1
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Wendt A, Möhner M. Occupational solar exposure and basal cell carcinoma. A review of the epidemiologic literature with meta-analysis focusing on particular methodological aspects. Eur J Epidemiol 2024; 39:13-25. [PMID: 38170370 PMCID: PMC10810945 DOI: 10.1007/s10654-023-01061-w] [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: 03/03/2023] [Accepted: 09/11/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Numerous epidemiologic studies and a few systematic reviews have investigated the association between occupational solar exposure and basal cell carcinoma (BCC). However, previous reviews have several deficits with regard to included and excluded studies/risk estimates and the assessment of risk of selection bias (RoSB). Our aim was to review epidemiologic studies with a focus on these deficits and to use meta-(regression) analyses to summarize risk estimates. METHODS We systematically searched PubMed (including MEDLINE) and Embase for epidemiologic studies. Study evaluation considered four main aspects of risk of bias assessments, i.e. Selection of subjects (selection bias); Exposure variables; Outcome variables; Data analysis. RESULTS Of 56 identified references, 32 were used for meta-(regression) analyses. The overall pooled risk estimate for BCC comparing high/present vs. low/absent occupational solar exposure was 1.20 (95% CI 1.02-1.43); among studies without major deficits regarding data analysis, it was 1.10 (95% CI 0.91-1.33). Studies with low and high RoSB had pooled risk estimates of 0.83 (95% CI 0.73-0.93) and 1.95 (95% CI 1.42-2.67), respectively. The definitions of exposure and outcome variables were not correlated with study risk estimates. Studies with low RoSB in populations with the same latitude or lower than Germany had a pooled risk estimate of 1.01 (95% CI 0.88-1.15). CONCLUSION Due to the different associations between occupational solar exposure and BCC among studies with low and high RoSB, we reason that the current epidemiologic evidence base does not permit the conclusion that regular outdoor workers have an increased risk of BCC.
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Affiliation(s)
- Andrea Wendt
- Federal Institute for Occupational Safety and Health, Nöldnerstr. 40-42, 10317, Berlin, Germany.
| | - Matthias Möhner
- Federal Institute for Occupational Safety and Health, Nöldnerstr. 40-42, 10317, Berlin, Germany
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2
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Lashway SG, Worthen ADM, Abuasbeh JN, Harris RB, Farland LV, O'Rourke MK, Dennis LK. A meta-analysis of sunburn and basal cell carcinoma risk. Cancer Epidemiol 2023; 85:102379. [PMID: 37201363 DOI: 10.1016/j.canep.2023.102379] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/01/2023] [Accepted: 05/03/2023] [Indexed: 05/20/2023]
Abstract
Basal cell carcinoma (BCC) is the most common cancer in the United States. Sunburn is a modifiable risk factor for BCC. The objective of this project was to synthesize research on BCC and sunburn to quantify the impact and severity of sunburn at different life stages on BCC risk in the general population. A systematic literature search of four electronic databases was conducted and data were extracted by two independent reviewers using standardized forms. Data from 38 studies were pooled using both dichotomous and dose-response meta-analytic methods. BCC risk increased with ever experiencing a sunburn in childhood (OR=1.43, 95% CI: 1.19, 1.72) and with ever experiencing a sunburn in life (OR= 1.40, 95% CI: 1.02, 1.45). Every five sunburns experienced per decade in childhood increased BCC risk by 1.86 (95% CI: 1.73, 2.00) times. Every five sunburns experienced per decade in adulthood increased BCC risk by 2.12 (95% CI: 1.75, 2.57) times and every five sunburns per decade of life increased BCC risk by 1.91 (95% CI: 1.42, 2.58) times. The data on sunburn exposure and BCC show that an increase in number of sunburns at any age increased the risk of BCC. This may inform future prevention efforts.
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Affiliation(s)
- Stephanie G Lashway
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
| | - Aimee D M Worthen
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
| | - Jumanah N Abuasbeh
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
| | - Robin B Harris
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
| | - Leslie V Farland
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
| | - Mary Kay O'Rourke
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
| | - Leslie K Dennis
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
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3
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Mahamat‐Saleh Y, Al‐Rahmoun M, Severi G, Ghiasvand R, Veierod MB, Caini S, Palli D, Botteri E, Sacerdote C, Ricceri F, Lukic M, Sánchez MJ, Pala V, Tumino R, Chiodini P, Amiano P, Colorado‐Yohar S, Chirlaque M, Ardanaz E, Bonet C, Katzke V, Kaaks R, Schulze MB, Overvad K, Dahm CC, Antoniussen CS, Tjønneland A, Kyrø C, Bueno‐de‐Mesquita B, Manjer J, Jansson M, Esberg A, Mori N, Ferrari P, Weiderpass E, Boutron‐Ruault M, Kvaskoff M. Baseline and lifetime alcohol consumption and risk of skin cancer in the European Prospective Investigation into Cancer and Nutrition cohort (EPIC). Int J Cancer 2023; 152:348-362. [PMID: 36053839 PMCID: PMC10087036 DOI: 10.1002/ijc.34253] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 06/16/2022] [Accepted: 07/05/2022] [Indexed: 02/01/2023]
Abstract
Experimental evidence suggests that alcohol induces cutaneous carcinogenesis, yet epidemiological studies on the link between alcohol intake and skin cancer have been inconsistent. The European Prospective Investigation into Cancer and Nutrition (EPIC) is a prospective cohort initiated in 1992 in 10 European countries. Alcohol intake at baseline and average lifetime alcohol intake were assessed using validated country-specific dietary and lifestyle questionnaires. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated in Cox models. A total of 14 037 skin cancer cases (melanoma: n = 2457; basal-cell carcinoma (BCC): n = 8711; squamous-cell carcinoma (SCC): n = 1928; unknown: n = 941) were identified among 450 112 participants (average follow-up: 15 years). Baseline alcohol intake was positively associated with SCC (>15 vs 0.1-4.9 g/day: HR = 1.44, 95% CI = 1.17-1.77; Ptrend = .001), BCC (HR = 1.12, 95% CI = 1.01-1.23; Ptrend = .04), and melanoma risks in men (HR = 1.17, 95% CI = 0.95-1.44; Ptrend = .17), while associations were more modest in women (SCC: HR = 1.09, 95% CI = 0.90-1.30; Ptrend = .13; BCC: HR = 1.08, 95% CI = 1.00-1.17, Ptrend = .03; melanoma: HR = 0.93, 95% CI = 0.80-1.08, Ptrend = .13). Associations were similar for lifetime alcohol intake, with an attenuated linear trend. Lifetime liquor/spirit intake was positively associated with melanoma (fourth vs first quartile: HR = 1.47, 95% CI = 1.08-1.99; Ptrend = .0009) and BCC risks in men (HR = 1.17, 95% CI = 1.04-1.31; Ptrend = .14). Baseline and lifetime intakes of wine were associated with BCC risk (HR = 1.25 in men; HR = 1.11-1.12; in women). No statistically significant associations were found between beverage types and SCC risk. Intake of beer was not associated with skin cancer risk. Our study suggests positive relationships between alcohol intake and skin cancer risk, which may have important implications for the primary prevention of skin cancer.
