1
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Tønder JE, Bønnelykke-Behrndtz ML, Laurberg T, Røssell EL, Sollie M. Melanoma risk, tumour stage, and melanoma-specific mortality in individuals with diabetes: a systematic review and meta-analysis. BMC Cancer 2024; 24:812. [PMID: 38972968 PMCID: PMC11229239 DOI: 10.1186/s12885-024-12598-8] [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: 02/14/2024] [Accepted: 07/03/2024] [Indexed: 07/09/2024] Open
Abstract
BACKGROUND Cancer has become the leading diabetes-related cause of death in high-income countries, and more knowledge is needed to clarify the impact of diabetes on site-specific cancers. The purpose of this study is to assess the association between diabetes and malignant melanoma by conducting a comprehensive systematic review and meta-analysis. METHODS Using predefined eligibility criteria, PubMed, The Cochrane Library and Web of Science were systematically searched up to February 22, 2023. Exposure was defined as diabetes or type 2 diabetes and the outcomes were defined as melanoma incidence, melanoma stage or melanoma-specific mortality. The identified articles were evaluated by two independent reviewers and quality assessment was conducted using the Newcastle-Ottawa Scale for observational studies. Meta-analyses were conducted using RevMan 5.4.1 on melanoma risk using adjusted risk estimates and on melanoma stage using a dichotomous model. RESULTS The literature search revealed 20 studies in total eligible for inclusion, 14 for the analysis of melanoma risk, 3 for melanoma thickness and ulceration, and 4 for melanoma-specific survival. According to the meta-analyses, diabetes did not impact the risk of developing melanoma (RR:1.05, 95%CI:0.99-1.12, p = 0.10). However, type 2 diabetes was associated with more advanced melanoma stages at the time of diagnosis (Breslow-thickness > 1 mm: RR 1.35, 95%CI: 1.22-1.49, p = < 0.001) and presence of ulceration (RR 1.30, 95%CI: 1.00-1.68, p = 0.05). A meta-analysis on the association between diabetes and melanoma-specific mortality was not feasible due to diverse study designs. CONCLUSION Our meta-analysis found no association between diabetes and the risk of developing melanoma, but diabetes was associated with increased tumour thickness and the presence of ulceration at the time of diagnosis. Further research is warranted to explore the association between diabetes melanoma stage and prognosis. TRIAL REGISTRATION PROSPERO ID CRD42023394187.
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Affiliation(s)
- Jens Ejrnæs Tønder
- Department of Plastic and Breast Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N, 8200, Denmark.
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.
| | | | - Tinne Laurberg
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Eeva-Liisa Røssell
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Martin Sollie
- Department of Plastic and Breast Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N, 8200, Denmark
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2
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Barlow R, Shah A, Mohandas P. Pigmented skin lesions. BMJ 2024; 385:e077845. [PMID: 38857912 DOI: 10.1136/bmj-2023-077845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Affiliation(s)
- Richard Barlow
- Birmingham Queen Elizabeth Hospital, Birmingham, UK
- Patient author
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3
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Hafez SY, Alraddadi EA, Ramadan M, Alsalamah F, Alghumuy R, Aljuhani FF. Assessment of prevalence of sunscreen use and related practices among people living in Saudi Arabia: A cross-sectional survey-based study. J Cosmet Dermatol 2024; 23:1718-1725. [PMID: 38234195 DOI: 10.1111/jocd.16191] [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: 11/09/2023] [Revised: 01/03/2024] [Accepted: 01/08/2024] [Indexed: 01/19/2024]
Abstract
BACKGROUND The use of sunscreen significantly reduces the risk of skin cancer and helps maintain skin health; however, improper use can decrease its effectiveness. This study aimed to investigate the prevalence and factors associated with sunscreen use in Saudi Arabia as well as identifying areas of weakness in sunscreen practices. METHODS A cross-sectional survey-based study was conducted with a diverse population sample in Saudi Arabia. Participants were asked about their sunscreen usage habits, motivations, and knowledge of proper application techniques. Demographic information, including age, gender, and skin type, were also collected. RESULTS A total of 2321 individuals participated in the study. More than two-thirds of the participants reported using sunscreen either always, regularly, or often, primarily to maintain a light skin color and prevent skin cancer. Factors associated with sunscreen use included younger age (18-40 years old), female gender, history of sunburn, and fair skin. Despite the majority reporting healthy sun exposure habits, several shortcomings were identified in sunscreen practices, including incorrect application and suboptimal reapplication frequency. CONCLUSION While sunscreen use is common among the study population, there is a need for improved education on proper application techniques. National awareness campaigns, especially those utilizing popular social media and digital platforms in Saudi Arabia, should focus on disseminating accurate sunscreen use guidelines to maximize sun protection and skin health.
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Affiliation(s)
- Salwa Y Hafez
- College of Nursing, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Ministry of National Guard - Health Affairs, Jeddah, Saudi Arabia
| | - Eman A Alraddadi
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Ministry of National Guard - Health Affairs, Jeddah, Saudi Arabia
- Department of Basic Sciences, College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Majed Ramadan
- Ministry of National Guard - Health Affairs, Jeddah, Saudi Arabia
- Population Health Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Faris Alsalamah
- Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Raghad Alghumuy
- College of Nursing, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Faisal F Aljuhani
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Collage of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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4
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Fink D. What is the safe noise exposure level to prevent noise-induced hearing loss? JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024:10.1038/s41370-024-00660-3. [PMID: 38637639 DOI: 10.1038/s41370-024-00660-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 04/20/2024]
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5
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Brandlmaier M, Hoellwerth M, Koelblinger P, Lang R, Harrer A. Adjuvant PD-1 Checkpoint Inhibition in Early Cutaneous Melanoma: Immunological Mode of Action and the Role of Ultraviolet Radiation. Cancers (Basel) 2024; 16:1461. [PMID: 38672543 PMCID: PMC11047851 DOI: 10.3390/cancers16081461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 04/03/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Melanoma ranks as the fifth most common solid cancer in adults worldwide and is responsible for a significant proportion of skin-tumor-related deaths. The advent of immune checkpoint inhibition with anti-programmed death protein-1 (PD-1) antibodies has revolutionized the adjuvant treatment of high-risk, completely resected stage III/IV melanoma. However, not all patients benefit equally. Current strategies for improving outcomes involve adjuvant treatment in earlier disease stages (IIB/C) as well as perioperative treatment approaches. Interfering with T-cell exhaustion to counteract cancer immune evasion and the immunogenic nature of melanoma is key for anti-PD-1 effectiveness. Yet, the biological rationale for the efficacy of adjuvant treatment in clinically tumor-free patients remains to be fully elucidated. High-dose intermittent sun exposure (sunburn) is a well-known primary risk factor for melanomagenesis. Also, ultraviolet radiation (UVR)-induced immunosuppression may impair anti-cancer immune surveillance. In this review, we summarize the current knowledge about adjuvant anti-PD-1 blockade, including a characterization of the main cell types most likely responsible for its efficacy. In conclusion, we propose that local and systemic immunosuppression, to some extent UVR-mediated, can be restored by adjuvant anti-PD-1 therapy, consequently boosting anti-melanoma immune surveillance and the elimination of residual melanoma cell clones.
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Affiliation(s)
- Matthias Brandlmaier
- Department of Dermatology and Allergology, Paracelsus Medical University, 5020 Salzburg, Austria; (M.B.); (M.H.); (P.K.)
| | - Magdalena Hoellwerth
- Department of Dermatology and Allergology, Paracelsus Medical University, 5020 Salzburg, Austria; (M.B.); (M.H.); (P.K.)
| | - Peter Koelblinger
- Department of Dermatology and Allergology, Paracelsus Medical University, 5020 Salzburg, Austria; (M.B.); (M.H.); (P.K.)
| | - Roland Lang
- Department of Dermatology and Allergology, Paracelsus Medical University, 5020 Salzburg, Austria; (M.B.); (M.H.); (P.K.)
| | - Andrea Harrer
- Department of Dermatology and Allergology, Paracelsus Medical University, 5020 Salzburg, Austria; (M.B.); (M.H.); (P.K.)
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University and Center for Cognitive Neuroscience, 5020 Salzburg, Austria
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6
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Dachani S, Kaleem M, Mujtaba MA, Mahajan N, Ali SA, Almutairy AF, Mahmood D, Anwer MK, Ali MD, Kumar S. A Comprehensive Review of Various Therapeutic Strategies for the Management of Skin Cancer. ACS OMEGA 2024; 9:10030-10048. [PMID: 38463249 PMCID: PMC10918819 DOI: 10.1021/acsomega.3c09780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/02/2024] [Accepted: 02/08/2024] [Indexed: 03/12/2024]
Abstract
Skin cancer (SC) poses a global threat to the healthcare system and is expected to increase significantly over the next two decades if not diagnosed at an early stage. Early diagnosis is crucial for successful treatment, as the disease becomes more challenging to cure as it progresses. However, identifying new drugs, achieving clinical success, and overcoming drug resistance remain significant challenges. To overcome these obstacles and provide effective treatment, it is crucial to understand the causes of skin cancer, how cells grow and divide, factors that affect cell growth, and how drug resistance occurs. In this review, we have explained various therapeutic approaches for SC treatment via ligands, targeted photosensitizers, natural and synthetic drugs for the treatment of SC, an epigenetic approach for management of melanoma, photodynamic therapy, and targeted therapy for BRAF-mutated melanoma. This article also provides a detailed summary of the various natural drugs that are effective in managing melanoma and reducing the occurrence of skin cancer at early stages and focuses on the current status and future prospects of various therapies available for the management of skin cancer.
