancer incidence. This paper examines trends of the three major histotypes of skin cancer in an environment favorable for skin cancer registration. Methods Trends of skin cancer incidence by histotype in the Swiss Canton of Neuchâtel (165,000 inhabitants) were analyzed on the basis of 4,455 incident cases of basal cell, squamous cell carcinoma, and malignant melanoma registered over the period 1976-1998. Results Trends over the last decade considered tended to be downwards for squamous cell carcinoma in both sexes, were still on the rise for basal cell carcinoma, and leveled off for malignant melanoma in both sexes. Conclusions Different trends were confirmed in this population between skin cancer histotypes related to cumulative intense sun exposure (squamous cell carcinoma) and those mainly related to more complex patterns of exposure to sunlight (basal cell carcinoma and malignant melanoma).
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Affiliation(s)
- F Levi
- Registre neuchâtelois des tumeurs, Neuchâtel, Switzerland.
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Savoye I, Olsen CM, Whiteman DC, Bijon A, Wald L, Dartois L, Clavel-Chapelon F, Boutron-Ruault MC, Kvaskoff M. Patterns of Ultraviolet Radiation Exposure and Skin Cancer Risk: the E3N-SunExp Study. J Epidemiol 2018; 28:27-33. [PMID: 29176271 PMCID: PMC5742376 DOI: 10.2188/jea.je20160166] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 12/23/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND While ultraviolet (UV) radiation exposure is a recognized risk factor for skin cancer, associations are complex and few studies have allowed a direct comparison of exposure profiles associated with cutaneous melanoma, basal-cell carcinoma (BCC), and squamous-cell carcinoma (SCC) within a single population. METHODS We examined associations between UV exposures and skin cancer risk in a nested case-control study within E3N, a prospective cohort of 98,995 French women born in 1925-1950. In 2008, a lifetime UV exposure questionnaire was sent to all reported skin cancer cases and three controls per case, which were matched on age, county of birth, and education. Analyses were performed using conditional logistic regression and included 366 melanoma cases, 1,027 BCC cases, 165 SCC cases, and 3,647 controls. RESULTS A history of severe sunburns <25 years was associated with increased risks of all skin cancers (melanoma: OR 2.7; BCC: OR 1.7; SCC: OR 2.0 for ≥6 sunburns vs. none), while sunburns ≥25 years were associated with BCC and SCC only. While high-sun protection factor sunscreen use before age 25 was associated with lower BCC risk (Ptrend = 0.02), use since age 25 and reapplication of sunscreen were associated with higher risks of all three types of skin cancer. There were positive linear associations between total UV score and risks of BCC (Ptrend = 0.01) and SCC (Ptrend = 0.09), but not melanoma. While recreational UV score was strongly associated with BCC, total and residential UV scores were more strongly associated with SCC. CONCLUSIONS Melanoma, BCC, and SCC are associated with different sun exposure profiles in women.
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Affiliation(s)
- Isabelle Savoye
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Catherine M Olsen
- Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- School of Public Health, the University of Queensland, Herston, Queensland, Australia
| | - David C Whiteman
- Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- School of Public Health, the University of Queensland, Herston, Queensland, Australia
| | - Anne Bijon
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Lucien Wald
- MINES ParisTech, PSL-Research University, O.I.E. – Centre Observation, Impacts, Energy, Sophia Antipolis, France
| | - Laureen Dartois
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Françoise Clavel-Chapelon
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Marie-Christine Boutron-Ruault
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Marina Kvaskoff
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
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Riccò M, Razio B, Poletti L, Panato C. Knowledge, attitudes, and sun-safety practices among agricultural workers in the Autonomous Province of Trento, North-Eastern Italy (2016). GIORN ITAL DERMAT V 2017; 155:31-40. [PMID: 28895375 DOI: 10.23736/s0392-0488.17.05672-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The purpose of this study was to determine and evaluate sun safety knowledge, attitudes and practices (KAP) among agricultural workers (AWs) in the Autonomous Province of Trento (North-Eastern Italy). METHODS A cross sectional study was performed among AWs who attended pesticide training courses (2016). Participants received a structured questionnaire focusing on KAP towards sun protective behaviors. Synthetic scores for knowledge (GKS), risk perception (RPS), behavioral adaptation and use of personal protective equipment (SPPS) were calculated. Regression analysis was modelled in order to assess GKS, RPS and individual factors as predictors of SPPS. RESULTS The sample included 204 AWs (89.7% males, 10.3% females, mean age 43.9±15.9 years). Sun protective behaviors were irregularly referred by participants, in particular receiving medical skin assessment by a dermatologist (33.8%), avoiding sun radiations at noon and taking rest breaks in shady areas (30.9%), and wearing sunscreen (13.3%). GKS was correlated with RPS, and RPS was characterized as a significant predictor of SPPS (B=0.307; 95% CI 0.224-0.389, P<0.001), alongside increased seniority (B=4.957: 95% CI 3.064-6.851, P<0.001) and previous history of sunburns (B=5.829; 95% CI 1.520-10.139, P=0.008). CONCLUSIONS Our findings indicate that AWs are not appropriately aware of the risks associated with occupational exposure to solar radiation, and eventually report inadequate skin cancer prevention practices. Since SPPS found significant predictors in individual factors, tailored interventions and training may contribute to fill knowledge gaps and raise the concerns of AWs towards occupational dermatological disorders.