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Affiliation(s)
- Yahya Mahamat‐Saleh
- Paris‐Saclay University, UVSQInserm, Gustave Roussy, “Exposome and Heredity” team, CESPVillejuifFrance
| | - Marie Al‐Rahmoun
- Paris‐Saclay University, UVSQInserm, Gustave Roussy, “Exposome and Heredity” team, CESPVillejuifFrance
| | - Gianluca Severi
- Paris‐Saclay University, UVSQInserm, Gustave Roussy, “Exposome and Heredity” team, CESPVillejuifFrance
| | - Reza Ghiasvand
- Oslo Centre for Biostatistics and EpidemiologyOslo University HospitalOsloNorway
- Department of ResearchCancer Registry of Norway, Oslo University HospitalOsloNorway
| | - Marit B. Veierod
- Oslo Centre for Biostatistics and Epidemiology, Department of BiostatisticsInstitute of Basic Medical Sciences, University of OsloOsloNorway
| | - Saverio Caini
- Cancer Risk Factors and Life‐Style Epidemiology Unit, Institute for Cancer ResearchPrevention and Clinical Network (ISPRO)FlorenceItaly
| | - Domenico Palli
- Cancer Risk Factors and Life‐Style Epidemiology Unit, Institute for Cancer ResearchPrevention and Clinical Network (ISPRO)FlorenceItaly
| | - Edoardo Botteri
- Department of ResearchCancer Registry of Norway, Oslo University HospitalOsloNorway
- Section for Colorectal Cancer ScreeningCancer Registry of Norway, Oslo University HospitalOsloNorway
| | - Carlotta Sacerdote
- Piedmont Reference Centre for Epidemiology and Cancer Prevention (CPO Piemonte)TurinItaly
| | | | - Marko Lukic
- Faculty of Health Sciences, Department of Community MedicineUniversity of Tromsø, The Arctic University of NorwayNorway
| | - Maria J. Sánchez
- Escuela Andaluza de Salud Pública (EASP)GranadaSpain
- Instituto de Investigación Biosanitaria ibs.GRANADAGranadaSpain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)MadridSpain
- Department of Preventive Medicine and Public HealthUniversity of GranadaGranadaSpain
| | - Valeria Pala
- Epidemiology and Prevention Unit Fondazione IRCCS Istituto Nazionale dei Tumori di MilanoMilanItaly
| | - Rosario Tumino
- Hyblean Association for Epidemiological Research AIRE—ONLUSRagusaItaly
| | - Paolo Chiodini
- Dipartimento di Salute Mentale e Fisica e Medicina PreventivaUniversità degli Studi della Campania “Luigi Vanvitelli”NaplesItaly
| | - Pilar Amiano
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)MadridSpain
- Ministry of Health of the Basque GovernmentSub‐Directorate for Public Health and Addictions of GipuzkoaSan SebastianSpain
- Biodonostia Health Research InstituteEpidemiology of Chronic and Communicable Diseases GroupSan SebastiánSpain
| | - Sandra Colorado‐Yohar
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)MadridSpain
- Department of EpidemiologyMurcia Regional Health Council, IMIB‐Arrixaca, Murcia UniversityMurciaSpain
- Research Group on Demography and Health, National Faculty of Public HealthUniversity of AntioquiaMedellínColombia
| | - María‐Dolores Chirlaque
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)MadridSpain
- Department of EpidemiologyMurcia Regional Health Council, IMIB‐Arrixaca, Murcia UniversityMurciaSpain
| | - Eva Ardanaz
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)MadridSpain
- Navarra Public Health InstitutePamplonaSpain
- IdiSNA, Navarra Institute for Health ResearchPamplonaSpain
| | - Catalina Bonet
- Unit of Nutrition and Cancer, Catalan Institute of Oncology—ICONutrition and Cancer Group, Bellvitge Biomedical Research Institute—(IDIBELL), L'Hospitalet de LlobregatBarcelonaSpain
| | - Verena Katzke
- Division of Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
| | - Rudolf Kaaks
- Division of Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
| | - Matthias B. Schulze
- Department of Molecular EpidemiologyGerman Institute of Human Nutrition Potsdam‐RehbrueckeNuthetalGermany
- Institute of Nutritional ScienceUniversity of PotsdamNuthetalGermany
| | - Kim Overvad
- Department of Public HealthAarhus UniversityAarhus CDenmark
| | | | | | - Anne Tjønneland
- Danish Cancer Society Research Center; DietGenes and Environment Nutrition and Biomarkers (NAB)CopenhagenDenmark
| | - Cecilie Kyrø
- Centre for NutritionPrevention and Health Services, National Institute for Public Health and the Environment (RIVM)BilthovenThe Netherlands
| | - Bas Bueno‐de‐Mesquita
- Centre for NutritionPrevention and Health Services, National Institute for Public Health and the Environment (RIVM)BilthovenThe Netherlands
| | - Jonas Manjer
- Department of SurgerySkåne University Hospital Malmö Lund University MalmöMalmöSweden
| | - Malin Jansson
- Department of Surgery and Perioperative Sciences/SurgeryUmeå UniversityUmeåSweden
| | | | - Nagisa Mori
- International Agency for Research on CancerWorld Health OrganizationLyonFrance
| | - Pietro Ferrari
- International Agency for Research on CancerWorld Health OrganizationLyonFrance
