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Lacson JCA, Sutton SK, Kim Y, Roetzheim RG, Vadaparampil ST, Soto-Torres B, Kanetsky PA. Predictors of correct recall of genetic risk information among Hispanic individuals in Florida and Puerto Rico. PATIENT EDUCATION AND COUNSELING 2023; 117:107978. [PMID: 37708699 PMCID: PMC10872848 DOI: 10.1016/j.pec.2023.107978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/03/2023] [Accepted: 09/08/2023] [Indexed: 09/16/2023]
Abstract
OBJECTIVE To identify predictors of genetic risk recall and examine whether recall influences adoption of skin cancer preventive behaviors among Hispanic individuals. METHODS Hispanic participants randomized to intervention arms (n = 463) of a precision prevention trial were provided MC1R risk information (average, higher) and asked to recall their risk after 3 and 9 months. Predictors of recall (correct versus did not recall/misremembered) were determined by backwards stepwise logistic regression. Intervention effects on preventive behaviors were estimated within strata of 3-month recall. RESULTS Age inversely predicted correct recall in both risk groups (average: OR3-months(3)= 0.97, 95%CI:0.94-1.01, OR9-months(9)= 0.96, 95%CI:0.93-0.99; higher: OR3 = 0.98, 95%CI:0.95-1.01, OR9 = 0.98, 95%CI:0.95-1.00). Education positively predicted recall among participants at average risk (OR3 =1.64, 95%CI:1.06-2.63, OR9 =1.73, 95%CI:1.12-2.81). Darker untanned skin color inversely predicted recall among participants at higher risk (OR3 =0.68, 95%CI:0.45-0.99, OR9 =0.74, 95%CI:0.50-1.09). Intervention effects for routine sunscreen use and undergoing a clinical skin exam were stronger among participants at higher risk who correctly recalled at 3 months than those who did not recall/misremembered. CONCLUSIONS Younger age, higher education, and lighter untanned skin color predicted correct recall. Better recall may improve skin cancer prevention outcomes. PRACTICE IMPLICATIONS Additional strategies are needed to boost recall among Hispanic individuals who are older, less educated, and darker-skinned.
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Affiliation(s)
- John Charles A Lacson
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Steven K Sutton
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Youngchul Kim
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Richard G Roetzheim
- Department of Family Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Susan T Vadaparampil
- Department of Health and Behavioral Outcomes, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | - Peter A Kanetsky
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA.
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Chong Y, Tu X, Lu Y, Gao Z, He X, Hong J, Wu J, Wu D, Xi D, Deng W. Two High-Quality Cygnus Genome Assemblies Reveal Genomic Variations Associated with Plumage Color. Int J Mol Sci 2023; 24:16953. [PMID: 38069278 PMCID: PMC10707585 DOI: 10.3390/ijms242316953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 11/26/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023] Open
Abstract
As an exemplary model for examining molecular mechanisms responsible for extreme phenotypic variations, plumage color has garnered significant interest. The Cygnus genus features two species, Cygnus olor and Cygnus atratus, that exhibit striking disparities in plumage color. However, the molecular foundation for this differentiation has remained elusive. Herein, we present two high-quality genomes for C. olor and C. atratus, procured using the Illumina and Nanopore technologies. The assembled genome of C. olor was 1.12 Gb in size with a contig N50 of 26.82 Mb, while its counterpart was 1.13 Gb in size with a contig N50 of 21.91 Mb. A comparative analysis unveiled three genes (TYR, SLC45A2, and SLC7A11) with structural variants in the melanogenic pathway. Notably, we also identified a novel gene, PWWP domain containing 2A (PWWP2A), that is related to plumage color, for the first time. Using targeted gene modification analysis, we demonstrated the potential genetic effect of the PWWP2A variant on pigment gene expression and melanin production. Finally, our findings offer insight into the intricate pattern of pigmentation and the role of polygenes in birds. Furthermore, these two high-quality genome references provide a comprehensive resource and perspective for comparative functional and genetic studies of evolution within the Cygnus genus.