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Affiliation(s)
- Matteo Riccò
- Operative Unit for Health and Safety in the Workplaces, Department of Prevention, Provincial Agency for Health Services (APSS) of the Autonomous Province of Trento, Trento, Italy - .,Local Health Unit of Reggio Emilia, Department of Public Health, Service for Health and Safety in the Workplace, AUSL IRCCS Reggio Emilia, Reggio Emilia, Italy -
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Gaspari V, Patrizi A, Venturi M, Misciali C, Fanti PA. The epidemic spreading of basal cell carcinoma: incidence trend, demographic features, characteristics and risk factors in a retrospective study of 8557 lesions in Bologna. A 25-year analysis in a Dermatology referral center. GIORN ITAL DERMAT V 2017; 155:24-30. [PMID: 28421727 DOI: 10.23736/s0392-0488.17.05617-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to retrospectively analyze all the cases of BCC histologically diagnosed in the Cutaneous Tumor Center of Dermatology of Bologna University, in a period between 1990 and 2014. METHODS All the consecutive histopathologically diagnosed BCCs at the Dermatology of the Bologna University from 1990 to 2014 were retrospectively reviewed. We evaluated the absolute number of basal cell carcinoma (BCCs), the demographic features of patients and the characteristics of BCCs with statistically significant correlations. RESULTS During the investigated 25 years, 8557 BCCs were collected in 7297 patients. We observed that the incidence of this cancer, after stabilizing around a plateau of 400 cases/year in 2005, progressively increased onwards reaching a maximum of cases (821) in 2014 (+105.25%), with an 8.32% mean increase per year in those last 9 years. Moreover, we found a significant correlation (P<0.01%) between gender and the onset of BCC, between the anatomic location and the occurrence of the tumor, between the onset of recurrent or new BCCs and sun exposure. CONCLUSIONS The present study collects the largest series in the Italian literature focused on demographic features and characteristics of BCC, highlights its higher increasing incidence in Bologna and the need to improve preventive strategies to stem the epidemic diagnosis of BCC.
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Affiliation(s)
- Valeria Gaspari
- Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Annalisa Patrizi
- Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Michela Venturi
- Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy -
| | - Cosimo Misciali
- Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Pier A Fanti
- Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
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Non-melanoma skin cancer and risk of Alzheimer's disease and all-cause dementia. PLoS One 2017; 12:e0171527. [PMID: 28225789 PMCID: PMC5321271 DOI: 10.1371/journal.pone.0171527] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 01/23/2017] [Indexed: 01/10/2023] Open
Abstract
Cancer patients may be at decreased risk of Alzheimer's disease. This hypothesis is best developed for non-melanoma skin cancer (NMSC), but supportive epidemiological data are sparse. We therefore conducted a nationwide cohort study of the association between NMSC and Alzheimer's disease (main outcome) and all-cause dementia. Using Danish medical databases, we identified adults diagnosed with NMSC between 1 January 1980 and 30 November 2013 (n = 216,221) and a comparison cohort of five individuals matched to each NMSC patient by sex and birth year (n = 1,081,097). We followed individuals from the time of diagnosis, or corresponding date for matched comparators, until a dementia diagnosis, death, emigration, or 30 November 2013, whichever came first. We used stratified Cox regression adjusted for comorbidities to compute hazard ratios (HRs) associating NMSC with dementia. We computed cumulative risks of dementia, treating death as a competing risk. NMSC was associated with a HR of 0.95 (95% confidence interval [CI]: 0.92-0.98) for Alzheimer's disease and 0.92 (95% CI: 0.90-0.94) for all-cause dementia. HRs were similar for basal cell and squamous cell carcinoma, the two most common forms of NMSC. Estimates of risk reduction were more pronounced in the beginning of follow-up, reaching null after 5-10 years. At the end of follow-up (34 years), cumulative risk of Alzheimer's disease was 4.6% (95% CI: 4.4%-4.8%) among patients with NMSC vs. 4.7% (95% CI: 4.6%-4.9%) in the comparison cohort. In conclusion, NMSC was associated with 2%-10% reductions in relative risks of Alzheimer's disease and all-cause dementia. However, these small inverse associations may have been caused by ascertainment bias due to decreased awareness of NMSC tumors in persons with undiagnosed early cognitive impairment or by confounding from a more neuroprotective lifestyle among persons with NMSC.
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Lange E, Blizzard L, Venn A, Francis H, Jones G. Disease-modifying anti-rheumatic drugs and non-melanoma skin cancer in inflammatory arthritis patients: a retrospective cohort study. Rheumatology (Oxford) 2016; 55:1594-600. [PMID: 27185957 DOI: 10.1093/rheumatology/kew214] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The aim was to determine the non-melanoma skin cancer (NMSC) risk in patients with RA or PsA exposed to MTX and other DMARDs. METHODS Information on medication was collected on 405 patients with RA or PsA in two private rheumatology practices and was matched to comprehensive histologically confirmed cancer registry data for the years 1978-2005. Relative risks (RRs) were estimated by logarithmic binomial modelling, and standardized incidence ratios (SIRs) were calculated from year-, sex- and age-specific rates of NMSC for the local population. RESULTS Compared with no MTX usage, any MTX usage was associated with a higher rate of at least one histopathologically confirmed NMSC (SIR 4.64, 95% CI: 0.67, 33.2). The SIR was 4.81 (95% CI: 3.60, 6.29) for those receiving a cumulative dose >8000 mg compared with SIR 2.31 (95% CI: 1.58, 2.36) for <5000 mg. An increased risk was shown for both basal cell carcinomas and squamous cell carcinomas, with an apparent dose-response relationship for basal cell carcinomas but not for squamous cell carcinomas. There was an increased risk of NMSC in patients taking CSA (RR = 2.51, 95% CI: 1.23, 5.13) and D-Pen (RR 3.49, 95% CI: 1.34, 4.63) in addition to MTX, but not for patients taking AZA or LEF. CONCLUSION MTX, and concurrent MTX and CSA or D-Pen use, is associated with an increased risk of NMSC. These results should encourage greater clinical vigilance for NMSC in treated patients with RA and PsA.