| | | | | | - Marina Kvaskoff
- Paris‐Saclay University, UVSQInserm, Gustave Roussy, “Exposome and Heredity” team, CESPVillejuifFrance
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4
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Hezaveh E, Jafari S, Jalilpiran Y, Zargarzadeh N, Mahdavi R, Gargari BP. Dietary components and the risk of non-melanoma skin cancer: A systematic review of epidemiological studies. Crit Rev Food Sci Nutr 2021:1-16. [PMID: 34933633 DOI: 10.1080/10408398.2021.2016600] [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: 10/19/2022]
Abstract
Non-melanoma skin cancer (NMSC) is the most common cancer among white-skinned people. The main environmental risk factor for all types of skin cancer is ultraviolet (UV) exposure to the sun. However, significant modifiable risk factors, such as diet, have been studied about NMSC risk. Several original studies have been conducted on the link between various dietary components and the risk of NMSC in the past decade, but have not been systematically reviewed. This review focuses on the potential impact of dietary components in the prevention of NMSC and evaluates the findings of epidemiologic evidence for dietary factors. We conducted a systematic search of three databases, including Scopus, ISI Web of Science, and PubMed, to identify relevant epidemiological studies published between 2000 and July 6, 2021. Finally, forty-three articles were included. Because of the inherent limitations of epidemiological studies, no definitive conclusions can be drawn; however, the links between folate, citrus, caffeine, and alcohol with BCC are notable; thus, high dietary folate intake, as well as citrus and alcohol consumption, are associated with an increased risk of basal cell carcinoma (BCC), whereas caffeine is associated with a lower risk. More research is required to reach a definitive conclusion.
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Affiliation(s)
- Erfan Hezaveh
- Department of Biochemistry and Dietetics, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sahar Jafari
- Department of Community Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yahya Jalilpiran
- Department of Clinical Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Nikan Zargarzadeh
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Mahdavi
- Nutrition Research Center, Department of Biochemistry and Dietetics, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bahram Pourghassem Gargari
- Nutrition Research Center, Department of Biochemistry and Dietetics, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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5
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Loney T, Paulo MS, Modenese A, Gobba F, Tenkate T, Whiteman DC, Green AC, John SM. Global evidence on occupational sun exposure and keratinocyte cancers: a systematic review. Br J Dermatol 2020; 184:208-218. [PMID: 32320481 DOI: 10.1111/bjd.19152] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2020] [Indexed: 12/29/2022]
Abstract
Individual studies have suggested that the association between occupational exposure to solar ultraviolet radiation (UVR) and the development of keratinocyte cancers (KCs) may only be valid in populations of European ancestry living in certain geographical regions. Comparative global data are scarce and so this review aimed to summarize current evidence on the association between occupational exposure to solar UVR and the development of KCs, with a specific focus on geographical location and skin colour. Ovid MEDLINE, PubMed, Embase and Web of Science were searched for potentially relevant records. Extracted data were summarized by study, country and region. We included one prospective cohort study and 18 case-control studies (n = 15 233) from 12 countries in regions where the majority of the population is white skinned (Americas, Europe and Oceania). Eighteen of the 19 studies reported effect estimates suggesting an increased risk of basal cell carcinoma (BCC) and/or squamous cell carcinoma (SCC) among outdoor workers. Only 11 studies found a significantly increased risk and many had imprecise estimates. There was a significantly increased risk of BCC and SCC in individual studies in North America, Latin America and the Caribbean, Western Europe and Southern Europe, but not across regions or countries. Overall, 95% of studies reported higher risks among outdoor workers, although the increases in risk were statistically significant in just over half of the studies. Well-designed and sufficiently powered occupational case-control and cohort studies with adequate adjustment for confounding factors and other risk factors are required to provide more accurate risk estimates for occupational KC.