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Affiliation(s)
- Yuqing Chong
- Faculty of Animal Science and Technology, Yunnan Agricultural University, Kunming 650201, China; (Y.C.); (Y.L.); (Z.G.); (X.H.); (J.H.); (J.W.); (D.X.)
| | - Xiaolong Tu
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China;
| | - Ying Lu
- Faculty of Animal Science and Technology, Yunnan Agricultural University, Kunming 650201, China; (Y.C.); (Y.L.); (Z.G.); (X.H.); (J.H.); (J.W.); (D.X.)
| | - Zhendong Gao
- Faculty of Animal Science and Technology, Yunnan Agricultural University, Kunming 650201, China; (Y.C.); (Y.L.); (Z.G.); (X.H.); (J.H.); (J.W.); (D.X.)
| | - Xiaoming He
- Faculty of Animal Science and Technology, Yunnan Agricultural University, Kunming 650201, China; (Y.C.); (Y.L.); (Z.G.); (X.H.); (J.H.); (J.W.); (D.X.)
| | - Jieyun Hong
- Faculty of Animal Science and Technology, Yunnan Agricultural University, Kunming 650201, China; (Y.C.); (Y.L.); (Z.G.); (X.H.); (J.H.); (J.W.); (D.X.)
| | - Jiao Wu
- Faculty of Animal Science and Technology, Yunnan Agricultural University, Kunming 650201, China; (Y.C.); (Y.L.); (Z.G.); (X.H.); (J.H.); (J.W.); (D.X.)
| | - Dongdong Wu
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China;
| | - Dongmei Xi
- Faculty of Animal Science and Technology, Yunnan Agricultural University, Kunming 650201, China; (Y.C.); (Y.L.); (Z.G.); (X.H.); (J.H.); (J.W.); (D.X.)
| | - Weidong Deng
- Faculty of Animal Science and Technology, Yunnan Agricultural University, Kunming 650201, China; (Y.C.); (Y.L.); (Z.G.); (X.H.); (J.H.); (J.W.); (D.X.)
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Crowder SL, Buro AW, Lacson JCA, Del Rio J, Kim Y, Roetzheim RG, Sutton SK, Vadaparampil ST, Soto-Torres B, Stern M, Kanetsky PA. Qualitative assessment of uptake retention and evaluation of prevention materials for skin cancer among Hispanics. PATIENT EDUCATION AND COUNSELING 2023; 112:107742. [PMID: 37028174 PMCID: PMC10164708 DOI: 10.1016/j.pec.2023.107742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/23/2023] [Accepted: 04/03/2023] [Indexed: 05/09/2023]
Abstract
OBJECTIVE Examine retention and evaluation of incorporating melanocortin-1 receptor genetic risk information materials in a skin cancer prevention intervention conducted in Hispanics living near Tampa, Florida and Ponce, Puerto Rico. METHODS Two researchers applied thematic content analysis to identify major themes of open-ended responses (n = 1689) from 489 participants. RESULTS Five major thematic categories emerged: 1) intervention comments; 2) tips and tricks; 3) cancer prevention; 4) general information; and 5) risk factors and genetics. Responses captured under intervention comments (e.g., information was clear, easy to understand) and tips and tricks for sun protection (e.g., using sunscreen, wearing protective clothing) were most frequent. Participants noted the importance of conducting skin exams professionally or at home. English-preferring Tampa residents stated their individual risk factors, especially race and/or ethnicity, more frequently than Ponce residents and Spanish-preferring Tampa residents. Ponce residents were more likely to comment on wanting to share intervention materials with family and friends. CONCLUSION Findings suggest Hispanic participants implemented sun safety activities.
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Affiliation(s)
- Sylvia L Crowder
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, USA
| | - Acadia W Buro
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, USA
| | - John Charles A Lacson
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, USA
| | - Jocelyn Del Rio
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, USA
| | - Youngchul Kim
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Richard G Roetzheim
- Department of Family Medicine, Morsani College of Medicine, University of South Florida, Tampa, USA
| | - Steven K Sutton
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Susan T Vadaparampil
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, USA
| | | | - Marilyn Stern
- Department of Child and Family Studies, University of South Florida, Tampa, USA
| | - Peter A Kanetsky
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, USA.