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Affiliation(s)
- Eva Lange
- Menzies Institute for Medical Research, University of Tasmania
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania
| | - Hilton Francis
- Hilton Francis & Associates, Hobart, Tasmania, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania
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Gómez M, Guillem V, Pereira A, Ferrer-Marín F, Álvarez-Larrán A, Kerguelen A, Estrada N, Martínez-López J, Angona A, Amat P, Navarro B, Besses C, Hernández-Boluda JC. Risk factors for non-melanoma skin cancer in patients with essential thrombocythemia and polycythemia vera. Eur J Haematol 2015; 96:285-90. [DOI: 10.1111/ejh.12588] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2015] [Indexed: 12/20/2022]
Affiliation(s)
- Montse Gómez
- Hematology and Medical Oncology Department; Hospital Clínico Universitario; INCLIVA; Valencia Spain
| | - Vicent Guillem
- Hematology and Medical Oncology Department; Hospital Clínico Universitario; INCLIVA; Valencia Spain
| | - Arturo Pereira
- Hemotherapy and Hemostasis Department; Hospital Clínic; Barcelona Spain
| | | | | | - Ana Kerguelen
- Hematology Department; Hospital La Paz; Madrid Spain
| | - Natàlia Estrada
- Hematology Department; Institut Català d'Oncologia-Hospital Germans Trias i Pujol; Badalona Spain
| | | | - Anna Angona
- Hematology Department; Hospital del Mar-IMIM; Barcelona Spain
| | - Paula Amat
- Hematology and Medical Oncology Department; Hospital Clínico Universitario; INCLIVA; Valencia Spain
| | - Blanca Navarro
- Hematology and Medical Oncology Department; Hospital Clínico Universitario; INCLIVA; Valencia Spain
| | - Carles Besses
- Hematology Department; Hospital del Mar-IMIM; Barcelona Spain
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Kearney GD, Rodriguez G, Quandt SA, Arcury JT, Arcury TA. Work Safety Climate, Safety Behaviors, and Occupational Injuries of Youth Farmworkers in North Carolina. Am J Public Health 2015; 105:1336-43. [PMID: 25973817 DOI: 10.2105/ajph.2014.302519] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The aims of this project were to describe the work safety climate and the association between occupational safety behaviors and injuries among hired youth farmworkers in North Carolina (n = 87). METHODS We conducted personal interviews among a cross-sectional sample of youth farmworkers aged 10 to 17 years. RESULTS The majority of youths reported that work safety practices were very important to management, yet 38% stated that supervisors were only interested in "doing the job quickly and cheaply." Few youths reported appropriate work safety behavior, and 14% experienced an injury within the past 12 months. In bivariate analysis, perceptions of work safety climate were significantly associated with pesticide exposure risk factors for rewearing wet shoes (P = .01), wet clothes (P = .01), and shorts (P = .03). CONCLUSIONS Youth farmworkers perceived their work safety climate as being poor. Although additional research is needed to support these findings, these results strengthen the need to increase employer awareness to improve the safety climate for protecting youth farmworkers from harmful exposures and injuries.
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Affiliation(s)
- Gregory D Kearney
- Gregory D. Kearney is with the Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC. Guadalupe Rodriguez and Thomas A. Arcury are with the Department of Family and Community Medicine, Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, NC. Sara A. Quandt is with the Department of Epidemiology and Prevention, Division of Public Health Sciences and Community Medicine, Center for Worker Health, Wake Forest School of Medicine. Justin T. Arcury is a statistical consultant in Raleigh, NC
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Gorayski P, Burmeister B, Foote M. Radiotherapy for cutaneous melanoma: current and future applications. Future Oncol 2015; 11:525-34. [PMID: 25675130 DOI: 10.2217/fon.14.300] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Cutaneous malignant melanoma remains a significant health burden worldwide despite advances in the management of locoregionally advanced and metastatic disease. Historically, the efficacy of radiation therapy (RT) has been questioned due to the perceived radioresistance of melanoma cancer cells in vitro. Nowadays, RT has limited indications for primary disease, but is used for high-risk nodal disease and in the palliative setting. This review article outlines the current role of RT for melanoma and its expanding role in oligometastatic disease scenarios as an alternative approach to surgery and highlights potential future applications to harness RT interaction with immunomodulatory targeted therapies.
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Affiliation(s)
- Peter Gorayski
- Department of Radiation Oncology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
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Sun Protection Behaviors Among Latino Migrant Farmworkers in Eastern North Carolina. J Occup Environ Med 2014; 56:1325-31. [DOI: 10.1097/jom.0000000000000275] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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La Rosa F, Liso A, Bianconi F, Duca E, Stracci F. Seasonal variation in the month of birth in patients with skin cancer. Br J Cancer 2014; 111:1810-3. [PMID: 25290092 PMCID: PMC4453742 DOI: 10.1038/bjc.2014.522] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Revised: 08/15/2014] [Accepted: 09/07/2014] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Month of birth influences the risk of developing several diseases. We investigated the influence of date of birth on melanoma skin cancer (MSC) and non-melanoma skin cancer (NMSC) incidence. METHODS Enhanced cancer registry data were analysed including 1751 MSC and 15 200 NMSC. RESULTS People born in February to April showed significantly elevated risks of NMSC compared with those born in summertime. CONCLUSIONS We demonstrated seasonality by date of birth for skin cancer incidence. Neonatal UV exposure may explain this finding.