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Affiliation(s)
- Sudharshan
Reddy Dachani
- Department
of Pharmacy Practice, College of Pharmacy, Shaqra University, Al-Dawadmi Campus, Al-Dawadmi 11961, Saudi Arabia
| | - Mohammed Kaleem
- Department
of Pharmacology, Babasaheb Balpande College of Pharmacy, Rashtrasant Tukadoji Maharaj Nagpur University, Nagpur 440037, Maharashtra, India
| | - Md. Ali Mujtaba
- Department
of Pharmaceutics, Faculty of Pharmacy, Northern
Border University, Arar 91911, Saudi Arabia
| | - Nilesh Mahajan
- Department
of Pharmaceutics, Dabasaheb Balpande College of Pharmacy, Rashtrasant Tukadoji Maharaj Nagpur University, Nagpur 440037, Maharashtra, India
| | - Sayyed A. Ali
- Department
of Pharmaceutics, Dabasaheb Balpande College of Pharmacy, Rashtrasant Tukadoji Maharaj Nagpur University, Nagpur 440037, Maharashtra, India
| | - Ali F Almutairy
- Department
of Pharmacology and Toxicology, College of Pharmacy, Qassim University, Buraydah 51452, Saudi Arabia
| | - Danish Mahmood
- Department
of Pharmacology and Toxicology, College of Pharmacy, Qassim University, Buraydah 51452, Saudi Arabia
| | - Md. Khalid Anwer
- Department
of Pharmaceutics, College of Pharmacy, Prince
Sattam Bin Abdulaziz University, P.O. Box 173, Al-Kharj 11942, Saudi Arabia
| | - Mohammad Daud Ali
- Department
of Pharmacy, Mohammed Al-Mana College for
Medical Sciences, Abdulrazaq Bin Hammam Street, Al Safa 34222, Dammam, Saudi Arabia
| | - Sanjay Kumar
- Department
of Life Sciences, Sharda School of Basic Sciences and Research, Sharda University, Uttar Pradesh 201306, India
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7
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Tod B, Whitaker D, Visser W, Isaacs T, Jacobs T, Wiid K, Dlova NC, Wright CY. Integrated sun protection advice for the South African population. Int J Dermatol 2024; 63:277-287. [PMID: 38124402 DOI: 10.1111/ijd.16980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/30/2023] [Accepted: 12/02/2023] [Indexed: 12/23/2023]
Abstract
Exposure to solar ultraviolet radiation (UVR) is associated with several cutaneous adverse effects. However, to the best of our knowledge, in South Africa there are no formal guidelines on sun protection. A group of South African dermatologists and researchers convened over the course of 1 year to deliberate on integrated advice for sun protection among the multi-ethnic South African population. For people with light skin and those with genetic skin disorders (e.g., oculocutaneous albinism), sun protection was identified as critical to prevent sunburn, skin cancer, and photoaging. The evidence is less clear for people with medium and darker skin types, especially the latter, in whom melanin may confer a degree of protection against some parts of the solar spectrum. Recent studies have demonstrated that visible light can cause pigmentary changes in individuals with darker skin types in particular. Sun protection for people of all skin colors is beneficial to protect against photoaging and ocular damage. Herein sun protection advice is suggested for South Africans of all skin colors to reduce morbidity and mortality from sun exposure, particularly relating to skin cancer. Several knowledge gaps are identified as future research priorities.
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Affiliation(s)
- Bianca Tod
- Division of Dermatology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | | | - Willie Visser
- Division of Dermatology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Thuraya Isaacs
- Division of Dermatology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | | | - Kim Wiid
- L'Oréal Dermatological Beauty, Johannesburg, South Africa
| | - Ncoza C Dlova
- Dermatology Department, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Caradee Y Wright
- Climate Change and Health Research Programme, Environment and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa
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8
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Law CK, Cust AE, Smit AK, Trevena L, Fernandez-Penas P, Nieweg OE, Menzies AM, Wordsworth S, Morton RL. Long-term cost-effectiveness of a melanoma prevention program using genomic risk information compared with standard prevention advice in Australia. Genet Med 2023; 25:100970. [PMID: 37658729 DOI: 10.1016/j.gim.2023.100970] [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: 02/26/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/03/2023] Open
Abstract
PURPOSE Evidence indicates that a melanoma prevention program using personalized genomic risk provision and genetic counseling can affect prevention behaviors, including reducing sunburns in adults with no melanoma history. This analysis evaluated its longer-term cost-effectiveness from an Australian health system perspective. METHODS The primary outcome was incremental cost effectiveness ratio (ICER) of genomic risk provision (intervention) compared with standard prevention advice. A decision-analytic Markov model was developed using randomized trial data to simulate lifetime cost-effectiveness. All costs were presented in 2018/19 Australian dollars (AUD). The intervention effect on reduced sunburns was stratified by sex and traditional risk, which was calculated through a validated prediction model. Deterministic and probabilistic sensitivity analyses were undertaken for robustness checks. RESULTS The per participant cost of intervention was AUD$189. Genomic risk provision targeting high-traditional risk individuals produced an ICER of AUD$35,254 (per quality-adjusted life year gained); sensitivity analyses indicated the intervention would be cost-effective in more than 50% of scenarios. When the intervention was extended to low-traditional risk groups, the ICER was AUD$43,746 with a 45% probability of being cost-effective. CONCLUSION Genomic risk provision targeted to high-traditional melanoma risk individuals is likely a cost-effective strategy for reducing sunburns and will likely prevent future melanomas and keratinocyte carcinomas.
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Affiliation(s)
- Chi Kin Law
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, Australia.
| | - Anne E Cust
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia; Melanoma Institute Australia, The University of Sydney, Sydney, Australia; School of Public Health, The University of Sydney, Sydney, Australia
| | - Amelia K Smit
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia; Melanoma Institute Australia, The University of Sydney, Sydney, Australia; School of Public Health, The University of Sydney, Sydney, Australia
| | - Lyndal Trevena
- School of Public Health, The University of Sydney, Sydney, Australia
| | | | - Omgo E Nieweg
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia; Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Alexander M Menzies
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Royal North Shore and Mater Hospitals, Sydney, Australia
| | - Sarah Wordsworth
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Rachael L Morton
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, Australia; Melanoma Institute Australia, The University of Sydney, Sydney, Australia
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9
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De Dominici M, DeGregori J. Our ancestry dictates clonal architecture and skin cancer susceptibility. Nat Genet 2023; 55:1428-1429. [PMID: 37537258 DOI: 10.1038/s41588-023-01467-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Affiliation(s)
- Marco De Dominici
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - James DeGregori
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
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10
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Cole Y, Ilyas AM, Ilyas EN. Assessment of UV Protection for Children's Summer Clothing. Cureus 2023; 15:e44137. [PMID: 37753032 PMCID: PMC10518426 DOI: 10.7759/cureus.44137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/28/2023] Open
Abstract
INTRODUCTION Excess ultraviolet (UV) radiation exposure during childhood poses a particular long-term risk of developing skin cancer later in life however recent studies have called attention to the absorption of chemical sunscreen ingredients into the bloodstream with unclear significance. This has led to recommendations to consider sun protection in the form of clothing to reduce the need for sunscreen products. METHODS Ten brands of routine summer clothing not labeled as sun protective from five distributors marketed for children were identified with varying price ranges. Summer clothing items consisting of T-shirts and tops were evaluated for fiber composition, cost, and UPF testing was performed to determine UVA and UVB transmittance. Results: Around 88.2% of blended textile compositions compared to 60% of 100% cotton textiles offered adequate UV protection with an Ultraviolet Protection Factor (UPF) greater than 15. 58% of blended fabrics compared to 50% of cotton textiles offered a UPF greater than 30. There was no correlation between brand and cost with UPF values. Conclusions: In the absence of regulations for testing and labeling of all children's garments for UV protection, guidelines for the pediatric population for choosing clothing for the summer should reflect the information available to consumers that is easy to understand and more likely to result in higher UPF values. Based on fiber composition, blended textiles are more likely to have adequate UV protection compared to 100% cotton or 100% polyester.
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Affiliation(s)
- Yonesha Cole
- Dermatology, Drexel University College of Medicine, Philadelphia, USA
| | - Amber M Ilyas
- Health and Environmental Impact, AmberNoon LLC, King of Prussia, USA
| | - Erum N Ilyas
- Dermatology, Drexel University College of Medicine, Philadelphia, USA
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11
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Kliniec K, Tota M, Zalesińska A, Łyko M, Jankowska-Konsur A. Skin Cancer Risk, Sun-Protection Knowledge and Behavior in Athletes-A Narrative Review. Cancers (Basel) 2023; 15:3281. [PMID: 37444391 DOI: 10.3390/cancers15133281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 07/15/2023] Open
Abstract
Outdoor sports are associated with increased exposure to ultraviolet radiation, which may result in sunburn, solar damage, and skin cancers. Water and winter sports create additional adverse conditions, such as washing away sunscreen by water and reflection of UV rays by the water and snow. Sweating-increased skin photosensitivity and activity-induced immunosuppression are associated with a greater risk of developing skin cancers. In this review, we focus on a group of athletes and sports participants and analyze 62 articles concerning sun exposure during outdoor sports, the risk of developing skin cancer, and knowledge and behavior regarding photoprotection methods. Various practices have been linked to an increased risk of developing basal cell carcinoma (BCC), squamous cell carcinoma (SCC), malignant melanoma (MM), or UV-induced skin damage. Water sports and mountaineering increase the risk of BCC. Surfing and swimming are risk factors for SCC. Melanoma is more common in swimmers, surfers, and marathon runners. Photoprotection behaviors can reduce potential skin damage and skin cancers. Athletes' knowledge about the risk of malignant lesions was satisfactory, but despite the risks, outdoor sports participants seem not to protect themselves from the sun adequately.
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Affiliation(s)
- Katarzyna Kliniec
- Student Research Group of Experimental Dermatology, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland
| | - Maciej Tota
- Student Research Group of Experimental Dermatology, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland
| | - Aleksandra Zalesińska
- Student Research Group of Experimental Dermatology, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland
| | - Magdalena Łyko
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland
| | - Alina Jankowska-Konsur
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland
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12
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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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13
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Mueller AM, Goessinger EV, Cerminara SE, Kostner L, Amaral M, Huber SM, Passweg LP, Moreno LG, Bodenmann D, Kunz M, Levesque MP, Maul JT, Cheng PF, Navarini AA, Maul LV. Educational level-dependent melanoma awareness in a high-risk population in Switzerland. Front Oncol 2023; 13:1174542. [PMID: 37207151 PMCID: PMC10189064 DOI: 10.3389/fonc.2023.1174542] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 04/13/2023] [Indexed: 05/21/2023] Open
Abstract
Introduction The worldwide incidence of melanoma has been increasing rapidly in recent decades with Switzerland having one of the highest rates in Europe. Ultraviolet (UV) radiation is one of the main risk factors for skin cancer. Our objective was to investigate UV protective behavior and melanoma awareness in a high-risk cohort for melanoma. Methods In this prospective monocentric study, we assessed general melanoma awareness and UV protection habits in at-risk patients (≥100 nevi, ≥5 dysplastic nevi, known CDKN2A mutation, and/or positive family history) and melanoma patients using questionnaires. Results Between 01/2021 and 03/ 2022, a total of 269 patients (53.5% at-risk patients, 46.5% melanoma patients) were included. We observed a significant trend toward using a higher sun protection factor (SPF) in melanoma patients compared with at-risk patients (SPF 50+: 48% [n=60] vs. 26% [n=37]; p=0.0016). Those with a college or university degree used a high SPF significantly more often than patients with lower education levels (p=0.0007). However, higher educational levels correlated with increased annual sun exposure (p=0.041). Neither a positive family history for melanoma, nor gender or Fitzpatrick skin type influenced sun protection behavior. An age of ≥ 50 years presented as a significant risk factor for melanoma development with an odd's ratio of 2.32. Study participation resulted in improved sun protection behavior with 51% reporting more frequent sunscreen use after study inclusion. Discussion UV protection remains a critical factor in melanoma prevention. We suggest that melanoma awareness should continue to be raised through public skin cancer prevention campaigns with a particular focus on individuals with low levels of education.