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Affiliation(s)
- T Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - M S Paulo
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - A Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | - F Gobba
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | - T Tenkate
- School of Occupational and Public Health, Ryerson University, Toronto, ON, Canada
| | - D C Whiteman
- QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Brisbane, QLD, Australia
| | - A C Green
- QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Brisbane, QLD, Australia.,CRUK Manchester Institute, University of Manchester, Manchester, UK
| | - S M John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Lower-Saxonian Institute of Occupational Dermatology, Osnabrück, Germany
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6
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Andersen PA, Buller DB, Walkosz BJ, Scott MD, Beck L, Liu X, Abbott A, Eye R, Cutter G. A Randomized Trial of an Advanced Sun Safety Intervention for Vacationers at 41 North American Resorts. JOURNAL OF HEALTH COMMUNICATION 2017; 22:951-963. [PMID: 29161214 PMCID: PMC6309206 DOI: 10.1080/10810730.2017.1382615] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Taking vacations in sunny locations is associated with the development of skin cancer. This study tested a multi-component sun protection intervention based on diffusion of innovations theory and transportation theory designed to increase vacationers' comprehensive sun protection, i.e., use of clothing, hats, and shade, and use, pre-application, and reapplication of sunscreen. The trial enrolled 41 warm weather resorts in North America in a pair-matched group randomized pretest-posttest design and assessed samples of adult vacationers at resort outdoor recreation venues regarding sun protection at pretest (n = 3,531) and posttest (n = 3,226). While results showed no overall effect of the intervention on comprehensive sun protection across venues, the intervention produced statistically significant improvements in sun protection at waterside venues (pools and beaches). The intervention's overall effects may have been impeded by a lack of uniformly robust implementation, low interest in skin cancer prevention by guests, or shortcomings of the theories used to create prevention messages. The intervention may have worked best with guests in the highest-risk recreation venue, i.e., waterside recreation where they exposed the most skin. Alternative approaches that alter resort organizations, such as through changes in policy, environmental features, or occupational efforts might be more effective than targeting vacationers with behavior-change messages.
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Affiliation(s)
- Peter A. Andersen
- School of Communication, San Diego State University, San Diego, California, USA
| | | | | | | | - Larry Beck
- L. Robert Payne School of Hospitality and Tourism Management, San Diego State University, San Diego, California, USA
| | - Xia Liu
- Klein Buendel, Inc., Golden, Colorado, USA
| | - Allison Abbott
- School of Communication, San Diego State University, San Diego, California, USA
| | - Rachel Eye
- Klein Buendel, Inc., Golden, Colorado, USA
| | - Gary Cutter
- School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
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7
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Yen H, Dhana A, Okhovat JP, Qureshi A, Keum N, Cho E. Alcohol intake and risk of nonmelanoma skin cancer: a systematic review and dose-response meta-analysis. Br J Dermatol 2017; 177:696-707. [PMID: 28745396 DOI: 10.1111/bjd.15647] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2017] [Indexed: 12/12/2022]
Abstract
Nonmelanoma skin cancer (NMSC) comprises mainly basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC). The association between alcohol intake and NMSC has been inconclusive; therefore the objective of this study is to quantify the relationship between alcohol intake and NMSC using meta-analyses. A systematic literature search of PubMed and Embase was performed on 30 October 2016. Eligible articles were case-control or cohort studies that examined alcohol intake and risk of BCC or cSCC and reported relative risks (RRs) with 95% confidence intervals (CIs). Of the 307 articles identified, 13 case-control and cohort studies were included in the systematic review, including 95 241 NMSC cases (91 942 BCC and 3299 cSCC cases). A random-effects model was used to obtain summary RRs and 95% CIs for dose-response meta-analyses. For every 10-gram increase in ethanol intake per day, a positive association was found for both BCC (summary RR of 1·07; 95% CI 1·04-1·09) and cSCC (summary RR of 1·11; 95% CI 1·06-1·16). While there was evidence suggesting a nonlinear association for BCC, it may be due to the sparse data at higher alcohol intake levels. This meta-analysis found evidence that alcohol drinking is positively associated with both BCC and cSCC risk in a dose-dependent manner. These results should be interpreted with caution due to potential residual confounding. Nonetheless, because alcohol drinking is a prevalent and modifiable behaviour, it could serve as an important public health target to reduce the global health burden of NMSC.
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Affiliation(s)
- H Yen
- Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A.,National Cheng Kung University Hospital and College of Medicine, Tainan, Taiwan
| | - A Dhana
- Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A.,Division of Dermatology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - J-P Okhovat
- Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A.,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, U.S.A
| | - A Qureshi
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI, U.S.A.,Department of Epidemiology, School of Public Health, Brown University, Providence, RI, U.S.A.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, U.S.A
| | - N Keum
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A
| | - E Cho
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI, U.S.A.,Department of Epidemiology, School of Public Health, Brown University, Providence, RI, U.S.A.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, U.S.A
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8
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Walkosz BJ, Scott MD, Buller DB, Andersen PA, Beck L, Cutter GR. Prevalence of Sun Protection at Outdoor Recreation and Leisure Venues at Resorts in North America. AMERICAN JOURNAL OF HEALTH EDUCATION 2017; 48:90-99. [PMID: 29147456 DOI: 10.1080/19325037.2016.1271755] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background Exposure to solar ultra violet radiation (UVR) is a primary risk factor for skin cancer. Vacationers often fail to protect themselves from harmful UVR. Purpose The study assessed the sun protection practices of resort guests in various outdoor leisure and recreation venues during warm-weather seasons. Method 41 North American resorts were enrolled in a quasi-experimental randomized controlled trial. Adult guests were observed (n=4091) and surveyed (n=3694) in a cross sectional sample. Data collection was conducted in recreation and leisure venues with outdoors commons/reception areas acting as the comparison condition. Results The mean percent of vacationers at pools and beaches were more likely (p < 0.001) to wear sunscreen than in commons areas but less likely (p < 0.001) to wear cover-up clothing or use shade. In both samples, the combined sun protection scores were higher in commons areas compared to all venues except for outdoor dining (p < 0.001). Discussion Sun safety was suboptimal in all venues and was potentially mitigated by venue type. Translation to Health Education Practice Approaches are needed to encourage vacationers to practice comprehensive sun protection and to work with resorts to construct built environments that facilitate rather than act as barriers to sun safety.