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Affiliation(s)
- F La Rosa
- Department of Experimental Medicine, Public Health Section, University of Perugia, 06126 Perugia, Italy
| | - A Liso
- Department of Medicine and Surgery, University of Foggia, 71122 Foggia, Italy
| | - F Bianconi
- Department of Experimental Medicine, Public Health Section, University of Perugia, 06126 Perugia, Italy
| | - E Duca
- Department of Health, Regional Government of Umbria, 06124 Perugia, Italy
| | - F Stracci
- Department of Experimental Medicine, Public Health Section, University of Perugia, 06126 Perugia, Italy
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Denzer N, Vogt T, Reichrath J. Vitamin D receptor (VDR) polymorphisms and skin cancer. DERMATO-ENDOCRINOLOGY 2014. [DOI: 10.4161/derm.16519] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Deng F, Gao Y, L V JH, Gao JM. Methylenetetrahydrofolate reductase gene polymorphisms and skin cancer risk: a meta-analysis. Cancer Genet 2014; 207:299-305. [PMID: 25306137 DOI: 10.1016/j.cancergen.2014.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 08/06/2014] [Accepted: 08/15/2014] [Indexed: 10/24/2022]
Abstract
We sought to determine whether the methylenetetrahydrofolate reductase (MTHFR) A1298C and C677T polymorphisms are associated with increased skin cancer risk. We performed literature searches of the PubMed, BIOSIS Previews, and Web of Science databases to identify eligible articles published through September 15, 2013. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using fixed-effects or random-effects models. Publication bias and subgroup analyses were also performed. Eight articles, which consisted of 10,066 subjects (2,672 patients and 7,394 controls), were included in the meta-analysis. Homozygous MTHFR 1298C individuals were 1.29 times more likely to develop skin cancer (95% CI, 1.04-1.61) compared with A1298C allele (AA or AC) carriers. There was an increased risk for C allele homozygotes compared with the 1,298 AA+AC carriers (OR, 1.45; 95% CI, 1.08-1.96) when restricted to basal cell carcinomas (BCC). The 1298C homozygote carriers increased the odds of BCC by 1.47 times (95% CI, 1.07-2.01) compared with those who were 1298A homozygote carriers. ORs for all genetic models yielded a null association. The data obtained from this meta-analysis suggest that the MTHFR 1298C allele is associated with increased skin cancer risk, particularly BCC; however, no association was observed between the MTHFR C677T polymorphism and skin cancer.
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Affiliation(s)
- Feng Deng
- Institution of Medical Management and Policy Research, College of Public Policy and Management, Xi'an Jiao Tong University, Xi'an, China
| | - Ying Gao
- Department of Radiotherapy Oncology, The First Affiliated Hospital of Medical College of Xi'an Jiao Tong University, Xi'an, China
| | - Ju-hong L V
- Department of Pediatrics Baoji Central Hospital of Shaanxi Province, Baoji, China
| | - Jian-min Gao
- Institution of Medical Management and Policy Research, College of Public Policy and Management, Xi'an Jiao Tong University, Xi'an, China.
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Thomas G, Nadiarnykh O, van Voskuilen J, Hoy CL, Gerritsen HC, Sterenborg HJCM. Estimating the risk of squamous cell cancer induction in skin following nonlinear optical imaging. JOURNAL OF BIOPHOTONICS 2014; 7:492-505. [PMID: 23401419 DOI: 10.1002/jbio.201200207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 12/31/2012] [Accepted: 01/16/2013] [Indexed: 05/08/2023]
Abstract
High power femto-second (fs) laser pulses used for in-vivo nonlinear optical (NLO) imaging can form cyclobutane pyrimidine dimers (CPD) in DNA, which may lead to carcinogenesis via subsequent mutations. Since UV radiation from routine sun exposure is the primary source of CPD lesions, we evaluated the risk of CPD-related squamous cell carcinoma (SCC) in human skin due to NLO imaging relative to that from sun exposure. We developed a unique cancer risk model expanding previously published estimation of risk from exposure to continuous wave (CW) laser. This new model showed that the increase in CPD-related SCC in skin from NLO imaging is negligible above that due to regular sun exposure.
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Affiliation(s)
- Giju Thomas
- Centre for Optical Diagnostics and Therapy, Erasmus Medical Centre, Post Box 2040, 3000 CA, Rotterdam, The Netherlands.
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Ozbakir B, Crielaard BJ, Metselaar JM, Storm G, Lammers T. Liposomal corticosteroids for the treatment of inflammatory disorders and cancer. J Control Release 2014; 190:624-36. [PMID: 24878183 DOI: 10.1016/j.jconrel.2014.05.039] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 05/13/2014] [Accepted: 05/20/2014] [Indexed: 01/08/2023]
Abstract
Glucocorticoids (GC) are known for their potent immunosuppressive and anti-inflammatory properties. As a consequence, they have been extensively used for the treatment of many different diseases. Prolonged and/or high-dose GC therapy, however, generally comes with severe side effects, resulting not only from their very diverse mechanism(s) of action, but also from their relatively poor biodistribution. Drug delivery systems, and in particular liposomes, have been extensively used to enhance the biodistribution and the target site accumulation of GC, and to thereby improve the balance between their efficacy and their toxicity. Many different types of liposomes have been employed, and both local and systemic treatments have been evaluated. We here summarize the progress made in the use of liposomal GC formulations for the treatment of asthma, rheumatoid arthritis, multiple sclerosis and cancer, and we show that the targeted delivery of GC to pathological sites holds significant clinical potential.
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Affiliation(s)
- Burcin Ozbakir
- Department of Pharmaceutics, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG Utrecht, The Netherlands
| | - Bart J Crielaard
- Department of Pharmaceutics, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG Utrecht, The Netherlands; Department of Pediatrics-Hematology/Oncology, Weill Cornell Medical College, 515 E71st Street, 10021 NY, USA
| | - Josbert M Metselaar
- Department of Controlled Drug Delivery, MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente, 7500 AE Enschede, The Netherlands
| | - Gert Storm
- Department of Pharmaceutics, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG Utrecht, The Netherlands; Department of Controlled Drug Delivery, MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente, 7500 AE Enschede, The Netherlands.
| | - Twan Lammers
- Department of Pharmaceutics, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG Utrecht, The Netherlands; Department of Experimental Molecular Imaging, RWTH - Aachen University, Helmholtz Institute for Biomedical Engineering, Pauwelsstrasse 30, 52074 Aachen, Germany; Department of Controlled Drug Delivery, MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente, 7500 AE Enschede, The Netherlands.