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Affiliation(s)
- Alina Miriam Mueller
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Elisabeth Victoria Goessinger
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Sara Elisa Cerminara
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Lisa Kostner
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Margarida Amaral
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | | | | | | | | | - Michael Kunz
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | - Mitchell Paul Levesque
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Julia-Tatjana Maul
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Phil Fang Cheng
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - Alexander Andreas Navarini
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Lara Valeska Maul
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
- *Correspondence: Lara Valeska Maul,
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14
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Sun exposure and protection practices among Florida college marching band members and alumni: a cross-sectional study. Arch Dermatol Res 2022; 315:1171-1179. [DOI: 10.1007/s00403-022-02486-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/28/2022] [Accepted: 11/17/2022] [Indexed: 12/05/2022]
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15
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Lergenmuller S, Rueegg CS, Perrier F, Robsahm TE, Green AC, Lund E, Ghiasvand R, Veierød MB. Lifetime Sunburn Trajectories and Associated Risks of Cutaneous Melanoma and Squamous Cell Carcinoma Among a Cohort of Norwegian Women. JAMA Dermatol 2022; 158:1367-1377. [PMID: 36197657 PMCID: PMC9535508 DOI: 10.1001/jamadermatol.2022.4053] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/31/2022] [Indexed: 01/13/2023]
Abstract
Importance To our knowledge, no study has prospectively investigated sunburn patterns over age periods from childhood to adulthood and their associations with skin cancer risk. Objective To identify lifetime trajectories of sunburns and compare the association between these trajectories and subsequent risk of cutaneous melanoma and squamous cell carcinoma (cSCC). Design, Setting, and Participants This population-based cohort study included participants from the Norwegian Women and Cancer Study, established in 1991, with follow-up through 2018. Baseline questionnaires were issued from 1991 to 2007, with follow-up questionnaires every 5 to 7 years. Data analysis was performed from March 16, 2021, to December 4, 2021. Exposures Participants reported pigmentation factors, sunbathing vacations, and indoor tanning. Annual frequencies of sunburns were reported for childhood, adolescence, and adulthood. Main Outcomes and Measures Information on cancer diagnoses, emigration, and death were obtained through linkage to the Cancer Registry of Norway using the unique personal identification number of Norwegian citizens. Results Of the 172 472 women (age range, 31-70 years) who returned questionnaires, 169 768 received questions about sunburns at study inclusion. Five classes (stable low, low-moderate-low, low to high, high to low, and stable high) of individual lifetime sunburn trajectories with similar shapes were estimated in 3 samples up to 39 years (n = 159 773), up to 49 years (n = 153 297), and up to 59 years (n = 119 170). Mean follow-up ranged from 14.3 to 19.5 years in the 3 samples, during which 1252 to 1774 women were diagnosed with incident primary melanoma and 739 to 871 women with incident primary cSCC. With hazard ratios (HRs) and 95% CIs estimated using a Cox proportional hazards model, the stable high and high to low trajectories showed statistically significant increased melanoma and cSCC risks compared with the stable low trajectory across all samples (≤39 years for stable high and high to low trajectories: melanoma: HR, 1.50 [95% CI, 1.28-1.75] and HR, 1.44 [95% CI, 1.20-1.73]; cSCC: HR, 1.51 [95% CI, 1.22-1.87] and HR, 1.47 [95% CI, 1.14-1.91]). Other trajectories showed increased risk, though generally weaker and mainly estimates that were not statistically significant. There was no statistically significant heterogeneity between melanoma and cSCC estimates. Conclusion and Relevance This cohort study showed that high sunburn frequency throughout life was associated with increased melanoma and cSCC risk. Furthermore, sunburns in childhood are especially important for subsequent risk of these skin cancers. Avoiding sunburns throughout life, in particular in childhood, is therefore crucial.
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Affiliation(s)
- Simon Lergenmuller
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Now with Department of Clinical and Registry-Based Research, Institute of Population-Based Cancer Research, Cancer Registry of Norway, Oslo, Norway
| | - Corina S. Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Flavie Perrier
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Trude E. Robsahm
- Department of Research, Institute of Population-Based Cancer Research, Cancer Registry of Norway, Oslo, Norway
| | - Adele C. Green
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- Cancer Research UK Manchester and Faculty of Biology, Medicine and Health, University of Manchester, Manchester, England, United Kingdom
| | - Eiliv Lund
- Department of Research, Institute of Population-Based Cancer Research, Cancer Registry of Norway, Oslo, Norway
- Department of Public Health, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
| | - Reza Ghiasvand
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
- Department of Research, Institute of Population-Based Cancer Research, Cancer Registry of Norway, Oslo, Norway
| | - Marit B. Veierød
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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16
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Walz SN, Martineau J, Scampa M, Kalbermatten DF, Oranges CM. Melanoma of the Upper Limb and Shoulder: A Surveillance, Epidemiology, and End Results Analysis of Epidemiology and Survival 2000-2019. Cancers (Basel) 2022; 14:cancers14225672. [PMID: 36428763 PMCID: PMC9688102 DOI: 10.3390/cancers14225672] [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: 09/30/2022] [Revised: 11/07/2022] [Accepted: 11/15/2022] [Indexed: 11/22/2022] Open
Abstract
(1) Background: Melanoma is the most common life-threatening cancer among skin cancers. Almost all locations of the skin can be affected by melanoma, and the upper limbs are one of the most frequent locations. We aimed to study the epidemiology and survival outcomes of patients with melanoma localized in the upper extremities compared with other sites. (2) Methods: The National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) database is considered the most representative of the U.S. population; we extracted melanoma cases diagnosed between 2000 and 2019. Several characteristics, including demographical, pathological, and therapeutic, were recorded, and upper extremity melanomas and melanomas from other areas were compared. Overall survival was assessed, and the groups were compared. (3) Results: 69,436 patients had melanoma in the upper limbs and shoulders and 204,794 in other body parts. Overall, 35,267 patients with upper extremity melanoma were males, 34,169 were females, and the mean age was 60. For the rest of the body, there were 118,654 males and 86,140 females, with a mean age of 59. Surgery alone was the most commonly used treatment, while radiation therapy was the least used for all sites. Women appear to have better survival than men. Superficial spreading melanoma is the least lethal subtype, while nodular melanoma is the most dangerous. (4) Conclusion: Women under 50 are more at risk than men of the same age. The trend reverses after age 50 where men are at greater risk. In addition to gender and age, disease stage and major histologic subtypes influence survival.
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17
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Huang JJ, Geduldig JE, Jacobs EB, Tai TYT, Ahmad S, Chadha N, Buxton DF, Vinod K, Wirostko BM, Kang JH, Wiggs JL, Ritch R, Pasquale LR. Head and Neck Region Dermatological Ultraviolet-Related Cancers are Associated with Exfoliation Syndrome in a Clinic-Based Population. Ophthalmol Glaucoma 2022; 5:663-671. [PMID: 35470101 PMCID: PMC9587131 DOI: 10.1016/j.ogla.2022.04.002] [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: 02/12/2022] [Revised: 04/12/2022] [Accepted: 04/18/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE We assessed the relationship between ultraviolet (UV)-associated dermatological carcinomas (basal cell carcinoma [BCC] and squamous cell carcinoma [SCC]) and exfoliation syndrome (XFS) or exfoliation glaucoma (XFG). DESIGN Case-control study. PARTICIPANTS Between 2019 and 2021, 321 participants and control subjects (XFS or XFG = 98; primary open-angle glaucoma [POAG] = 117; controls = 106; ages 50-90 years) were recruited. METHODS A cross-sectional survey assessing medical history, maximum known intraocular pressure, cup-to-disc ratio, Humphrey visual field 24-2, the propensity to tan or burn in early life, history of BCC or SCC, and XFS or XFG diagnosis. The multivariable models adjusted for age, sex, medical history, eye color, hair color, and likeliness of tanning versus burning at a young age. MAIN OUTCOME MEASURES History of diagnosed XFS or XFG. RESULTS Any history of BCC or SCC in the head and neck region was associated with a 2-fold higher risk of having XFS or XFG versus having POAG or being a control subject (odds ratio [OR], 2.01; 95% confidence interval [CI], 1.04-3.89) in a multivariable-adjusted analysis. We observed a dose-response association in which the chance of having XFS or XFG increased by 67% per head and neck BCC or SCC occurrence (OR, 1.67; 95% CI, 1.09-2.56). When we excluded POAG participants, head and neck BCC or SCC was associated with a 2.8-fold higher risk of XFS or XFG (OR, 2.80; 95% CI, 1.12-7.02), and each additional occurrence had a 2-fold higher risk of XFS or XFG (OR, 1.97; 95% CI, 1.09-3.58). The association between head and neck region BCC or SCC and POAG compared with the control subjects was null (OR, 1.42; 95% CI, 0.58-3.48). With BCC or SCC located anywhere on the body, there was a nonsignificantly higher risk of having XFS or XFG compared with having POAG or being a control subject (OR, 1.65; 95% CI, 0.88-3.09). CONCLUSIONS Head and neck region BCCs or SCCs are associated with a higher risk of having XFS or XFG. These findings support prior evidence that head and neck UV exposure may be a risk factor for XFS.
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Affiliation(s)
- Jeff J Huang
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Jack E Geduldig
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Erica B Jacobs
- New York Eye and Ear Infirmary of Mount Sinai, New York, New York
| | - Tak Yee T Tai
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York; New York Eye and Ear Infirmary of Mount Sinai, New York, New York
| | - Sumayya Ahmad
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York; New York Eye and Ear Infirmary of Mount Sinai, New York, New York
| | - Nisha Chadha
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York; New York Eye and Ear Infirmary of Mount Sinai, New York, New York
| | - Douglas F Buxton
- New York Eye and Ear Infirmary of Mount Sinai, New York, New York
| | - Kateki Vinod
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York; New York Eye and Ear Infirmary of Mount Sinai, New York, New York
| | | | - Jae H Kang
- Channing Division of Network of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Janey L Wiggs
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Robert Ritch
- New York Eye and Ear Infirmary of Mount Sinai, New York, New York
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York; New York Eye and Ear Infirmary of Mount Sinai, New York, New York
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18
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Chang MS, Hartman RI, Trepanowski N, Giovannucci EL, Nan H, Li X. Cumulative Erythemal Ultraviolet Radiation and Risk of Cancer in 3 Large US Prospective Cohorts. Am J Epidemiol 2022; 191:1742-1752. [PMID: 35671977 PMCID: PMC9991893 DOI: 10.1093/aje/kwac101] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 05/20/2022] [Accepted: 06/01/2022] [Indexed: 01/29/2023] Open
Abstract
Ultraviolet radiation (UVR) exposure is the major risk factor for melanoma. However, epidemiologic studies on UVR and noncutaneous cancers have reported inconsistent results, with some suggesting an inverse relationship potentially mediated by vitamin D. To address this, we examined 3 US prospective cohorts, the Health Professionals Follow-up Study (HPFS) (1986) and Nurses' Health Study (NHS) I and II (1976 and 1989), for associations between cumulative erythemal UVR and incident cancer risk, excluding nonmelanoma skin cancer. We used a validated spatiotemporal model to calculate erythemal UVR. Participants (47,714 men; 212,449 women) were stratified into quintiles by cumulative average erythemal UVR, using the first quintile as referent, for Cox proportional hazards regression analysis. In the multivariable-adjusted meta-analysis of all cohorts, compared with the lowest quintile, risk of any cancer was slightly increased across all other quintiles (highest quintile hazard ratio (HR) = 1.04, 95% confidence interval (CI): 1.01, 1.07; P for heterogeneity = 0.41). All UVR quintiles were associated with similarly increased risk of any cancer excluding melanoma. As expected, erythemal UVR was positively associated with risk of melanoma (highest quintile HR = 1.17, 95% CI: 1.04, 1.31; P for heterogeneity = 0.83). These findings suggest that elevated UVR is associated with increased risk of both melanoma and noncutaneous cancers.