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Affiliation(s)
- Barbara J Walkosz
- Senior Scientist, Klein Buendel, Inc., 1667 Cole Boulevard, Suite 225, Golden, CO 80401
| | - Michael D Scott
- Professor Emeritus at California State University and President Mikonics, Inc., 40 B Old Road South, Santa Fe, NM 87540
| | - David B Buller
- Senior Scientist and Director of Research, Klein Buendel, Inc., 1667 Cole Boulevard, Suite 225, Golden, CO 80401
| | - Peter A Andersen
- Professor Emeritus, School of Communication, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182
| | - Larry Beck
- Professor, L. Robert Payne School of Hospitality and Tourism Management, Room PSFA 445, San Diego State University, San Diego, CA 92182
| | - Gary R Cutter
- Professor, Department of Biostatistics, School of Public Health, RPHB 401B, University of Alabama, 1720 2Avenue South, Birmingham, AL 35294
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9
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Buller DB, Andersen PA, Walkosz BJ, Scott MD, Beck L, Cutter GR. Rationale, design, samples, and baseline sun protection in a randomized trial on a skin cancer prevention intervention in resort environments. Contemp Clin Trials 2015; 46:67-76. [PMID: 26593781 DOI: 10.1016/j.cct.2015.11.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 11/17/2015] [Accepted: 11/19/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Exposure to solar ultraviolet radiation during recreation is a risk factor for skin cancer. A trial evaluated an intervention to promote advanced sun protection (sunscreen pre-application/reapplication; protective hats and clothing; use of shade) during vacations. MATERIALS AND METHODS Adult visitors to hotels/resorts with outdoor recreation (i.e., vacationers) participated in a group-randomized pretest-posttest controlled quasi-experimental design in 2012-14. Hotels/resorts were pair-matched and randomly assigned to the intervention or untreated control group. Sun. protection (e.g., clothing, hats, shade and sunscreen) was measured in cross-sectional samples by observation and a face-to-face intercept survey during two-day visits. RESULTS Initially, 41 hotel/resorts (11%) participated but 4 dropped out before posttest. Hotel/resorts were diverse (employees=30 to 900; latitude=24° 78' N to 50° 52' N; elevation=2ft. to 9726ft. above sea level), and had a variety of outdoor venues (beaches/pools, court/lawn games, golf courses, common areas, and chairlifts). At pretest, 4347 vacationers were observed and 3531 surveyed. More females were surveyed (61%) than observed (50%). Vacationers were mostly 35-60years old, highly educated (college education=68%) and non-Hispanic white (93%), with high-risk skin types (22%). Vacationers reported covering 60% of their skin with clothing. Also, 40% of vacationers used shade; 60% applied sunscreen; and 42% had been sunburned. CONCLUSIONS The trial faced challenges recruiting resorts but result showed that the large, multi-state sample of vacationers were at high risk for solar UV exposure.
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Affiliation(s)
- David B Buller
- Klein Buendel, Inc., 1667 Cole Boulevard, Suite 225, Golden, CO 80401, United States.
| | - Peter A Andersen
- School of Communication, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, United States.
| | - Barbara J Walkosz
- Klein Buendel, Inc., 1667 Cole Boulevard, Suite 225, Golden, CO 80401, United States.
| | - Michael D Scott
- California State University and President of Mikonics, Inc., 40 B Old Road South, Santa Fe, NM 87540, United States.
| | - Larry Beck
- L. Robert Payne School of Hospitality and Tourism Management, Room PSFA 445, San Diego State University, San Diego, CA 92182, United States.
| | - Gary R Cutter
- Department of Biostatistics, School of Public Health, RPHB 401B, University of Alabama, 1720 2nd Avenue South, Birmingham, AL 35294, United States.
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10
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Moustafa GA, Xanthopoulou E, Riza E, Linos A. Skin disease after occupational dermal exposure to coal tar: a review of the scientific literature. Int J Dermatol 2015; 54:868-79. [DOI: 10.1111/ijd.12903] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 11/13/2014] [Accepted: 11/23/2014] [Indexed: 11/27/2022]
Affiliation(s)
| | - Eleni Xanthopoulou
- Faculty of Medicine; National and Kapodistrian University of Athens; Athens Greece
| | - Elena Riza
- Department of Hygiene, Epidemiology and Medical Statistics; Medical School; University of Athens; Athens Greece
| | - Athena Linos
- Department of Hygiene, Epidemiology and Medical Statistics; Medical School; University of Athens; Athens Greece
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11
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Khalesi M, Whiteman DC, Rosendahl C, Johns R, Hackett T, Cameron A, Waterhouse M, Lucas RM, Kimlin MG, Neale RE. Basal cell carcinomas on sun-protected vs. sun-exposed body sites: a comparison of phenotypic and environmental risk factors. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2015; 31:202-11. [PMID: 25787710 DOI: 10.1111/phpp.12170] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/09/2015] [Indexed: 01/17/2023]
Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most commonly diagnosed cancer in White populations. There are indications that risk factors for BCC may differ according to the anatomic site of the tumour but this is not well understood. PURPOSE To compare phenotypic and environmental risk factors for BCCs arising on sun-protected sites with that of those on sun-exposed sites. METHODS We conducted a case-case study in which people who had been diagnosed with incident BCC were recruited between February 2012 and September 2013 in Brisbane, Australia. RESULTS Fair skin (OR: 4.50; 95% CI: 1.22, 16.59), having more than 15 lesions frozen/burnt off compared to less than 5 (OR: 5.68; 95% CI: 1.78, 18.08) and severe acne (OR: 5.25; 95% CI: 1.34, 20.56) were associated with increased risk of BCC on sun-protected sites. The presence of more than 5 nevi on the body was associated with decreased risk (OR: 0.28; 95% CI: 0.11, 0.71). CONCLUSIONS BCCs on sun-protected sites arise as a result of excessive sun exposure, most likely combined with phenotypic susceptibility. The strong negative association with nevi also suggests that there are constitutional factors that underlie the propensity for BCCs to arise on these body sites.