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Lucena EEDS, Costa DCB, da Silveira ÉJD, Lima KC. Adoption of photoprotection measures on lip and perioral regions among beach workers in North Brazil. Int J Dermatol 2014; 53:e480-5. [PMID: 24697313 DOI: 10.1111/ijd.12218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Workers from various occupational groups stand out as being more susceptible to photodamage. Behaviors that can reduce the risk of onset of these disorders include the limitation or reduction of sun exposure, use of photoprotective clothing, and correct use of sunscreen. The present study aimed to verify the use of photoprotection measures by beach workers on the lips and perioral regions, as well as investigate possible associations with sociodemographic, occupational, and health variables. MATERIALS AND METHODS For this purpose, calibrated researchers applied validated questionnaires. The participants were 362 beach workers with a minimum age of 18 years. Data were analyzed using chi-square tests and robust Poisson regression. RESULTS In regard to photoprotection measures, most of the population studied reported using some form of protection (80.1%). Among these, the most common were the use of a cap/hat (66.2%) and sunscreen (41.6%). Applying lipstick (3.6%) and using some other measure (4.2%) were the least reported. When compiling a multivariate analysis model, type of work (P = 0.001) was the only variable that explained the adoption of photoprotection measures, regardless of daily and accumulated exposure and the presence of habits. CONCLUSIONS In general, most workers reported using some form of photoprotection in the oral and perioral regions, and those exposed to direct solar radiation effectively confirmed this.
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Affiliation(s)
- Eudes Euler de Souza Lucena
- Department of Dentistry, Rio Grande do Norte State University, Caicó/RN, Brazil; Department of Dentistry, Federal University of Rio Grande do Norte, Natal/RN, Brazil
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Radespiel-Tröger M. Berufliche UV-Belastung und Hautkrebs. ZENTRALBLATT FUR ARBEITSMEDIZIN ARBEITSSCHUTZ UND ERGONOMIE 2014. [DOI: 10.1007/bf03346247] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Dono J, Ettridge KA, Sharplin GR, Wilson CJ. The relationship between sun protection policies and practices in schools with primary-age students: the role of school demographics, policy comprehensiveness and SunSmart membership. HEALTH EDUCATION RESEARCH 2014; 29:1-12. [PMID: 24270814 DOI: 10.1093/her/cyt105] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Schools can implement evidence-based sun protection policies that guide practices to help protect children from harmful sun exposure. This national study assessed the relationship between the existence and comprehensiveness of written policies and the comprehensiveness of sun protection practices. The impact of school demographics on the strength of the relationship was also examined, as was the possibility that 'SunSmart' membership would have an additional impact on practices, beyond having any formal policy. In 2011-12, staff members of 1573 schools catering to primary-age students completed a self-administered survey about sun protection policies and practices (response rate of 57%). Results showed that schools with a written policy had more comprehensive practices than schools without a written policy. The relationship between having a written policy and sun protection practices was stronger for remote schools compared with metropolitan and regional schools, and for schools catering to both primary and secondary students compared with primary students only. In addition, policy comprehensiveness was associated with practice comprehensiveness, and SunSmart membership was indirectly related to practice comprehensiveness via policy comprehensiveness. These results indicate that written policies relate to practice comprehensiveness, but the strength of the association can vary according to the characteristics of the organization.
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Affiliation(s)
- J Dono
- Population Health, South Australian Health and Medical Research Institute, PO BOX 11060, Adelaide SA, 5001, Australia, School of Psychology, University of Adelaide, Level 4 Hughes Building, SA 5005, Australia, Behavioural Research and Evaluation Unit, Cancer Council SA, PO BOX 929, Unley BC, 5061, Australia and Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, GPO Box 2100, Adelaide 5001, Australia
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Turner J, Parisi AV, Downs N, Lynch M. From ultraviolet to Prussian blue: a spectral response for the cyanotype process and a safe educational activity to explain UV exposure for all ages. Photochem Photobiol Sci 2014; 13:1753-64. [DOI: 10.1039/c4pp00166d] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The cyanotype process is characterisedviadynamic and spectral response in an educational toy (blue print paper) that can be used to provide outreach activities for UV exposure applications.
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Affiliation(s)
- J. Turner
- University of Southern Queensland
- Toowoomba, Australia
| | - A. V. Parisi
- University of Southern Queensland
- Toowoomba, Australia
| | - N. Downs
- University of Southern Queensland
- Toowoomba, Australia
| | - M. Lynch
- University of Southern Queensland
- Toowoomba, Australia
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Magro F, Peyrin-Biroulet L, Sokol H, Aldeger X, Costa A, Higgins PD, Joyce JC, Katsanos KH, Lopez A, de Xaxars TM, Toader E, Beaugerie L. Extra-intestinal malignancies in inflammatory bowel disease: results of the 3rd ECCO Pathogenesis Scientific Workshop (III). J Crohns Colitis 2014; 8:31-44. [PMID: 23721759 DOI: 10.1016/j.crohns.2013.04.006] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 04/05/2013] [Indexed: 12/28/2022]
Abstract
The incidence of lymphoproliferative disorders (LD) is increasing in developed countries. Patients with inflammatory bowel disease (IBD) exposed to thiopurines are at additional risk of three specific forms of LD: Epstein-Barr-Virus-related post-transplant like LD, hepato-splenic T-cell lymphoma and post-mononucleosis lymphoproliferation. The risk of the two latter forms of LD can be reduced when considering specific immunosuppressive strategies in young males. It is still unclear whether the risk of uterine cervix abnormalities is increased in IBD women, irrespective of the use of immunosuppressants. Given the excess risk demonstrated in various other contexts of immunosuppression, it is currently recommended that all women with IBD, particularly those receiving immunosuppressants, strictly adhere to a screening program of cervical surveillance and undergo vaccination against HPV, when appropriate. Patients with IBD receiving immunosuppressants are at increased risk of skin cancers. The risk of non-melanoma skin cancer is notably increased in patients receiving thiopurines. Recent data suggest that the risk of melanoma is mildly increased in patients exposed to anti-TNF therapy. All IBD patients should adhere to a program of sun protection and dermatological surveillance, whose details should take into account the other non-IBD-related risk factors.