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Affiliation(s)
| | | | | | | | | | - Xin Li
- Correspondence to Dr. Xin Li, Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Health Sciences Building, RG 5114, 1050 Wishard Boulevard., Indianapolis, IN 46202 (e-mail: )
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19
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Yen H, Yen H, Drucker AM, Han J, Li WQ, Li T, Qureshi A, Cho E. COX‐2‐Hemmer: Keine präventive Wirkung gegen Hautkrebs. J Dtsch Dermatol Ges 2022; 20:157-168. [PMID: 35146873 DOI: 10.1111/ddg.14649_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/10/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Hsuan Yen
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hsi Yen
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Dermatology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Aaron M Drucker
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Women's College Research Institute and Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada.,Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Jiali Han
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA.,Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, Indiana, USA
| | - Wen-Qing Li
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.,Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Tricia Li
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Abrar Qureshi
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.,Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Eunyoung Cho
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.,Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
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20
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Khan NH, Mir M, Qian L, Baloch M, Ali Khan MF, Rehman AU, Ngowi EE, Wu DD, Ji XY. Skin cancer biology and barriers to treatment: Recent applications of polymeric micro/nanostructures. J Adv Res 2022; 36:223-247. [PMID: 35127174 PMCID: PMC8799916 DOI: 10.1016/j.jare.2021.06.014] [Citation(s) in RCA: 60] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/11/2021] [Accepted: 06/13/2021] [Indexed: 12/15/2022] Open
Abstract
Background Skin cancer has been the leading type of cancer worldwide. Melanoma and non-melanoma skin cancers are now the most common types of skin cancer that have been reached to epidemic proportion. Based on the rapid prevalence of skin cancers, and lack of efficient drug delivery systems, it is essential to surge the possible ways to prevent or cure the disease. Aim of review Although surgical modalities and therapies have been made great progress in recent years, however, there is still an urgent need to alleviate its increased burden. Hence, understanding the precise pathophysiological signaling mechanisms and all other factors of such skin insults will be beneficial for the development of more efficient therapies. Key scientific concepts of review In this review, we explained new understandings about onset and development of skin cancer and described its management via polymeric micro/nano carriers-based therapies, highlighting the current key bottlenecks and future prospective in this field. In therapeutic drug/gene delivery approaches, polymeric carriers-based system is the most promising strategy. This review discusses that how polymers have successfully been exploited for development of micro/nanosized systems for efficient delivery of anticancer genes and drugs overcoming all the barriers and limitations associated with available conventional therapies. In addition to drug/gene delivery, intelligent polymeric nanocarriers platforms have also been established for combination anticancer therapies including photodynamic and photothermal, and for theranostic applications. This portfolio of latest approaches could promote the blooming growth of research and their clinical availability.
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Key Words
- 5-ALA, 5-aminolevulinic acid
- 5-FU, 5-fluorouracil
- AIDS, Acquired immune deficiency syndrome
- BCC, Basal cell carcinoma
- BCCs, Basal cell carcinomas
- Basal cell carcinoma
- CREB, response element-binding protein
- DDS, Drug delivery system
- DIM-D, Di indolyl methane derivative
- Drug delivery
- GNR-PEG-MN, PEGylated gold nanorod microneedle
- Gd, Gadolinium
- Gene delivery
- HH, Hedgehog
- HPMC, Hydroxypropyl methylcellulose
- IPM, Isopropyl myristate
- MCIR, Melanocortin-1 receptor
- MNPs, Magnetic nanoparticle
- MNs, Microneedles
- MRI, Magnetic Resonance Imaging
- MSC, Melanoma skin cancer
- Microneedles
- Mn, Manganese
- NMSC, Non melanoma skin cancer
- NPs, Nano Particles
- OTR, Organ transplant recipients
- PAMAM, Poly-amidoamines
- PAN, Polyacrylonitrile
- PATCH1, Patch
- PCL, Poly (ε-caprolactone)
- PDT, Photodynamic therapy
- PEG, Polyethylene glycol
- PLA, Poly lactic acid
- PLA-HPG, Poly (d-l-lactic acid)-hyperbranched polyglycerol
- PLGA, Poly (lactide-co-glycolide) copolymers
- PLL, Poly (L-lysine)
- Polymeric nanocarriers
- QDs, Quantum dots
- SC, Skin cancer
- SCC, Squamous cell Carcinoma
- SMO, Smoothen
- SPIO, Superparamagnetic iron oxide
- Squamous cell carcinoma
- UV, Ultra Violet
- cAMP, Cyclic adenosine monophosphate
- dPG, Dendritic polyglycerol
- hTERT, Human telomerase reverse transcriptase
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Affiliation(s)
- Nazeer Hussain Khan
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
- School of Life Sciences. Henan University, Kaifeng, Henan 475004, China
| | - Maria Mir
- Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan
| | - Lei Qian
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
| | - Mahnoor Baloch
- School of Natural Sciences, National University of Science and Technology, Islamabad 44000, Pakistan
| | - Muhammad Farhan Ali Khan
- Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan
| | - Asim-ur- Rehman
- Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan
| | - Ebenezeri Erasto Ngowi
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
- Department of Biological Sciences, Faculty of Sciences, Dar es Salaam University College of Education, Dar es Salaam 2329, Tanzania
| | - Dong-Dong Wu
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
- School of Stomatology, Henan University, Kaifeng, Henan 475004, China
| | - Xin-Ying Ji
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
- Kaifeng Key Laboratory of Infection and Biological Safety, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
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Yen H, Yen H, Drucker AM, Han J, Li WQ, Li T, Qureshi A, Cho E. COX-2 inhibitors show no preventive effect in the development of skin cancer. J Dtsch Dermatol Ges 2022; 20:157-166. [PMID: 35088518 DOI: 10.1111/ddg.14649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/10/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Some clinical trials found that cyclooxygenase-2 (COX-2) inhibitor use lowered the risk of skin cancer in high-risk groups. PATIENTS AND METHODS To determine whether COX-2 inhibitor use is associated with lower risk of basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (cSCC), and melanoma, we analyzed COX-2 inhibitor use and risk of skin cancer based on three prospective cohort studies, the Nurses' Health Study (NHS), NHS II, and the Health Professionals Follow-up Study, including 153,882 participants. Multivariable hazard ratios (HRs) and 95 % confidence intervals (CIs) for the association of COX-2 inhibitor use with risk of BCC, cSCC, and melanoma were estimated using Cox proportional hazards models. We pooled the results using a fixed effects model. RESULTS 16,142 BCC, 1,973 cSCC, and 631 melanoma cases were documented. Ever vs. never use of COX-2 inhibitor was associated with a modestly increased risk of BCC (multivariable HR 1.09, 95 % CI 1.05-1.14). The hazard ratio was similar for cSCC (multivariable HR 1.12, 95 % CI 1.00-1.27) and melanoma (multivariable HR 1.10, 95 % CI 0.89-1.38), but was not statistically significant. CONCLUSIONS Ever use of COX-2 inhibitor was not associated with a decreased skin cancer risk but was instead associated with a modest, increased risk of BCC.
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Affiliation(s)
- Hsuan Yen
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hsi Yen
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Dermatology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Aaron M Drucker
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Women's College Research Institute and Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada.,Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Jiali Han
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA.,Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN, USA
| | - Wen-Qing Li
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, USA.,Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Tricia Li
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Abrar Qureshi
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, USA.,Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Eunyoung Cho
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, USA.,Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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Viljoen C, Janse van Rensburg DCC, van Mechelen W, Verhagen E, Silva B, Scheer V, Besomi M, Gajardo-Burgos R, Matos S, Schoeman M, Jansen van Rensburg A, van Dyk N, Scheepers S, Botha T. Trail running injury risk factors: a living systematic review. Br J Sports Med 2022; 56:577-587. [PMID: 35022162 DOI: 10.1136/bjsports-2021-104858] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To review and frequently update the available evidence on injury risk factors and epidemiology of injury in trail running. DESIGN Living systematic review. Updated searches will be done every 6 months for a minimum period of 5 years. DATA SOURCES Eight electronic databases were searched from inception to 18 March 2021. ELIGIBILITY CRITERIA Studies that investigated injury risk factors and/or reported the epidemiology of injury in trail running. RESULTS Nineteen eligible studies were included, of which 10 studies investigated injury risk factors among 2 785 participants. Significant intrinsic factors associated with injury are: more running experience, level A runner and higher total propensity to sports accident questionnaire (PAD-22) score. Previous history of cramping and postrace biomarkers of muscle damage is associated with cramping. Younger age and low skin phototypes are associated with sunburn. Significant extrinsic factors associated with injury are neglecting warm-up, no specialised running plan, training on asphalt, double training sessions per day and physical labour occupations. A slower race finishing time is associated with cramping, while more than 3 hours of training per day, shade as the primary mode of sun protection and being single are associated with sunburn. An injury incidence range 0.7-61.2 injuries/1000 hours of running and prevalence range 1.3% to 90% were reported. The lower limb was the most reported region of injury, specifically involving blisters of the foot/toe. CONCLUSION Limited studies investigated injury risk factors in trail running. Our review found eight intrinsic and nine extrinsic injury risk factors. This review highlighted areas for future research that may aid in designing injury risk management strategies for safer trail running participation.PROSPERO registration numberCRD42021240832.