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Affiliation(s)
- Mohammad Khalesi
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,NHMRC Centre for Research Excellence in Sun and Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - David C Whiteman
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,NHMRC Centre for Research Excellence in Sun and Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Cliff Rosendahl
- Skin Cancer College Australasia, Brisbane, QLD, Australia.,School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Richard Johns
- Skin Cancer College Australasia, Brisbane, QLD, Australia
| | - Timothy Hackett
- Skin Cancer College Australasia, Brisbane, QLD, Australia.,School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Alan Cameron
- Skin Cancer College Australasia, Brisbane, QLD, Australia.,School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Mary Waterhouse
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia.,Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Michael G Kimlin
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,NHMRC Centre for Research Excellence in Sun and Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Rachel E Neale
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,NHMRC Centre for Research Excellence in Sun and Health, Queensland University of Technology, Brisbane, QLD, Australia
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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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13
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Khalesi M, Whiteman DC, Tran B, Kimlin MG, Olsen CM, Neale RE. A meta-analysis of pigmentary characteristics, sun sensitivity, freckling and melanocytic nevi and risk of basal cell carcinoma of the skin. Cancer Epidemiol 2013; 37:534-43. [DOI: 10.1016/j.canep.2013.05.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 04/23/2013] [Accepted: 05/29/2013] [Indexed: 01/03/2023]
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14
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Sánchez G, Nova J, de la Hoz F. Risk Factors for Basal Cell Carcinoma: A Study From the National Dermatology Center of Colombia. ACTAS DERMO-SIFILIOGRAFICAS 2012. [DOI: 10.1016/j.adengl.2012.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Abstract
Basal cell carcinoma is the most common malignant neoplasm in humans and its incidence has increased over the last decades. Its high frequency significantly burdens the health system, making the disease a public health issue. Despite the low mortality rates and the rare occurrence of metastases, the tumor may be locally invasive and relapse after treatment, causing significant morbidity. Exposure to ultraviolet radiation is the main environmental risk factor associated with its cause. However, other elements of risk are described, such as light skin phototypes, advanced age, family history of skin carcinoma, light eyes and blond hair, freckles in childhood and immunosuppression. Behavioral aspects such as occupational sun exposure, rural labor and sunburns at a young age also play a role. Between 30% and 75% of the sporadic cases are associated with patched hedgehog gene mutation, but other genetic changes are also described. The tumor is commonly found in concomitance with skin lesions related to chronic sun exposure, such as actinic keratoses, solar lentigines and facial telangiectasia. The prevention of basal cell carcinoma is based on the knowledge of risk factors, early diagnosis and treatment, as well as on the adoption of specific measures, particularly in susceptible populations. The authors present a review of the epidemiology of basal cell carcinoma.
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Affiliation(s)
- Valquiria Pessoa Chinem
- Department of Dermatology and Radiotherapy, Faculty of Medicine of Botucatu, Sao Paulo State University (FMB-UNESP), Botucatu, SP, Brasil
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Sánchez G, Nova J, de la Hoz F. [Risk factors for basal cell carcinoma: a study from the national dermatology center of Colombia]. ACTAS DERMO-SIFILIOGRAFICAS 2011; 103:294-300. [PMID: 22078143 DOI: 10.1016/j.ad.2011.07.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Revised: 07/06/2011] [Accepted: 07/29/2011] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Colombia is home to one of the areas with the highest levels of exposure to UV radiation in the world, namely, the Andes Mountains, which stretch along the equator. Recent studies have reported an increase in the incidence of basal cell carcinoma in Colombia, but the risk factors associated with the development of this disease have not been studied. OBJECTIVE To determine the risk factors for basal cell carcinoma in patients from the National Dermatology Center of Colombia. MATERIAL AND METHODS We performed a case-control study involving 406 individuals, and analyzed sociodemographic, epidemiological, and clinical factors using multiple logistic regression. RESULTS The following risk factors were identified: skin phototypes I to III (odds ratio [OR], 15.4), family history of skin cancer (OR, 5.8), past history of actinic keratosis (OR, 3.3), continued residence in a rural area after the age of 30 years (OR, 2.96), practice of outdoor sports (OR, 2.67), history of 10 or more episodes of sunburn (OR, 2.3), actinic conjunctivitis (OR, 2.26), and failure to use a hat in childhood (OR, 2.11). CONCLUSIONS Different factors specific to Colombia increase the risk of basal cell carcinoma. In particular, the association with phototype III could partly explain the increase in incidence detected in this country. Preventive programs should target the risk groups detected and highlight the importance of basing decisions on local evidence.
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Affiliation(s)
- G Sánchez
- Centro Dermatológico Federico Lleras Acosta E.S.E, Bogotá, Colombia.