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Wu YP, Hamilton JG, Kaphingst KA, Jensen JD, Kohlmann W, Parsons BG, Lillie HM, Wang X, Haaland B, Wankier AP, Grossman D, Hay JL. Increasing Skin Cancer Prevention in Young Adults: the Cumulative Impact of Personalized UV Photography and MC1R Genetic Testing. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:1059-1065. [PMID: 36306029 PMCID: PMC10502947 DOI: 10.1007/s13187-022-02232-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 06/02/2023]
Abstract
Skin cancer has become increasingly common among young adults; however, this population does not consistently adhere to recommended methods for preventing the disease. Interventions in college settings have relied on appearance-focused appeals and have not been able to examine the cumulative effect of multiple behavior change and skin cancer risk communication strategies. The goal of the current study was to examine the unique and combined impacts of personalized ultraviolet (UV) radiation photographs, genetic testing for skin cancer risk, and general skin cancer prevention education. Participants were randomly assigned to one of four conditions: (1) skin cancer prevention education, (2) education + UV photo, (3) education + genetic testing, and (4) education + UV photo + genetic testing. Self-reported sun protection, tanning, and sunburn were assessed at baseline, immediately post-intervention, and 1 month post-intervention. The findings indicated benefits of the interventions to skin cancer prevention behaviors in the overall sample; however, the combined (UV photo + genetic testing) intervention had the most consistent positive effects on behaviors. Intervention effects were distinct across seasons. These results suggest that interventions containing multiple skin cancer risk communication strategies hold promise in benefitting health-promoting behavior changes in an at-risk, young adult population.Trial Registration Number: NCT03979872; Registered 6/5/2019.
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Affiliation(s)
- Yelena P Wu
- Department of Dermatology, University of Utah Health Sciences Center, 30 North 1900 East, 4A330-Salt Lake City, UT, 84132, USA.
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Rm LL376, Salt Lake City, UT, 84112, USA.
| | - Jada G Hamilton
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
- Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
| | - Kimberly A Kaphingst
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Rm LL376, Salt Lake City, UT, 84112, USA
- Department of Communication, University of Utah, 255 Central Campus Drive, Salt Lake City, UT, 84112, USA
| | - Jakob D Jensen
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Rm LL376, Salt Lake City, UT, 84112, USA
- Department of Communication, University of Utah, 255 Central Campus Drive, Salt Lake City, UT, 84112, USA
| | - Wendy Kohlmann
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Rm LL376, Salt Lake City, UT, 84112, USA
| | - Bridget G Parsons
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Rm LL376, Salt Lake City, UT, 84112, USA
| | - Helen M Lillie
- Department of Communication, University of Utah, 255 Central Campus Drive, Salt Lake City, UT, 84112, USA
| | - Xuechen Wang
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Rm LL376, Salt Lake City, UT, 84112, USA
- Department of Population Health Sciences, University of Utah, 295 Chipeta Way, Williams Building Room 1N410, Salt Lake City, UT, 84108, USA
| | - Benjamin Haaland
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Rm LL376, Salt Lake City, UT, 84112, USA
- Department of Population Health Sciences, University of Utah, 295 Chipeta Way, Williams Building Room 1N410, Salt Lake City, UT, 84108, USA
| | - Ali P Wankier
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Rm LL376, Salt Lake City, UT, 84112, USA
| | - Douglas Grossman
- Department of Dermatology, University of Utah Health Sciences Center, 30 North 1900 East, 4A330-Salt Lake City, UT, 84132, USA
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Rm LL376, Salt Lake City, UT, 84112, USA
| | - Jennifer L Hay
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
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Abstract
Over the past decade, melanoma has led the field in new cancer treatments, with impressive gains in on-treatment survival but more modest improvements in overall survival. Melanoma presents heterogeneity and transcriptional plasticity that recapitulates distinct melanocyte developmental states and phenotypes, allowing it to adapt to and eventually escape even the most advanced treatments. Despite remarkable advances in our understanding of melanoma biology and genetics, the melanoma cell of origin is still fiercely debated because both melanocyte stem cells and mature melanocytes can be transformed. Animal models and high-throughput single-cell sequencing approaches have opened new opportunities to address this question. Here, we discuss the melanocytic journey from the neural crest, where they emerge as melanoblasts, to the fully mature pigmented melanocytes resident in several tissues. We describe a new understanding of melanocyte biology and the different melanocyte subpopulations and microenvironments they inhabit, and how this provides unique insights into melanoma initiation and progression. We highlight recent findings on melanoma heterogeneity and transcriptional plasticity and their implications for exciting new research areas and treatment opportunities. The lessons from melanocyte biology reveal how cells that are present to protect us from the damaging effects of ultraviolet radiation reach back to their origins to become a potentially deadly cancer.