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Affiliation(s)
- Carel Viljoen
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa .,Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam University Medical Centers, location VU University Medical Center, Amsterdam, The Netherlands.,Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, South Africa
| | - Dina C Christa Janse van Rensburg
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Medical Board Member, World Netball, Manchester, UK
| | - Willem van Mechelen
- Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam University Medical Centers, location VU University Medical Center, Amsterdam, The Netherlands.,School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia.,Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin, Ireland
| | - Evert Verhagen
- Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam University Medical Centers, location VU University Medical Center, Amsterdam, The Netherlands
| | - Bruno Silva
- School of Sports and Leisure, Department of Sports Science, Tourism and Leisure, Polytechnic Institute of Viana do Castelo, Melgaço, Portugal.,Research Center in Sports Science, Health Science and Human Development (CIDESD), University of Tras-os-Montes e Alto Douro, Vila Real, Portugal
| | - Volker Scheer
- Ultra Sports Science Foundation (USSF), Pierre-Benite, France
| | - Manuela Besomi
- Carrera de Kinesiología, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Rubén Gajardo-Burgos
- Escuela de Kinesiología, Instituto de Aparato Locomotor y Rehabilitación, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Sérgio Matos
- School of Sports and Leisure, Department of Sports Science, Tourism and Leisure, Polytechnic Institute of Viana do Castelo, Melgaço, Portugal.,Department of Sports, Higher Institute of Educational Sciences of the Douro, Penafiel, Portugal
| | - Marlene Schoeman
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Nicol van Dyk
- High Performance Unit, Irish Rugby Football Union, Dublin, Ireland
| | - Susan Scheepers
- Department of Library Services, University of Pretoria, Pretoria, South Africa
| | - Tanita Botha
- Department of Statistics, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria, South Africa
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23
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Kingdom R, Wright CF. Incomplete Penetrance and Variable Expressivity: From Clinical Studies to Population Cohorts. Front Genet 2022; 13:920390. [PMID: 35983412 PMCID: PMC9380816 DOI: 10.3389/fgene.2022.920390] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/09/2022] [Indexed: 12/20/2022] Open
Abstract
The same genetic variant found in different individuals can cause a range of diverse phenotypes, from no discernible clinical phenotype to severe disease, even among related individuals. Such variants can be said to display incomplete penetrance, a binary phenomenon where the genotype either causes the expected clinical phenotype or it does not, or they can be said to display variable expressivity, in which the same genotype can cause a wide range of clinical symptoms across a spectrum. Both incomplete penetrance and variable expressivity are thought to be caused by a range of factors, including common variants, variants in regulatory regions, epigenetics, environmental factors, and lifestyle. Many thousands of genetic variants have been identified as the cause of monogenic disorders, mostly determined through small clinical studies, and thus, the penetrance and expressivity of these variants may be overestimated when compared to their effect on the general population. With the wealth of population cohort data currently available, the penetrance and expressivity of such genetic variants can be investigated across a much wider contingent, potentially helping to reclassify variants that were previously thought to be completely penetrant. Research into the penetrance and expressivity of such genetic variants is important for clinical classification, both for determining causative mechanisms of disease in the affected population and for providing accurate risk information through genetic counseling. A genotype-based definition of the causes of rare diseases incorporating information from population cohorts and clinical studies is critical for our understanding of incomplete penetrance and variable expressivity. This review examines our current knowledge of the penetrance and expressivity of genetic variants in rare disease and across populations, as well as looking into the potential causes of the variation seen, including genetic modifiers, mosaicism, and polygenic factors, among others. We also considered the challenges that come with investigating penetrance and expressivity.
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Affiliation(s)
- Rebecca Kingdom
- Institute of Biomedical and Clinical Science, Royal Devon & Exeter Hospital, University of Exeter Medical School, Exeter, United Kingdom
| | - Caroline F Wright
- Institute of Biomedical and Clinical Science, Royal Devon & Exeter Hospital, University of Exeter Medical School, Exeter, United Kingdom
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24
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Entringer AC, Brannon LA, Whitaker WK. Educating outdoor workers using tailored and financial messages to encourage safe-sun behaviors. HEALTH EDUCATION RESEARCH 2021; 36:374-383. [PMID: 34037768 DOI: 10.1093/her/cyab008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 02/01/2021] [Indexed: 06/12/2023]
Abstract
Excessive and unsafe sun exposure represents a concerning hazard to the health of individuals. Of particular interest are those who are most susceptible to sun exposure, such as outdoor workers. The current study used a 3 × 2 between-subjects design to investigate the effectiveness of messages that varied the extent of personalization (i.e. generic message; occupation targeted message; individual tailored message) and the inclusion of content regarding financial consequences of skin cancer. Participants (N = 304) were recruited from the USA through Amazon's Mechanical Turk and randomly assigned to view a generic message, occupation targeted message, or individual tailored message. Additionally, participants were randomly assigned to view messages in which financial information was either present or not. Participants responded to questions assessing pre- and post-test sun protection behaviors. Individual tailored messaging was as effective as occupation targeted messaging, with both being more effective than generic messaging. This finding indicates that some degree of personalization is necessary when promoting safe-sun practices to outdoor workers, but that tailoring to individuals may not always be necessary. Inclusion of financial content in messaging resulted in greater intentions to practice sun protection behaviors. Results provide insight into effective methods for promoting sun protection.
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Affiliation(s)
- Aaron C Entringer
- Department of Psychological Sciences, Kansas State University, Manhattan, KS, USA
| | - Laura A Brannon
- Department of Psychological Sciences, Kansas State University, Manhattan, KS, USA
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25
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Holman DM, Ragan KR, Julian AK, Perna FM. The Context of Sunburn Among U.S. Adults: Common Activities and Sun Protection Behaviors. Am J Prev Med 2021; 60:e213-e220. [PMID: 33589300 PMCID: PMC8068601 DOI: 10.1016/j.amepre.2020.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/16/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Sunburn increases skin cancer risk and is common among U.S. adults. However, little is known about the contexts in which sunburns often occur. The purpose of this study is to examine the contextual factors surrounding sunburns among U.S. adults. METHODS Cross-sectional data from a 2018 online panel survey were analyzed. A total of 4,088 panel members were recruited by mail using probability-based, random sampling by address. Respondents were asked about their most recent sunburn, and analyses were limited to those who remembered their most recent sunburn (N=3,106). Data were weighted to match the U.S. Current Population Survey proportions; analyses were conducted in 2018 and 2019. RESULTS Participants' age ranged from 18 to 93 years. About half (50.8%) were women, and most (82.3%) were non-Hispanic White adults. Swimming or spending time in water (32.5%), working outside at home (26.2%), traveling/vacationing (20.7%), and engaging in nonswimming physical activity (14.2%) were the most frequently reported activities. Using sunscreen on the face, neck, and chest (38.8%) and on the body (19.9%) and wearing sunglasses (34.2%) were the most frequently reported sun safety behaviors. Wearing clothes to the ankles (6.6%) and a long-sleeved shirt (4.5%) were least frequently reported. CONCLUSIONS This study provides new information about the contexts in which adult sunburns often occur, especially about contexts unrelated to intentional tanning, which was relatively infrequent. The results suggest the need to promote multiple forms of sun protection tailored to specific outdoor activities and develop innovative solutions for outdoor physical and aquatic activities, which present unique sun safety challenges.
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Affiliation(s)
- Dawn M Holman
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Kathleen R Ragan
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Anne K Julian
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Frank M Perna
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
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Abstract
PRECIS In a cohort study of 120,307 participants with 25+ years of follow-up, a history of nonmelanoma skin cancer (NMSC) was associated with a 40% higher exfoliation glaucoma (XFG) risk. PURPOSE The purpose of this study was to evaluate the relationship between NMSC (a marker of ultraviolet radiation exposure) and XFG. METHODS We performed a cohort study of US women (n=79,102; 1980-2014) and men (n=41,205; 1986-2014), aged 40+ years and at risk for glaucoma who reported eye examinations. From 1984 (women)/1988 (men), we asked about basal cell carcinoma or squamous cell carcinoma history separately; in prior years, we asked about any NMSC history in a single question. Squamous cell carcinoma was confirmed with histopathology reports while basal cell carcinoma and any early (<1984/<1988) NMSC history was self-reported. Incident XFG cases (362 women and 83 men) were confirmed with medical records. Using pooled data, we estimated multivariable-adjusted relative risks [MVRRs; 95% confidence intervals (CIs)] with Cox proportional hazards models that were stratified by age (in mo), 2-year time period at risk and average lifetime residential latitude. RESULTS In multivariable-adjusted analyses, we observed a 40% higher XFG risk with any NMSC history (MVRR=1.40; 95% CI=1.08-1.82); the association was observed even with 4 and 8-year lags in NMSC history. Also, the NMSC association was stronger in younger (below 65 y; MVRR=2.56; 95% CI=1.62-4.05) versus older participants (65 y and above; MVRR=1.25; 95% CI=0.94-1.66; P for interaction=0.01) and those living in the northern latitudes (≥42°N; MVRR=1.92; 95% CI=1.28-2.88) versus more southern latitudes (<42°N; MVRR=1.19; 95% CI=0.86-1.66; P for interaction=0.04). CONCLUSION NMSC was associated with higher XFG risk, particularly among younger participants and those living in the Northern US.
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27
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Reducing the Incidence of Skin Cancer through Landscape Architecture Design Education. SUSTAINABILITY 2020. [DOI: 10.3390/su12229402] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
There is a high and growing incidence of skin cancer associated with overexposure to the sun. Most of a person’s exposure occurs during their first eighteen years of life. While many children are taught to wear hats and sunscreen, studies indicate these are inadequate. There is a pressing need to improve the design of our landscapes to reduce exposure. Landscape architects can play a key role in driving this process, but only if they understand the factors determining sun protection behaviours among children in the landscape, and how to design for these. We introduced a systematic evidence-based teaching approach to landscape architecture students in New Zealand where the incidence of skin cancer is one of the highest in the world. In this paper, we describe the methods we used to integrate scientific information into a creative design process that included four design phases: (1) review, summary and translation of evidential theory into design guidelines; (2) inventory and analysis of existing schoolyard; (3) redesign of schoolyard; and (4) final design evaluation. We found this process was effective in developing student appreciation for the need to improve sun protection through design, for increasing their understanding of the evidential science, in addition to developing their ability to translate, often inaccessible, evidential data into its spatial form implications. Furthermore, the process led to a high degree of confidence and pride among many students as their resulting design solutions were not only supported by evidence but were often highly creative. Such evidence-based design courses are essential for preparing future landscape architects to design landscapes that significantly reduce the incidence and health effects of skin cancer.