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17
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Bauer A, Diepgen T, Schmitt J. Is occupational solar ultraviolet irradiation a relevant risk factor for basal cell carcinoma? A systematic review and meta-analysis of the epidemiological literature. Br J Dermatol 2011; 165:612-25. [DOI: 10.1111/j.1365-2133.2011.10425.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Richmond-Sinclair N, van der Pols J, Green A. Melanocytic naevi and basal cell carcinoma: is there an association? J Eur Acad Dermatol Venereol 2011; 26:1092-6. [DOI: 10.1111/j.1468-3083.2011.04213.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sánchez G, Nova J, de la Hoz F, Castañeda C. Incidencia de cáncer de piel en Colombia, años 2003-2007. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.piel.2010.10.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
AbstractThe aim of the present case-control study was to assess the risk factors for Basal cell carcinoma (BCC) in the Montenegrin population. The study group was comprised of 100 consecutive patients with a diagnosis of BCC, while the control group consisted of patients who did not present skin cancer and who were individually matched to the cases by sex and age. The increased risk for BCC was associated with: the presence of nevi (odds ratio [OR] = 3.77; 95% confidence interval [CI] = 1.12–12.73), type of skin concerning to burn rather than to tan after repeated sun exposure in childhood or adolescence (OR = 3.14; 95% CI = 1.59–6.18), the skin reaction to burn after two or more hours of sunlight during childhood or adolescence (OR = 4.53; 95% CI = 2.37–8.63), the number of severe and painful sunburns during their lifetime(OR = 3.52; 95% CI = 1.68–7.38), outdoor work during the summer-time (OR = 2.73; 95% CI = 1.00–7.45), occupational exposure to chemicals (OR = 17.89; 95% CI = 2.82–113.52), history of eczema (OR = 4.17; 95% CI = 1.53–11.39), and history of previous BCC (OR = 3.86; 95% CI = 1.40–10.65). Our study confirms the role of environmental and constitutional factors in development of BCC.
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Schmitt J, Diepgen T, Bauer A. Occupational exposure to non-artificial UV-light and non-melanocytic skin cancer - a systematic review concerning a new occupational disease. J Dtsch Dermatol Ges 2009; 8:250-63, 250-64. [DOI: 10.1111/j.1610-0387.2009.07260.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Abstract
Coal Tar is a semisolid by-product obtained in the destructive distillation of bituminous coal, which functions in cosmetic products as a cosmetic biocide and denaturant--antidandruff agent is also listed as a function, but this is considered an over-the-counter (OTC) drug use. Coal Tar is a nearly black, viscous liquid, heavier than water, with a naphthalene-like odor and a sharp burning taste, produced in cooking ovens as a by-product in the manufacture of coke. Crude Coal Tar is composed of 48% hydrocarbons, 42% carbon, and 10% water. In 2002, Coal Tar was reported to the Food and Drug Administration (FDA) to be used in four formulations, all of which appear to be OTC drug products. Coal Tar is monographed by the FDA as Category I (safe and effective) OTC drug ingredient for use in the treatment of dandruff, seborrhoea, and psoriasis. Coal Tar is absorbed through the skin of animals and humans and is systemically distributed. In short-term studies, mice fed a diet containing Coal Tar found it unpalatable, but no adverse effects were reported other than weight loss; rats injected with Coal Tar experienced malaise in one study and decreased water intake and increased liver weights in another; rabbits injected with Coal Tar residue experienced eating avoidance, respiratory difficulty, sneezing, and weight loss. In a subchronic neurotoxicity study using mice, a mixture of phenols, cresols, and xylenols at concentrations approximately equal to those expected in Coal Tar extracts produced regionally selective effects, with a rank order of corpus striatum > cerebellum > cerebral cortex. Coal Tar applied to the backs of guinea pigs increases epidermal thickness. Painting female rabbits with tar decreases the absolute and relative weights of the ovaries and decreased the number of interstitial cells in the ovary. Four therapeutic Coal Tar preparations used in the treatment of psoriasis were mutagenic in the Ames assay. Urine and blood from patients treated with Coal Tar were genotoxic in bacterial assays. Coal Tar was genotoxic in a mammalian genotoxicity assay and induced DNA adducts in various tissue types. Chronic exposure of mice to Coal Tar significantly decreased survival and liver neoplasms were seen in a significant dose-related trend; in other studies using mice lung tumors and perianal skin cancers were found. Coal Tar was comedogenic in three small clinical studies. Folliculitis is associated with the prolonged use of some tars. Several published reports describe cases of contact sensitivity to Coal Tar. Polycyclic aromatic hydrocarbons, which make up Coal Tar, are photosensitizers and cause phototoxicity by an oxygen-dependent mechanism. A retrospective study of the reproductive toxicity of Coal Tar in humans compared exposed women to controls and found little difference in spontaneous abortion and congenital disorders. Cancer epidemiology studies of patients who have received Coal Tar therapy of one form or other have failed to link treatment with an increase in the risk of cancer. Although the Cosmetic Ingredient Review (CIR) Expert Panel believes that Coal Tar use as an antidandruff ingredient in OTC drug preparations is adequately addressed by the FDA regulations, the Panel also believes that the appropriate concentration of use of Coal Tar in cosmetic formulations should be that level that does not have a biological effect in the user. Additional data needed to make a safety assessment include product types in which Coal Tar is used (other than as an OTC drug ingredient), use concentrations, and the maximum concentration that does not induce a biological effect in users.
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Affiliation(s)
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- Cosmetic Ingredient Review, Washington, DC 20036, USA
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24
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Almahroos M, Kurban AK. Ultraviolet Carcinogenesis in Nonmelanoma Skin Cancer Part II: Review and Update on Epidemiologic Correlations. Skinmed 2007; 3:132-9. [PMID: 15133392 DOI: 10.1111/j.1540-9740.2004.02450.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The relationship between ultraviolet radiation and nonmelanoma skin cancer (NMSC) is further elucidated by a review of case-control studies relating type of exposure to the development of NMSC. Intermittent sun exposure is important in the pathogenesis of basal cell carcinoma, whereas cumulative exposure is important for both basal cell carcinoma and squamous cell carcinoma. The regional distribution of NMSC is also in areas of sun exposure. Furthermore, there are inherent risk factors for the development of NMSC that include hair and eye colors. Once an individual develops NMSC, he/she has increased risk of developing basal cell carcinoma, squamous cell carcinoma, or melanoma.