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Affiliation(s)
- Patricia P Centeno
- Molecular Oncology Group, Cancer Research UK Manchester Institute, The University of Manchester, Alderley Park, UK
| | - Valeria Pavet
- Molecular Oncology Group, Cancer Research UK Manchester Institute, The University of Manchester, Alderley Park, UK
| | - Richard Marais
- Molecular Oncology Group, Cancer Research UK Manchester Institute, The University of Manchester, Alderley Park, UK.
- Oncodrug Ltd, Alderly Park, Macclesfield, UK.
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Brady HL, Hamilton JG, Kaphingst KA, Jensen JD, Kohlmann W, Parsons BG, Lillie HM, Wankier AP, Smith HJ, Grossman D, Hay JL, Wu YP. 'I had a bigger cancer risk than I thought…': The experience of receiving personalized risk information as part of a skin cancer prevention intervention in the college setting. Health Expect 2022; 25:2937-2949. [PMID: 36225123 PMCID: PMC9700178 DOI: 10.1111/hex.13601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 07/25/2022] [Accepted: 08/25/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Diagnoses of both melanoma and nonmelanoma skin cancers are becoming increasingly common among young adults. Interventions in this population are a priority because they do not consistently follow skin cancer prevention recommendations. OBJECTIVES The goal of the current study was to examine college students' perspectives on and experience with receiving a skin cancer prevention intervention that provided personalized skin cancer risk feedback in the form of an ultraviolet (UV) photograph, the results of genetic testing for common skin cancer risk variants, and/or general skin cancer prevention education. METHODS Qualitative interviews were conducted with 38 college students who received a skin cancer prevention intervention. The interview covered students' feelings about their personal skin cancer risk information, the impact of the intervention on their skin cancer risk perceptions, actions or intentions to act with regard to their sun protection practices and feedback for improvement of the intervention content or delivery. RESULTS Participants reported that different intervention components contributed to increased awareness of their sun protection behaviours, shifts in cognitions about and motivation to implement sun protection strategies and reported changes to their skin cancer prevention strategies. CONCLUSION Our findings indicate that college students are interested in and responsive to these types of multicomponent skin cancer preventive interventions. Further, students demonstrate some motivation and intentionality toward changing their skin cancer risk behaviour in the short term. PATIENT OR PUBLIC CONTRIBUTION Participants involved in this study were members of the public (undergraduate students) who were involved in a skin cancer prevention intervention, then participated in semistructured interviews, which provided the data analysed for this study.