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28
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Low-level laser irradiation potentiates anticancer activity of p-coumaric acid against human malignant melanoma cells. Melanoma Res 2020; 30:136-146. [PMID: 30855528 DOI: 10.1097/cmr.0000000000000603] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
p-Coumaric acid (PCA) is a kind of phenolic compound, and as one of the cinnamic acid derivatives, it has many biological functions such as antioxidants, anti-inflammatory, antiplatelet, and anticancer activity. Low-level laser irradiation has received increasing interest in the fields of tissue regeneration and wound healing. In this study, the effect of low-level laser irradiation on human fibroblast cells (human dermal fibroblast) and human melanoma cancer cells (A375 and SK-MEL-37) treated with PCA was investigated. The human dermal fibroblast, A375, and SK-MEL-37 cells were exposed to low-level laser at 660-nm wavelength with 3 J/cm for 90 s, and then the cells were treated with different concentrations of PCA (0-1000 μg/ml for 24 h), separately. In another experiment, first the cells were treated by PCA and then irradiated with low-level laser as described before. The effect of various irradiation energy (1-6 J/cm) on the melanoma cells, which were then treated by PCA, was studied. The cell viability using MTT assay and lactate dehydrogenase assay was determined. Morphological changes owing to apoptosis induction by irradiation and PCA were detected by fluorescence microscopy using acridine orange/ethidium bromide double staining. The results showed that pretreatment with low-level laser irradiation and then PCA reduced the survival and growth of melanoma cells more than the early treatment with PCA and then low-level laser irradiation. Lactate dehydrogenase activity was reduced significantly by preirradiation and then PCA treatment in comparison with the dark group in melanoma cells. The cell cytotoxicity at different irradiation energy and then IC50 concentration of PCA was increased up to 3 J/cm and then decreased following increasing irradiation energy. The morphology study with light microscopy and apoptotic assay using acridine orange/ethidium bromide dual staining confirmed the MTT results. This study showed that low-level laser irradiation alone is not able to kill human normal fibroblast and human melanoma cancer cells. Preirradiation followed by treatment with PCA did not change the cell viability in human fibroblast significantly but reduced the cell viability in melanoma cells presumably through the apoptosis pathway.
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29
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Uncapping the bottle: A proposal to allow full-sized sunscreens in carry-on luggage to promote sun protection and prevent skin cancer. J Am Acad Dermatol 2020; 84:1206-1207. [PMID: 33129940 DOI: 10.1016/j.jaad.2020.10.066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 10/21/2020] [Indexed: 11/20/2022]
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Snyder A, Valdebran M, Terrero D, Amber KT, Kelly KM. Solar Ultraviolet Exposure in Individuals Who Perform Outdoor Sport Activities. SPORTS MEDICINE - OPEN 2020; 6:42. [PMID: 32880767 PMCID: PMC7471243 DOI: 10.1186/s40798-020-00272-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 08/13/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Skin cancer is the most common cancer in the USA. Therefore, it is important to review the contribution of ultraviolet radiation (UVR) exposure to skin cancer in individuals with the highest risk. Documenting the relationship between outdoor sports solar ultraviolet exposure and their risk of skin cancer along with appropriate risk mitigation strategies can help inform clinicians of practical information for counseling sun protective behaviors in this population. METHODS We conducted a review of the current evidence using PubMed to answer the following research questions: (1) How is ultraviolet radiation measured? (2) What is the modern utility of the ultraviolet index in modifying recreational sun protection behaviors? (3) What is the risk of developing skin cancer for outdoor sport participants? (4) What is the prevalence of skin cancer in sport participants? and (5) Is the number of nevi and solar lentigines elevated in outdoor sport participants? RESULTS Based on the literature, individuals who practice outdoor sport-related activities receive high ultraviolet radiation exposure, have a high risk for skin cancer, have a high prevalence for pigmented lesions, and may benefit from electronic sun protection educational interventions. CONCLUSIONS Individuals who practice outdoor sports experience substantially higher ultraviolet radiation exposure, routinely exceed the recommended exposure limits, and are at a higher risk of developing skin cancer. Therefore, those who are frequently engaged in outdoor leisure activities should be coached about efficient sun protective practices and relevant mobile technologies that may facilitate adherence.
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Affiliation(s)
- Alan Snyder
- College of Graduate Studies, Medical University of South Carolina, Charleston, SC, USA.
| | - Manuel Valdebran
- Division of Pediatric Dermatology, Department of Dermatology, Medical University of South Carolina, Charleston, SC, USA
| | - David Terrero
- College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, OH, USA
| | - Kyle T Amber
- Department of Dermatology, University of Illinois at Chicago, Chicago, IL, USA
| | - Kristen M Kelly
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA
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31
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Warszawik-Hendzel O, Olszewska M, Rakowska A, Sikora M, Hendzel P, Rudnicka L. Cardiovascular Drug Use and Risk of Actinic Keratosis: A Case-Control Study. Dermatol Ther (Heidelb) 2020; 10:735-743. [PMID: 32506248 PMCID: PMC7367976 DOI: 10.1007/s13555-020-00405-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Actinic keratosis (AK) is a precancerous skin lesion. Currently, many experts treat actinic keratosis as squamous cell carcinoma in situ. It is well established that exposure of the skin to ultraviolet radiation is a major risk factor for the development of actinic keratosis. Some studies suggest an association between keratinocyte cancers and photosensitizing cardiovascular drugs. The aim of this study was to establish an association between cardiovascular drug use and the presence of AK. METHODS A total of 400 patients were enrolled into the study (200 with AK; 200 healthy persons in the control group). The group of patients with AK consisted of 106 women and 94 men (mean age 71 years). The control group included 102 women and 98 men (mean age 69 years). An analysis of the risk factors for developing actinic keratosis was performed in all patients with AK on the basis of a detailed, standardized interview. RESULTS The statistical analysis showed that features independently associated with increased risk of AK included: age > 80 years (OR 4.14; 95% CI 2.4-7.3), positive cancer history (OR 1.94; 95% CI 1.0-3.6), positive history of sunburns when < 18 years old (OR 2.18; 95% CI 1.3-3.7) and taking angiotensin-converting enzyme inhibitors (OR 2.28; 95% CI 1.2-4.3), angiotensin receptor AT1 blockers (OR 2.90; 95% CI 1.1-7.9) and calcium channel blockers (OR 2.4; 95% CI 1.0-5.3). CONCLUSION In conclusion, our study presented an association between cardiovascular drug use and the risk of developing AK.
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Affiliation(s)
| | | | - Adriana Rakowska
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Mariusz Sikora
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Hendzel
- Department of Cardiac Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
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32
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Kassir M, Podder I, Olisova OY, Lomonosov KM, Lotti T, Goldust M. Melanoma: A silver lining in the black cloud of COVID-19. Dermatol Ther 2020; 33:e14070. [PMID: 32713069 DOI: 10.1111/dth.14070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Olga Yu Olisova
- Department of Dermatology and Venereology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Konstantin M Lomonosov
- Department of Dermatology and Venereology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Torello Lotti
- Department of Dermatology and Venereology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.,Department of Dermatology, University of Studies Guglielmo Marconi, Rome, Italy
| | - Mohamad Goldust
- Department of Dermatology, University of Rome G. Marconi, Rome, Italy.,Department of Dermatology, University Hospital Basel, Basel, Switzerland
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Kim S, Carson KA, Chien AL. Prevalence and correlates of sun protections with sunburn and vitamin D deficiency in sun-sensitive individuals. J Eur Acad Dermatol Venereol 2020; 34:2664-2672. [PMID: 32453868 DOI: 10.1111/jdv.16681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 05/12/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Sun sensitivity is an inherent risk factor for skin cancer. Sun protection is important in sun-sensitive individuals to reduce sunburns for skin cancer prevention. However, concerns have arose regarding the possible impact of sun protection on vitamin D deficiency. OBJECTIVE To examine the prevalence and correlates of sun-protective behaviours (staying in the shade, using sunscreen and wearing long sleeves) with sunburn and vitamin D deficiency in sun-sensitive individuals. METHODS This was a cross-sectional study of 2390 US non-Hispanic white adults aged 20-59 years in the National Health and Nutrition Examination Survey 2011-2014. Sun sensitivity was defined as self-reported tendency to severe sunburn when exposed to the sun for half an hour after months of non-sun exposure, and single serum 25(OH)D levels less than 50 nmol/L was determined as vitamin D deficiency. We calculated adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) using multivariable logistic regression taking into account the complex survey design. RESULTS Sun-sensitive individuals had higher odds of frequently staying in the shade (aOR = 3.08; 95% CI 2.19-4.33) and using sunscreen (aOR = 1.93; 1.44-2.59) but not associated with sun exposure time (aOR = 0.91; 0.62-1.32). Yet, sun-sensitive individuals had significantly higher likelihood of sunburns (aOR = 1.93; 1.45-2.55), and no increased likelihood of vitamin D deficiency (aOR = 1.15; 0.84-1.58). Among sun-sensitive individuals, being younger, male and spending more time outdoors were associated with increased odds of sunburns and the risk of sunburn was reduced with frequently staying in the shade and engaging in multimodal sun protections. CONCLUSION Sun-sensitive individuals more frequently used sun protection methods yet they still were significantly more likely to experience sunburns and the risk of vitamin D deficiency was not increased. Education on proper application of sunscreen combined with other sun-protective techniques is important to reduce sunburn in sun-sensitive populations.
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Affiliation(s)
- S Kim
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Dermatology, Soonchunhyang University Seoul Hospital, Seoul, South Korea
| | - K A Carson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - A L Chien
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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34
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Trager MH, Geskin LJ, Samie FH, Liu L. Biomarkers in melanoma and non‐melanoma skin cancer prevention and risk stratification. Exp Dermatol 2020; 31:4-12. [DOI: 10.1111/exd.14114] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 05/10/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Megan H. Trager
- Department of Dermatology Columbia University Irving Medical Center New York NYUSA
| | - Larisa J. Geskin
- Department of Dermatology Columbia University Irving Medical Center New York NYUSA
| | - Faramarz H. Samie
- Department of Dermatology Columbia University Irving Medical Center New York NYUSA
| | - Liang Liu
- The Hormel Institute University of Minnesota Austin MNUSA
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35
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Buller DB, Reynolds KD, Buller MK, Massie K, Berteletti J, Ashley J, Meenan R. Parent reports of sun safety communication and behaviour for students in a randomised trial on a school policy implementation intervention. Aust N Z J Public Health 2020; 44:208-214. [PMID: 32459394 DOI: 10.1111/1753-6405.12987] [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: 10/01/2019] [Revised: 02/01/2020] [Accepted: 03/01/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Schools are an important setting for skin cancer prevention. An intervention for implementation of school sun safety policy, Sun Safety Schools (SSS), was evaluated. METHODS Primary schools (n=118) in California school districts that had already adopted a sun safety policy were enrolled in a study with a randomised controlled design. Half of the schools were randomised to SSS intervention (N=58). Parents completed an online post-test. RESULTS More parents in intervention schools received information about sun safety (mean=26.3%, sd=3.1%, p=0.017) and children more frequently wore sun-protective clothing when not at school (mean=2.93, sd=0.03, p=0.033) than in control schools (mean=18.0%, sd=2.5%; mean=2.83, sd=0.03, respectively). In schools where principals reported implementing sun safety practices, parents reported that children spent less time outdoors at midday (mean=14.78 hours, sd=0.25, p=0.033) and fewer were sunburned (mean=12.7%, sd=1.1%, p=0.009) than in non-implementing schools (M=16.3 hours, sd=0.67; mean=21.2%, sd=3.8%, respectively). Parents who received sun safety information (mean=3.08, sd=0.04, p=0.008) reported more child sun protection than parents not receiving information (mean=2.96, sd=0.02). CONCLUSIONS A school district sun protection policy and support for implementation increased dissemination of sun safety information to parents and student sun safety. Implications for public health: Technical assistance for sun safety policies may increase sun protection of children.