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Affiliation(s)
- Mona Almahroos
- Department of Dermatology, Boston University School of Medicine, Boston, MA 02118, USA
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Raznatović M, Maksimović N, Janković J, Musić D. Impact of some constitutional characteristics on the development of basal cell carcinoma. VOJNOSANIT PREGL 2007; 64:375-9. [PMID: 17687940 DOI: 10.2298/vsp0706375r] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background/Aim. Basal cell carcinoma (BCC) is the most common form of skin cancer in the white population. Increasing incidence of BCC imposes the requirement to identify the risk factors due to eventual preventive action. The aim of this study was to assess the role of some constitutional characteristics in development of BCC among the Montenegrin population. Methods. A case-control study was conducted at the Dermatology Department of Clinical Center of Montenegro in Podgorica from 2002?2003. The study group included 100 histopatologically confirmed BCC cases, while the control group consisted of 100 patients from the same department, who did not present skin cancer and who were individually matched to the cases by sex and age (?5 years). All participants were interviewed using an epidemiological questionnaire. For statistical analysis t test and McNemar ?2 test for matched pairs and multivariate logistic regression analyses were used. Results. The risk for development of BCC was increased among the persons with lighter hair color (t = 4.63; df = 99; p < 0.001), fair skin (t = 2.37; df = 99; p = 0.020), lighter eyes color (t = 2.86; df = 99; p = 0.005), with nevuses (OR = 13.13; p = 0.025; 95% IP = 1.39-12.03), and among those whose skin tone after sun exposure remained light (OR = 3.14; p = 0.001; 95%IP = 1.59-6.18). Conclusion. Our study confirmed the significance of constitutional characteristics such as lighter hair color, fair skin, lighter eyes color, and the presence of nevuses in the development of BCC. .
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Affiliation(s)
- Milena Raznatović
- Klinicki centar Crne Gore, Hirurska klinika, Podgorica, Crna Gora, Medicinski fakultet, Beograd, Srbija
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Maksimović N, Raznatović M, Marinković J, Janković J. [Exposure to sun radiation as a risk factor for the occurrence of basal cell carcinoma in the Montenegrian population]. VOJNOSANIT PREGL 2006; 63:643-7. [PMID: 16875424 DOI: 10.2298/vsp0607643m] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIM [corrected] Basal cell carcinoma (BCC) is the most frequent form of carcinomas in the whites. Among the environmental factors, the most important risk factor for its occurrence is the expasure to sun radiation. The aim of this study was to assess the role of the sun radiation in the development of basal cell carcinoma BCC in the Montenegrian population. METHODS A case-control study was conducted in a period from 2002-2003. The study group included 100 histopatologically confirmed cases with BCC, while the control group included 100 patients from the same population, who did not present skin cancer and who were individually matched with the cases from the study group by sex and age (+/- 5 years). All the participants were interviewed using an epidemiological questionnaire. For statistical analysis, the chi-squared test and univariate logistic regression analysis were used. RESULTS The risk for development of BCC was increased in the persons: that always had burns with no tan during the exposure to sunlight (OR = 1.75; 95% CI = 1.20-2.55; p = 0.003); that developed sunburns after two hours of the exposure to sunlight (OR = 3.72; 95% CI = 2.39-5.79; p < 0.001) that kept light tan or remained without changes in childhood and adolescence after the repeated exposures to sunlight (OR = 2.92; 95% CI = 1.89-4.52; p < 0.001) that often had severe and painful sunburns (OR = 4.48; 95% CI = 2.74-7.33; p < 0.001). CONCLUSION Our study confirmed the significance of sunlight exposure for the development of BCC.
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Zak-Prelich M, Narbutt J, Sysa-Jedrzejowska A. Environmental risk factors predisposing to the development of basal cell carcinoma. Dermatol Surg 2004; 30:248-52. [PMID: 14871217 DOI: 10.1111/j.1524-4725.2004.30089.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Basal cell carcinomas (BCCs) are the most common malignancies in white people. The incidence varies depending on the region of the world, with the highest rate of 1% to 2% per year noted in Australia. It is estimated that BCC incidence increases by 5% annually. An increasing incidence of BCC is in line with the changes in the living style and exposure to various environmental factors. OBJECTIVE To present the environmental factors that may influence the development of BCCs. The influence of ultraviolet radiation exposure alone and in connection with immunosuppression, smoking, occupational factors, as well as arsenic and ionizing radiation exposure, was described. CONCLUSION BCC is a very complex disease, with many factors influencing its development. Environmental factors are very important for the prevalence of BCC, and most of them can be avoided. The exposure to ultraviolet radiation is undoubtedly of great risk; therefore, the national campaigns against aggressive, seasonal sun exposure, especially in children and adolescents, as well as using sunscreens, are of great value in the fight against BCC development.
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Ammirati CT, Ioffreda MD, Hruza GJ. Malignant tumors of the keratinocytes and adnexae. Facial Plast Surg Clin North Am 2004; 11:141-63. [PMID: 15062270 DOI: 10.1016/s1064-7406(02)00042-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Christie T Ammirati
- Department of Dermatology, Pennsylvania State University, Milton S. Hershey Medical Center, 500 University Drive, PO Box 850, Hershey, PA 17033, USA.
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Environmental Risk Factors Predisposing to the Development of Basal Cell Carcinoma. Dermatol Surg 2004. [DOI: 10.1097/00042728-200402002-00004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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