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Affiliation(s)
- Fernando Magro
- Gastroenterology Department, Centro Hospitalar S. João, Institute of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Porto, Portugal; Institute for Molecular and Cell Biology, University of Porto, Porto, Portugal
| | - Laurent Peyrin-Biroulet
- Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy, and Université Henri Poincaré 1,Vandoeuvre-lès-Nancy, France
| | - Harry Sokol
- Department of Gastroenterology, AP-HP, Hôpital Saint-Antoine F-75012 and ERL 1057 INSERM/UMRS 7203, UPMC Univ Paris 06F-75005, Paris, France
| | - Xavier Aldeger
- Department of Gastroenterology of University Hospital Doctor Josep Trueta de Girona, Spain
| | - Antonia Costa
- Department of Gynecology and Obstetrics Department, Centro Hospitalar S. João, Portugal, and Faculty of Medicine, Porto University, Porto, Portugal
| | - Peter D Higgins
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Joel C Joyce
- Department of Dermatology, Medical College of Wisconsin, WI, USA
| | - Konstantinos H Katsanos
- Department of Internal Medicine & Hepato-Gastroenterology Unit, Medical School University of Ioannina, Ioannina, Greece
| | - Anthony Lopez
- Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy, and Université Henri Poincaré 1,Vandoeuvre-lès-Nancy, France
| | | | - Elena Toader
- Gastroenterology and Hepatology Center, University Hospital Sf. Spiridon, and University of Medicine and Pharmacy Gr. T. Popa, Iasi, Romania
| | - Laurent Beaugerie
- Department of Gastroenterology, AP-HP, Hôpital Saint-Antoine F-75012 and ERL 1057 INSERM/UMRS 7203, UPMC Univ Paris 06F-75005, Paris, France.
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Development and validation of a lifetime exposure questionnaire for use among Chinese populations. Sci Rep 2013; 3:2793. [PMID: 24077356 PMCID: PMC3786302 DOI: 10.1038/srep02793] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 08/21/2013] [Indexed: 12/24/2022] Open
Abstract
The sunlight exposure questionnaire for use in the Chinese population was constructed based on extensive literature review and item suitability for measuring life-time exposure. The content validity index (CVI) was derived from ratings by, an expert panel to assess the item content and relevance. 650 population-based Chinese women completed the sunlight exposure questionnaire through telephone interview. To assess the questionnaire reliability, 94 women were re-interviewed after 2 weeks. 98.4% of the sunlight exposure questionnaire items were found to have valid CVI (>0.83). The Scree plot and the Principal Components Factor Analysis showed a two-factor construct was appropriate and no questionnaire item needed to be excluded. The questionnaire also had a good test-retest reliability (ICC: 0.59–0.93; k: 0.51–100). This sunlight exposure questionnaire was found to be adequate for measurement of life-time sunlight exposure among Hong Kong Chinese women.
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Wu SH, Ho SC, So E, Lam TP, Woo J, Yuen P, Qin L, Ku S. Sunlight exposure and breast density: a population-based study. J Breast Cancer 2013; 16:171-7. [PMID: 23843849 PMCID: PMC3706862 DOI: 10.4048/jbc.2013.16.2.171] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 04/16/2013] [Indexed: 11/30/2022] Open
Abstract
Purpose This study aims to assess the association of sunlight exposure with breast cancer risk, measured by the breast density assessed from Tabár's mammographic pattern in Chinese women. Methods A total of 676 premenopausal women were recruited to participate in this study, in which 650 completed a validated sunlight exposure questionnaire via telephone. The mammograms were classified according to Tabár's classification for parenchyma, and patterns IV & V and I, II & III indicated respectively high and low risk mammographic patterns for breast cancer. The odds ratios (OR) and 95% confidence intervals (CIs) for sun exposure-related variables were estimated using unconditional logistic regression with adjustment for potential confounders. Results Among 646 participants, women with high breast cancer risk (Tabár's patterns IV &V) had less hours spent in the sun than those with low risk (I, II & III) at any age stage. A higher level of sunlight exposure was associated with a significantly lower risk having high risk Tabár's pattern. Women aged 40 to 44 years who were in the highest tertile of lifetime total hours spent in the sun had a multi-adjusted OR of 0.41 (95% CI, 0.18-0.92; p for trend=0.03) compared with those in the lowest tertile (>2.19 hr/day vs. <1.32 hr/day). For hours spent in the sun across the ages of 6 to 12 years, the comparable OR was 0.37 (95% CI, 0.15-0.91; p for trend=0.03). Conclusion These findings suggest that higher sunlight exposure is related to a lower risk of having high risk breast density pattern in premenopausal women. Our results also suggest the most relevant period of exposure is during earlier life.
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Affiliation(s)
- Sheng-Hui Wu
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China. ; Division of Epidemiology, Department of Medicine, Institute of Medicine and public Health, Vanderbilt University Medical Center, Nashville, USA
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Sunlight, vitamin D and the prevention of cancer: a systematic review of epidemiological studies. Eur J Cancer Prev 2013; 18:458-75. [PMID: 19730382 DOI: 10.1097/cej.0b013e32832f9bb1] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The number of studies reporting beneficial effects of sunlight and vitamin D on several types of cancer with a high mortality rate is growing rapidly. Present health recommendations on sun exposure are mainly based on the increased risks for skin cancer. We reviewed all published studies concerning cancer and sun exposure and vitamin D, respectively, excluding those about skin cancer. Most identified ecological, case-control and prospective studies on the incidence and mortality of colorectal, prostate, breast carcinoma and non-Hodgkin lymphoma reported a significantly inverse association with sun exposure. The results of the included studies on the association between cancer risk and vitamin D were much less consistent. Only those studies that prospectively examined the 25-hydroxyvitamin D serum levels in relation to risk of colorectal cancer are homogeneous: they all reported inverse associations, although not all reaching statistical significance. The results of the intervention studies are suggestive of a protective role of high doses of vitamin D in cancer, but they have been criticized in the literature. We, therefore, conclude that there is accumulating evidence for sunlight as a protective factor for several types of cancer. The same conclusion can be made concerning high vitamin D levels and the risk of colorectal cancer. This evidence, however, is not conclusive, because the number of (good quality) studies is still limited and publication biases cannot be excluded. The discrepancies between the epidemiological evidence for a possible preventive effect of sunlight and vitamin D and the question of how to apply the findings on the beneficial effects of sunlight to (public) health recommendations are discussed.