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Affiliation(s)
- Hannah L. Brady
- Cancer Control and Population Sciences Division, Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Jada G. Hamilton
- Department of Psychiatry & Behavioral SciencesMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
- Department of MedicineMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Kimberly A. Kaphingst
- Cancer Control and Population Sciences Division, Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtahUSA
- Department of CommunicationUniversity of UtahSalt Lake CityUtahUSA
| | - Jakob D. Jensen
- Department of CommunicationUniversity of UtahSalt Lake CityUtahUSA
- Department of DermatologyUniversity of Utah Health Sciences CenterSalt Lake CityUtahUSA
| | - Wendy Kohlmann
- Cancer Control and Population Sciences Division, Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Bridget G. Parsons
- Cancer Control and Population Sciences Division, Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Helen M. Lillie
- Department of CommunicationUniversity of UtahSalt Lake CityUtahUSA
| | - Ali P. Wankier
- Cancer Control and Population Sciences Division, Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Heather J. Smith
- Cancer Control and Population Sciences Division, Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Douglas Grossman
- Cancer Control and Population Sciences Division, Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtahUSA
- Department of DermatologyUniversity of Utah Health Sciences CenterSalt Lake CityUtahUSA
| | - Jennifer L. Hay
- Department of Psychiatry & Behavioral SciencesMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Yelena P. Wu
- Cancer Control and Population Sciences Division, Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtahUSA
- Department of DermatologyUniversity of Utah Health Sciences CenterSalt Lake CityUtahUSA
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Jonnalagadda M, Bharti N, Kasibhatla SM, Wagh MA, Joshi R, Ozarkar S, Ashma R. MC1R diversity and its role in skin pigmentation variation in West Maharashtra, India. Am J Hum Biol 2022; 34:e23734. [PMID: 35188998 DOI: 10.1002/ajhb.23734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 02/02/2022] [Accepted: 02/08/2022] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES MC1R polymorphisms have been reported to be under a selective constraint in populations inhabiting high UVR regions such as Africans; however, these patterns are not consistent. Here we analyze the MC1R gene in West Maharashtra, India to see if sequence diversity corresponds to their diverse pigmentary profiles and if MC1R is constrained in dark skinned tribal as compared to lighter skinned caste populations. METHODS A 2648 bp region of this gene was sequenced in 102 individuals and the data was compared for π, ϴ diversity indices. Tajima's D was assessed for signatures of purifying selection and MC1R variants were associated with MI measures using the additive, dominant, and recessive models. Pairwise FST was tested among study populations and between study populations and 1000 Genomes regional samples. RESULTS MC1R diversity was not uniquely patterned among castes and tribes. Non-synonymous variants rs2228479A, rs1805007_T, and rs885479_A showed low variability in these populations. Selection tests did not indicate any constraint on MC1R and pairwise FST were also low among the study populations (-0.0163 to 0.06112). The SNP rs3212359 was significantly associated with MI measures when tested using different association models. CONCLUSIONS We do not find evidence of a selective constraint on MC1R. The presence of a large number of unique haplotypes and low FST values at this locus suggests that MC1R polymorphisms may not be influencing pigmentation variation among castes and tribes in this region. Observed associations between rs3212359 and MI measures need to be validated through studies on larger samples and in-vitro functional studies.
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Affiliation(s)
- Manjari Jonnalagadda
- Symbiosis School for Liberal Arts, Symbiosis International (Deemed University), Pune, India
| | - Neeraj Bharti
- HPC-MBA Group, C-DAC Innovation Park, Centre for Development of Advanced Computing, Pune, India
| | | | - Mayur A Wagh
- Symbiosis School for Liberal Arts, Symbiosis International (Deemed University), Pune, India
| | - Rajendra Joshi
- HPC-MBA Group, C-DAC Innovation Park, Centre for Development of Advanced Computing, Pune, India
| | - Shantanu Ozarkar
- Department of Anthropology, Savitribai Phule Pune University, Pune, India
| | - Richa Ashma
- Department of Zoology, Savitribai Phule Pune University, Pune, India
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Lacson JCA, Doyle SH, Del Rio J, Forgas SM, Carvajal R, Gonzalez-Calderon G, Ramírez Feliciano A, Kim Y, Roetzheim RG, Sutton SK, Vadaparampil ST, Soto-Torres B, Kanetsky PA. A randomized clinical trial of precision prevention materials incorporating MC1R genetic risk to improve skin cancer prevention activities among Hispanics. CANCER RESEARCH COMMUNICATIONS 2022; 2:28-38. [PMID: 35845857 PMCID: PMC9286490 DOI: 10.1158/2767-9764.crc-21-0114] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose Skin cancer incidence is increasing among Hispanics, who experience worse outcomes than non-Hispanic Whites. Precision prevention incorporating genetic testing for MC1R, a skin cancer susceptibility marker, may improve prevention behavior. Patients and Methods Hispanic participants (n=920) from Tampa, FL and Ponce, PR, were block-randomized within MC1R higher- and average-risk groups to precision prevention or generic prevention arms. We collected baseline information on demographics, family history of cancer, phenotypic characteristics, health literacy, health numeracy, and psychosocial measures. Participants reported weekday and weekend sun exposure (in hours), number of sunburns, frequency of five sun protection behaviors, intentional outdoor and indoor tanning, and skin examinations at baseline, three months, and nine months. Participants also reported these outcomes for their eldest child ≤10 years old. Results Among MC1R higher-risk participants, precision prevention increased sunscreen use (OR=1.74, p=0.03) and receipt of a clinical skin exam (OR=6.51, p=0.0006); and it decreased weekday sun exposure hours (β=-0.94, p=0.005) and improved sun protection behaviors (β=0.93, p=0.02) in their children. There were no significant intervention effects among MC1R average risk participants. The intervention did not elevate participant cancer worry. We also identified moderators of the intervention effect among both average- and higher-risk participants. Conclusions Receipt of MC1R precision prevention materials improved some skin cancer prevention behaviors among higher-risk participants and their children and did not result in reduced prevention activities among average-risk participants. Despite these encouraging findings, levels of sun protection behaviors remained suboptimal among participants, warranting more awareness and prevention campaigns targeted to Hispanics.