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Affiliation(s)
| | - Kim D Reynolds
- School of Community and Global Health, Claremont Graduate University, California, US
| | | | - Kim Massie
- School of Community and Global Health, Claremont Graduate University, California, US
| | | | | | - Richard Meenan
- Kaiser Permanente Center for Health Research, Oregon, US
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DeFlorio-Barker S, Holman D, Landolfi R, Arnold BF, Colford JM, Weisberg SB, Schiff KC, Sams EA, Wade TJ. Incidence and public health burden of sunburn among beachgoers in the United States. Prev Med 2020; 134:106047. [PMID: 32142856 PMCID: PMC7271251 DOI: 10.1016/j.ypmed.2020.106047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 02/28/2020] [Accepted: 03/02/2020] [Indexed: 12/28/2022]
Abstract
The beach environment creates many barriers to effective sun protection, putting beachgoers at risk for sunburn, a well-established risk factor for skin cancer. Our objective was to estimate incidence of sunburn among beachgoers and evaluate the relationship between sunburn incidence and sun-protective behaviors. A secondary analysis, of prospective cohorts at 12 locations within the U.S. from 2003 to 2009 (n = 75,614), were pooled to evaluate sunburn incidence 10-12 days after the beach visit. Behavioral and environmental conditions were cross-tabulated with sunburn incidence. Multivariable logistic regression was used to estimate the association between new sunburn and sun-protective behaviors. Overall, 13.1% of beachgoers reported sunburn. Those aged 13-18 years (16.5%), whites (16.0%), and those at beach locations along the Eastern Seaboard (16.1%), had the highest incidence of sunburn. For those spending ≥5 h in the sun, the use of multiple types of sun protection reduced odds of sunburn by 55% relative to those who used no sun protection (Odds Ratio = 0.45 (95% Confidence Interval:0.27-0.77)) after adjusting for skin type, age, and race. Acute health effects of sunburn tend to be mild and self-limiting, but potential long-term health consequences are more serious and costly. Efforts to encourage and support proper sun-protective behaviors, and increase access to shade, protective clothing, and sunscreen, can help prevent sunburn and reduce skin cancer risk among beachgoers.
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Affiliation(s)
- Stephanie DeFlorio-Barker
- Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, 109 T.W. Alexander Drive M/D B243-01, Research Triangle Park, NC 27709, USA.
| | - Dawn Holman
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Robert Landolfi
- Office of Atmospheric Programs, Office of Air and Radiation, U.S. Environmental Protection Agency, Washington, DC, USA.
| | - Benjamin F Arnold
- Division of Epidemiology & Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, CA, USA.
| | - John M Colford
- Division of Epidemiology & Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, CA, USA.
| | - Stephen B Weisberg
- Southern California Coastal Water Research Project Authority, Costa Mesa, CA, USA.
| | - Kenneth C Schiff
- Southern California Coastal Water Research Project Authority, Costa Mesa, CA, USA.
| | - Elizabeth A Sams
- Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, 109 T.W. Alexander Drive M/D B243-01, Research Triangle Park, NC 27709, USA.
| | - Timothy J Wade
- Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, 109 T.W. Alexander Drive M/D B243-01, Research Triangle Park, NC 27709, 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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Abstract
The incidence of melanoma continues to increase worldwide. In the United States, melanoma is the fifth most common cancer in men and the sixth most common cancer in women. The risk factors contributing to melanoma have largely remained unchanged, but there is a new focus on modifiable risk factors including sun exposure and ultraviolet light. A large public initiative supported by the Centers for Disease Control focuses on educating the public on the risks of sun exposure and indoor tanning. Early detection and resection of melanoma lesions is necessary to prevent metastasis and reduce medical costs.
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Affiliation(s)
- Stephanie Carr
- General Surgery, Marshfield Medical Center, 1000 North Oak Avenue, Marshfield, WI 54449, USA
| | - Christy Smith
- General Surgery, Marshfield Medical Center, 1000 North Oak Avenue, Marshfield, WI 54449, USA
| | - Jessica Wernberg
- General Surgery, Marshfield Medical Center, 1000 North Oak Avenue, Marshfield, WI 54449, USA.
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Young AR, Narbutt J, Harrison GI, Lawrence KP, Bell M, O'Connor C, Olsen P, Grys K, Baczynska KA, Rogowski-Tylman M, Wulf HC, Lesiak A, Philipsen PA. Optimal sunscreen use, during a sun holiday with a very high ultraviolet index, allows vitamin D synthesis without sunburn. Br J Dermatol 2019; 181:1052-1062. [PMID: 31069787 PMCID: PMC6899952 DOI: 10.1111/bjd.17888] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2019] [Indexed: 12/17/2022]
Abstract
Background Sunlight contains ultraviolet (UV)A and UVB radiation. UVB is essential for vitamin D synthesis but is the main cause of sunburn and skin cancer. Sunscreen use is advocated to reduce the sun's adverse effects but may compromise vitamin D status. Objectives To assess the ability of two intervention sunscreens to inhibit vitamin D synthesis during a week‐long sun holiday. Methods The impact of sunscreens on vitamin D status was studied during a 1‐week sun holiday in Tenerife (28° N). Comparisons were made between two formulations, each with a sun protection factor (SPF) of 15. The UVA‐protection factor (PF) was low in one case and high in the other. Healthy Polish volunteers (n = 20 per group) were given the sunscreens and advised on the correct application. Comparisons were also made with discretionary sunscreen use (n = 22) and nonholiday groups (51·8° N, n = 17). Sunscreen use in the intervention groups was measured. Behaviour, UV radiation exposure, clothing cover and sunburn were monitored. Serum 25‐hydroxyvitamin D3 [25(OH)D3] was assessed by high‐performance liquid chromatography–tandem mass spectrometry. Results Use of intervention sunscreens was the same (P = 0·60), and both equally inhibited sunburn, which was present in the discretionary use group. There was an increase (P < 0·001) in mean ± SD 25(OH)D3 (28·0 ± 16·5 nmol L−1) in the discretionary use group. The high and low UVA‐PF sunscreen groups showed statistically significant increases (P < 0·001) of 19·0 ± 14·2 and 13·0 ± 11·4 nmol L−1 25(OH)D3, respectively with P = 0·022 for difference between the intervention sunscreens. The nonholiday group showed a fall (P = 0·08) of 2·5 ± 5·6 nmol L−1 25(OH)D3. Conclusions Sunscreens may be used to prevent sunburn yet allow vitamin D synthesis. A high UVA‐PF sunscreen enables significantly higher vitamin D synthesis than a low UVA‐PF sunscreen because the former, by default, transmits more UVB than the latter. What's already known about this topic? Action spectra (wavelength dependence) for erythema and the cutaneous formation of vitamin D overlap considerably in the ultraviolet (UV)B region. Theoretically, sunscreens that inhibit erythema should also inhibit vitamin D synthesis. To date, studies on the inhibitory effects of sunscreens on vitamin D synthesis have given conflicting results, possibly, in part, because people typically apply sunscreen suboptimally. Many studies have design flaws.
What does this study add? Sunscreens (sun protection factor, SPF 15) applied at sufficient thickness to inhibit sunburn during a week‐long holiday with a very high UV index still allow a highly significant improvement of serum 25‐hydroxyvitamin D3 concentration. An SPF 15 formulation with high UVA protection enables better vitamin D synthesis than a low UVA protection product. The former allows more UVB transmission.
Linked Editorial: https://doi.org/10.1111/bjd.18273. https://doi.org/10.1111/bjd.18492 available online https://www.bjdonline.com/article/optimal-sunscreen-use-during-a-sun-holiday-with-a-very-high-ultraviolet-index-allows-vitamin-d-synthesis-without-sunburn/
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Affiliation(s)
- A R Young
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | - J Narbutt
- Medical University of Łódź, Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, Łódź, 90-647, Poland
| | - G I Harrison
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | - K P Lawrence
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | - M Bell
- Walgreens Boots Alliance Inc., Nottingham, NG90 5EF, U.K
| | - C O'Connor
- Walgreens Boots Alliance Inc., Nottingham, NG90 5EF, U.K
| | - P Olsen
- Bispebjerg Hospital, Department of Dermatological Research, Copenhagen, 2400, Denmark
| | - K Grys
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | - K A Baczynska
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxfordshire, OX11 0RQ, U.K
| | | | - H C Wulf
- Bispebjerg Hospital, Department of Dermatological Research, Copenhagen, 2400, Denmark
| | - A Lesiak
- Medical University of Łódź, Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, Łódź, 90-647, Poland
| | - P A Philipsen
- Bispebjerg Hospital, Department of Dermatological Research, Copenhagen, 2400, Denmark
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Melanoma signature in Brazil: epidemiology, incidence, mortality, and trend lessons from a continental mixed population country in the past 15 years. Melanoma Res 2019; 28:629-636. [PMID: 30204684 DOI: 10.1097/cmr.0000000000000511] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The current research aimed to understand melanoma epidemiology in Brazil and to evaluate temporal trends in incidence and mortality. The data came from Brazilian Hospital Cancer Registries, Population Based Cancer Registries, and the National Mortality Information System from 2000 to 2014. Descriptive statistics were used for epidemiological and clinical characteristics. To describe trends in change in incidence and mortality rates, the Average Annual Percentage Change (AAPC) was calculated. Between 2000 and 2013, in men, the median incidence rate rose from 2.52 to 4.84, with an AAPC of +21.5% [95% confidence interval (CI): 15.4-28] and in women from 1.93 to 3.22 per 100 000, with an AAPC of +13.9% (95% CI: 8.1-20). Regarding mortality, between 2000 and 2014, the rates went from 0.85 to 0.9 per 100 000 for men (AAPC=+0.8, 95% CI: 0.4-1.1) and from 0.56 for 0.53 per 100 000 for women (AAPC=-0.1, 95% CI: -0.2 to 0). From the database, a total of 28 624 patients with melanoma were included. Most of the patients were females (51.9%), White (75%) and with stage I or II (53.2%). Sex, ethnicity, education level, geographical area of the cancer center, topography, histology, time between diagnosis and treatment, and early death were significantly associated with distant metastases. Brazil is a large country with a very young population and a low rate of melanoma incidence and prevalence that should increase over the years. Understanding the trends attributed to melanoma is important for behavioral counseling interventions that focus on promoting skin cancer prevention.