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Turner J, Parisi AV. Influence of reflected UV irradiance on occupational exposure from combinations of reflective wall surfaces. Photochem Photobiol Sci 2013; 12:1589-95. [DOI: 10.1039/c3pp50059d] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Song F, Qureshi AA, Giovannucci EL, Fuchs CS, Chen WY, Stampfer MJ, Han J. Risk of a second primary cancer after non-melanoma skin cancer in white men and women: a prospective cohort study. PLoS Med 2013; 10:e1001433. [PMID: 23630459 PMCID: PMC3635863 DOI: 10.1371/journal.pmed.1001433] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 03/15/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Previous studies suggest a positive association between history of non-melanoma skin cancer (NMSC) and risk of subsequent cancer at other sites. The purpose of this study is to prospectively examine the risk of primary cancer according to personal history of NMSC. METHODS AND FINDINGS In two large US cohorts, the Health Professionals Follow-up Study (HPFS) and the Nurses' Health Study (NHS), we prospectively investigated this association in self-identified white men and women. In the HPFS, we followed 46,237 men from June 1986 to June 2008 (833,496 person-years). In the NHS, we followed 107,339 women from June 1984 to June 2008 (2,116,178 person-years). We documented 29,447 incident cancer cases other than NMSC. Cox proportional hazard models were used to calculate relative risks (RRs) and 95% confidence intervals (CIs). A personal history of NMSC was significantly associated with a higher risk of other primary cancers excluding melanoma in men (RR=1.11; 95% CI 1.05-1.18), and in women (RR=1.20; 95% CI 1.15-1.25). Age-standardized absolute risk (AR) was 176 in men and 182 in women per 100,000 person-years. For individual cancer sites, after the Bonferroni correction for multiple comparisons (n=28), in men, a personal history of NMSC was significantly associated with an increased risk of melanoma (RR=1.99, AR=116 per 100,000 person-years). In women, a personal history of NMSC was significantly associated with an increased risk of breast (RR=1.19, AR=87 per 100,000 person-years), lung (RR=1.32, AR=22 per 100,000 person-years), and melanoma (RR=2.58, AR=79 per 100,000 person-years). CONCLUSION This prospective study found a modestly increased risk of subsequent malignancies among individuals with a history of NMSC, specifically breast and lung cancer in women and melanoma in both men and women.
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Affiliation(s)
- Fengju Song
- Department of Epidemiology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Abrar A. Qureshi
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Edward L. Giovannucci
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Charlie S. Fuchs
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, United States of America
| | - Wendy Y. Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, United States of America
| | - Meir J. Stampfer
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, United States of America
| | - Jiali Han
- Department of Epidemiology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
- * E-mail:
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Lucena EEDS, Costa DCB, Silveira ÉJDD, Lima KCD. Prevalência de lesões labiais em trabalhadores de praia e fatores associados. Rev Saude Publica 2012. [DOI: 10.1590/s0034-89102012000600015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Analisar a prevalência de lesões labiais decorrentes da exposição solar e potenciais associações em trabalhadores de praia. MÉTODOS: Estudo transversal com 362 trabalhadores de cinco praias urbanas em Natal, RN, de agosto a dezembro de 2010. Os participantes responderam um questionário validado com dados pessoais, de ocupação e de saúde e passaram por exame clínico dos lábios feito por pesquisadores calibrados. As possíveis associações das variáveis sociodemográficas, ocupacionais e de saúde geral com a presença de lesões labiais foram avaliadas pelo teste do qui-quadrado para um nível de significância de 5%. A análise multivariada foi feita utilizando-se a regressão robusta de Poisson. RESULTADOS: Dos trabalhadores examinados, 27,1% apresentavam lesões labiais. Desses, 76,8% eram do sexo masculino; 61,6% tinham pele morena ou negra; 94,5% trabalhavam informalmente; e 85,4% trabalhavam expostos ao sol. A maioria (81,1%) relatou uso de algum tipo de fotoproteção: protetor solar (38,7%); protetor labial (15,3%); boné/chapéu (72,4%). Aproximadamente 28% eram fumantes e 48% consumiam álcool regularmente. A fotoproteção com uso de boné/chapéu foi associada à presença de lesões labiais decorrentes da exposição solar. CONCLUSÕES: Observou-se alta prevalência de lesões labiais nos indivíduos expostos ao sol, a qual foi associada ao uso de boné/chapéu como forma de fotoproteção.
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Abstract
It is estimated that 5-10% of all cutaneous malignancies involve the periocular region and management of periocular skin cancers account for a significant proportion of the oculoplastic surgeon's workload. Epithelial tumours are most frequently encountered, including basal cell carcinoma, squamous cell carcinoma, and sebaceous gland carcinoma, in decreasing order of frequency. Non-epithelial tumours, such as cutaneous melanoma and Merkel cell carcinoma, rarely involve the ocular adnexae. Although non-surgical treatments for periocular malignancies are gaining in popularity, surgery remains the main treatment modality and has as its main aims tumour clearance, restoration of the eyelid function, protection of the ocular surface, and achieving a good cosmetic outcome. The purpose of this article is to review the management of malignant periocular tumours, with particular emphasis on surgical management.
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Affiliation(s)
- C Rene
- Department of Ophthalmology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
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Kim SK, Kim YW, Youn HJ, Park HS, Jung SH. Primary cutaneous malignant melanoma of the breast. JOURNAL OF THE KOREAN SURGICAL SOCIETY 2012; 83:388-92. [PMID: 23230558 PMCID: PMC3514482 DOI: 10.4174/jkss.2012.83.6.388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 09/25/2012] [Accepted: 10/09/2012] [Indexed: 12/01/2022]
Abstract
Cutaneous malignant melanoma of the breast can be divided into two categories: primary and metastatic lesions. Cutaneous malignant melanoma of the breast is a rare tumor, accounting for less than 5% of all malignant melanomas. Clinical features and diagnostic methods of primary cutaneous malignant melanoma of the breast are similar to those arising from other cutaneous areas. Treatment of choice is wide local excision with adequate resection margin according to tumor thickness. Sentinel lymph node biopsy should be performed because the presence of lymph node metastasis is the most important prognostic factor. There have been only limited reports involving primary cutaneous malignant melanoma of the breast. Thus, we report a case of primary cutaneous malignant melanoma in a 59-year-old woman with a review of the recent literature.