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Affiliation(s)
- John Charles A. Lacson
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Scarlet H. Doyle
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Jocelyn Del Rio
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Stephanie M. Forgas
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Rodrigo Carvajal
- Biostatistics and Bioinformatics Shared Resources, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Guillermo Gonzalez-Calderon
- Biostatistics and Bioinformatics Shared Resources, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | | | - Youngchul Kim
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Richard G. Roetzheim
- Department of Family Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Steven K. Sutton
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Susan T. Vadaparampil
- Department of Health and Behavioral Outcomes, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Brenda Soto-Torres
- Public Health Program, Ponce Health Sciences University, Ponce, Puerto Rico
| | - Peter A. Kanetsky
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida.,Corresponding Author: Peter A. Kanetsky, Department of Cancer Epidemiology, Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL 33612-9416. Phone: 813-745-2299; E-mail:
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Behavioral and Psychological Outcomes Associated with Skin Cancer Genetic Testing in Albuquerque Primary Care. Cancers (Basel) 2021; 13:cancers13164053. [PMID: 34439206 PMCID: PMC8394482 DOI: 10.3390/cancers13164053] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/28/2021] [Accepted: 08/03/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Genetic information is publicly available but research examining the best use of such information has not engaged diverse members of the public. We examined public reactions to melanoma genetic testing (using the melanocortin-1 receptor [MC1R] gene) in a study randomizing (like the flip of a coin) 600 diverse primary care patients to a MC1R test offer or usual care. We found that testing did not improve sun protection and skin cancer screening, nor did it lead worry to increase. However, groups less aware of their skin cancer risk, including those who thought their risk was “unlikely” at the start of the study, showed significant improvements in sun protection at three months. In conclusion, testing might be very helpful for certain people who have the most to learn about their risk, who may become motivated to protect themselves from the damaging effects of the sun as a result of skin cancer genetic testing. Abstract Public availability of genetic information is increasing; thus, efforts to improve diversity in basic and translational research in genomics is a top priority. Given the increasing U.S. incidence and mortality of melanoma, and the prevalence of common melanocortin-1 receptor (MC1R) gene melanoma risk variants in the general population, we examined genomic testing of MC1R for skin cancer risk in a randomized controlled trial in Albuquerque, New Mexico primary care. Participants were 48% Hispanic and were randomized 5:1 to a MC1R test invitation or usual care. We assessed 3 month sun protection, skin cancer screening, and skin cancer worry outcomes associated with testing, and key effect moderators (e.g., cancer risk perceptions, and skin cancer risk factors). Our findings indicate that the primary outcomes were unchanged by the MC1R test offer, test acceptance, and level of risk feedback. Moderator analyses showed that those with lower risk perception, and those with skin that readily tans, significantly increased their sun protection in response to higher than average risk feedback. Risk feedback did not prompt cancer worry, and average risk feedback did not erode existing sun protection. This study paves the way for the development of tailored strategies to address low skin cancer risk awareness in this understudied context of public health genomics.
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