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Affiliation(s)
- Seon Kwang Kim
- Department of Surgery, Chonbuk National University Medical School, Jeonju, Korea
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Pan ZY, Lin JR, Cheng TT, Wu JQ, Wu WY. In vivo reflectance confocal microscopy of Basal cell carcinoma: feasibility of preoperative mapping of cancer margins. Dermatol Surg 2012; 38:1945-50. [PMID: 23039159 PMCID: PMC3546396 DOI: 10.1111/j.1524-4725.2012.02587.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Reflectance confocal microscopy (RCM) images skin at cellular resolution and has shown utility for the diagnosis of nonmelanoma skin cancer in vivo. It has the potential to define lesion margins before surgical therapy.
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Affiliation(s)
- Zhan-Yan Pan
- Department of Dermatology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
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Sun-protection habits of primary students in a coastal area of Greece. J Skin Cancer 2012; 2012:629652. [PMID: 23091726 PMCID: PMC3467799 DOI: 10.1155/2012/629652] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Revised: 08/23/2012] [Accepted: 09/03/2012] [Indexed: 11/24/2022] Open
Abstract
Aim. The aim of the present study was to record habits and attitudes of primary school students in Greece regarding sun-protection measures. Materials and Methods. 2,163 students with an average age of 9.9 (±1.1) years, studying in 14 schools of a Greek region, constituted our sample. The SPSS 17.0 software was used for the statistical analysis and significance level was set to P ≤ 0.05. Results. Our sample had an equal gender distribution. 16% of the students belonged to the high-risk group, 70.2% of the participants lived 0–5 km away from the sea (urban area), 84.2% of the students were Greek, and 15.8% had non-Greek nationality. Half of the participants said they wear a hat when under the sun and 72% of them said they use sunscreen. 33.1% of the students said they had a sunburn last summer. Greek students as well as those who lived near the sea had better behaviour patterns regarding sun protection. Finally, children who did not use a sunscreen systematically had suffered sunburns more often than the rest. Conclusions. Health education programmes are necessary for students and parents/teachers alike, in order to raise awareness about everyday sun protection.
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Cancer therapy and vaccination. J Immunol Methods 2012; 382:1-23. [PMID: 22658969 DOI: 10.1016/j.jim.2012.05.014] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Revised: 04/01/2012] [Accepted: 05/24/2012] [Indexed: 12/18/2022]
Abstract
Cancer remains one of the leading causes of death worldwide, both in developed and in developing nations. It may affect people at all ages, even fetuses, but the risk for most varieties increases with age. Current therapeutic approaches which include surgery, chemotherapy and radiotherapy are associated with adverse side effects arising from lack of specificity for tumors. The goal of any therapeutic strategy is to impact on the target tumor cells with limited detrimental effect to normal cell function. Immunotherapy is cancer specific and can target the disease with minimal impact on normal tissues. Cancer vaccines are capable of generating an active tumor-specific immune response and serve as an ideal treatment due to their specificity for tumor cells and long lasting immunological memory that may safeguard against recurrences. Cancer vaccines are designed to either prevent (prophylactic) or treat established cancer (therapeutic). Identification of tumor-associated antigens (TAAs) and tumor-specific antigens (TSAs) has led to increased efforts to develop vaccination strategies. Vaccines may be composed of whole cells or cell extracts, genetically modified tumor cells to express costimulatory molecules, dendritic cells (DCs) loaded with TAAs, immunization with soluble proteins or synthetic peptides, recombinant viruses or bacteria encoding tumor-associated antigens, and plasmid DNA encoding TSAs or TAAs in conjunction with appropriate immunomodulators. All of these antitumor vaccination approaches aim to induce specific immunological responses and localized to TAAs, destroying tumor cells alone and leaving the vast majority of other healthy cells of the body untouched.
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Kimlin MG, Guo Y. Assessing the impacts of lifetime sun exposure on skin damage and skin aging using a non-invasive method. THE SCIENCE OF THE TOTAL ENVIRONMENT 2012; 425:35-41. [PMID: 22459885 DOI: 10.1016/j.scitotenv.2012.02.080] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Revised: 02/28/2012] [Accepted: 02/29/2012] [Indexed: 05/31/2023]
Abstract
BACKGROUND Ultraviolet radiation exposure during an individuals' lifetime is a known risk factor for the development of skin cancer. However, less evidence is available on assessing the relationship between lifetime sun exposure and skin damage and skin aging. OBJECTIVES This study aims to assess the relationship between lifetime sun exposure and skin damage and skin aging using a non-invasive measure of exposure. METHODS We recruited 180 participants (73 males, 107 females) aged 18-83 years. Digital imaging of skin hyperpigmentation (skin damage) and skin wrinkling (skin aging) on the facial region was measured. Lifetime sun exposure (presented as hours) was calculated from the participants' age multiplied by the estimated annual time outdoors for each year of life. We analyzed the effects of lifetime sun exposure on skin damage and skin aging. We adjust for the influence of age, sex, occupation, history of skin cancer, eye color, hair color, and skin color. RESULTS There were non-linear relationships between lifetime sun exposure and skin damage and skin aging. Younger participant's skin is much more sensitive to sun exposure than those who were over 50 years of age. As such, there were negative interactions between lifetime sun exposure and age. Age had linear effects on skin damage and skin aging. CONCLUSION The data presented showed that self reported lifetime sun exposure was positively associated with skin damage and skin aging, in particular, the younger people. Future health promotion for sun exposure needs to pay attention to this group for skin cancer prevention messaging.
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Affiliation(s)
- Michael G Kimlin
- AusSun Research Lab, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia.
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