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Toro-Huamanchumo CJ, Burgos-Muñoz SJ, Vargas-Tineo LM, Perez-Fernandez J, Vargas-Tineo OW, Burgos-Muñoz RM, Zentner-Guevara JA, Bada C. Awareness, behavior and attitudes concerning sun exposure among beachgoers in the northern coast of Peru. PeerJ 2019; 7:e6189. [PMID: 30671297 PMCID: PMC6338095 DOI: 10.7717/peerj.6189] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 11/30/2018] [Indexed: 11/21/2022] Open
Abstract
Background Skin cancer incidence has increased over the last years, becoming a major public health problem. Objective To describe the awareness, behavior and attitudes concerning sun exposure among beachgoers in the northern coast of Peru. Methods We conducted a cross-sectional study in the Pimentel beach, Peru. The “Beach Questionnaire” was used and we surveyed all the beachgoers from 8 a.m. to 4 p.m. and from March 5 to March 19. For the statistical analysis, sun exposure habits, sunburns history, knowledge, attitudes and practices were crossed with sex using the chi2 test. Results We surveyed 410 beachgoers, the most frequent phototype was type III (40.5%). Only the 13.66% of the respondents correctly answered the seven knowledge questions related to sun exposure and skin cancer. Men more frequently agreed that “when they are tanned their clothes looks nicer” (p = 0.048). Likewise, regarding the questions “Sunbathing is relaxing” and “Sunbathing improves my mood”, men agreed or totally agreed with more frequency than women (63.64% vs. 46.15%, p < 0.001; and 61.36% vs 49.15%, p = 0.014, respectively). Regarding sun protection practices, women more frequently used sunshade (p = 0.001) and sunscreen (SPF ≥ 15) (p < 0.001) when compared to the male group. Conclusion Sun exposure is a potentially preventable risk factor for skin cancer. Thus, awareness of the risks of UVR overexposure and adequate sun-protective behaviors and attitudes are essential. Our results, however, are not as favorable as expected. Public health efforts should encourage sun-safety precautions and intervention campaigns should be carried out in recreational settings, such as the beaches.
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Affiliation(s)
- Carlos J Toro-Huamanchumo
- Universidad de San Martín de Porres, Facultad de Medicina, Centro de Investigación en Epidemiología Clínica y Medicina Basada en Evidencias, Lima, Peru
| | | | | | | | | | | | | | - Carlos Bada
- School of Medicine, Universidad de San Martín de Porres, Lima, Peru.,Clínica San Judas Tadeo, Lima, Peru
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Meyer MKH, Christensen ASP, Tolstrup JS, Dalum P, Køster B. Association between sunburn and demographic factors and health behaviour among Danish students. Prev Med 2019; 118:92-97. [PMID: 30342110 DOI: 10.1016/j.ypmed.2018.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 06/29/2018] [Accepted: 08/07/2018] [Indexed: 11/19/2022]
Abstract
Sunburn is associated with an increased risk for skin cancer. Denmark has one of the highest incidences of melanoma in the world, although it is a relatively northern country. The objective of this study was to determine whether sunburn is associated with demographic factors and health behaviour among young Danes. Cross-sectional data of >55,000 15- to 25-year-old students participating in the Danish National Youth Study were collected in 2014. Multilevel logistic regression analysis was used to determine associations. Overall, 45% of the students had experienced at least one sunburn in Denmark, and 60% had experienced one sunburn abroad in the past year. Females had higher odds for sunburns than males. Education and geographical region were associated with sunburn but with opposite trends related for sunburn experienced in Denmark and abroad. Students who had poor dietary habits (only abroad), indulged in binge-drinking, smoked (only in Denmark), and more physical activity (only abroad) had higher odds for having a sunburns. We conclude that sunburn is prevalent among young Danes, especially those travelling abroad. Although we found some associations with demographic factors and health behaviour, there were no evident tendencies, thus indicating that broad population-based campaigning should be the preferred intervention.
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Affiliation(s)
| | | | | | - Peter Dalum
- Danish SunSmart Campaign, Danish Cancer Society, Copenhagen, Denmark
| | - Brian Køster
- Danish SunSmart Campaign, Danish Cancer Society, Copenhagen, Denmark
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Narbutt J, Philipsen PA, Harrison GI, Morgan KA, Lawrence KP, Baczynska KA, Grys K, Rogowski-Tylman M, Olejniczak-Staruch I, Tewari A, Bell M, O'Connor C, Wulf HC, Lesiak A, Young AR. Sunscreen applied at ≥ 2 mg cm -2 during a sunny holiday prevents erythema, a biomarker of ultraviolet radiation-induced DNA damage and suppression of acquired immunity. Br J Dermatol 2018; 180:604-614. [PMID: 30307614 DOI: 10.1111/bjd.17277] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND Sun protection factor (SPF) is assessed with sunscreen applied at 2 mg cm-2 . People typically apply around 0·8 mg cm-2 and use sunscreen daily for holidays. Such use results in erythema, which is a risk factor for skin cancer. OBJECTIVES To determine (i) whether typical sunscreen use resulted in erythema, epidermal DNA damage and photoimmunosuppression during a sunny holiday, (ii) whether optimal sunscreen use inhibited erythema and (iii) whether erythema is a biomarker for photoimmunosuppression in a laboratory study. METHODS Holidaymakers (n = 22) spent a week in Tenerife (very high ultraviolet index) using their own sunscreens without instruction (typical sunscreen use). Others (n = 40) were given SPF 15 sunscreens with instructions on how to achieve the labelled SPF (sunscreen intervention). Personal ultraviolet radiation (UVR) exposure was monitored electronically as the standard erythemal dose (SED) and erythema was quantified. Epidermal cyclobutane pyrimidine dimers (CPDs) were determined by immunostaining, and immunosuppression was assessed by contact hypersensitivity (CHS) response. RESULTS There was no difference between personal UVR exposure in the typical sunscreen use and sunscreen intervention groups (P = 0·08). The former had daily erythema on five UVR-exposed body sites, increased CPDs (P < 0·001) and complete CHS suppression (20 of 22). In comparison, erythema was virtually absent (P < 0·001) when sunscreens were used at ≥ 2 mg cm-2 . A laboratory study showed that 3 SED from three very different spectra suppressed CHS by around ~50%. CONCLUSIONS Optimal sunscreen use prevents erythema during a sunny holiday. Erythema predicts suppression of CHS (implying a shared action spectrum). Given that erythema and CPDs share action spectra, the data strongly suggest that optimal sunscreen use will also reduce CPD formation and UVR-induced immunosuppression.
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Affiliation(s)
- J Narbutt
- Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, Medical University of Łódź, 90-647, Łódź, Poland
| | - P A Philipsen
- University of Copenhagen, Bispebjerg Hospital, Department of Dermatological Research, Copenhagen, 2400, Denmark
| | - G I Harrison
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | - K A Morgan
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | - K P Lawrence
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | - K A Baczynska
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, OX11 0RQ, U.K
| | - K Grys
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | | | - I Olejniczak-Staruch
- Dermoklinika Centrum Medyczne, Łódź, 90-436, Poland.,Department of Dermatology and Venereology, Medical University of Łódź, 90-647, Łódź, Poland
| | - A Tewari
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | - M Bell
- Walgreens Boots Alliance Inc., Nottingham, NG90 5EF, U.K
| | - C O'Connor
- Walgreens Boots Alliance Inc., Nottingham, NG90 5EF, U.K
| | - H C Wulf
- University of Copenhagen, Bispebjerg Hospital, Department of Dermatological Research, Copenhagen, 2400, Denmark
| | - A Lesiak
- Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, Medical University of Łódź, 90-647, Łódź, Poland
| | - A R Young
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
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44
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Determinants of Sunburn and Sun Protection of Agricultural Workers During Occupational and Recreational Activities. J Occup Environ Med 2018; 59:1089-1094. [PMID: 28858909 DOI: 10.1097/jom.0000000000001140] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to identify determinants of occupational sunburn in agricultural workers and assess their occupational and recreational sun protection habits. METHODS Specific surveys of agricultural workers in Switzerland and France were conducted (N = 1538). Multivariate logistic regressions identified occupational sunburn determinants. Occupational and recreational sun protection habits were estimated and correlated. RESULTS One-year occupational and recreational sunburn prevalences were 19.8% and 11.5%, respectively. Occupational sunburn increased with having a recent recreational sunburn, highly sensitive skin, young age, high perceived skin cancer risk, using sunscreen, and not wearing a hat. Correlation between protection habits during work and leisure was substantial (rs 0.5 to 0.7). Skin health knowledge was high and pro-tanning attitude moderate. CONCLUSION Potentially modifiable sunburn determinants and suboptimal recreational and occupational sun protection practices were identified in agricultural workers. Refining and tailoring sun protection messages targeting the agricultural sector are needed.
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Brinker TJ, Heckl M, Gatzka M, Heppt MV, Resende Rodrigues H, Schneider S, Sondermann W, de Almeida E Silva C, Kirchberger MC, Klode J, Enk AH, Knispel S, von Kalle C, Stoffels I, Schadendorf D, Nakamura Y, Esser S, Assis A, Bernardes-Souza B. A Skin Cancer Prevention Facial-Aging Mobile App for Secondary Schools in Brazil: Appearance-Focused Interventional Study. JMIR Mhealth Uhealth 2018. [PMID: 29523502 PMCID: PMC5866300 DOI: 10.2196/mhealth.9794] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background The incidence of melanoma is increasing faster than any other major cancer both in Brazil and worldwide. Southeast Brazil has especially high incidences of melanoma, and early detection is low. Exposure to ultraviolet (UV) radiation is a primary risk factor for developing melanoma. Increasing attractiveness is a major motivation among adolescents for tanning. A medical student-delivered intervention that takes advantage of the broad availability of mobile phones and adolescents’ interest in their appearance indicated effectiveness in a recent study from Germany. However, the effect in a high-UV index country with a high melanoma prevalence and the capability of medical students to implement such an intervention remain unknown. Objective In this pilot study, our objective was to investigate the preliminary success and implementability of a photoaging intervention to prevent skin cancer in Brazilian adolescents. Methods We implemented a free photoaging mobile phone app (Sunface) in 15 secondary school classes in southeast Brazil. Medical students “mirrored” the pupils’ altered 3-dimensional (3D) selfies reacting to touch on tablets via a projector in front of their whole grade accompanied by a brief discussion of means of UV protection. An anonymous questionnaire capturing sociodemographic data and risk factors for melanoma measured the perceptions of the intervention on 5-point Likert scales among 356 pupils of both sexes (13-19 years old; median age 16 years) in grades 8 to 12 of 2 secondary schools in Brazil. Results We measured more than 90% agreement in both items that measured motivation to reduce UV exposure and only 5.6% disagreement: 322 (90.5%) agreed or strongly agreed that their 3D selfie motivated them to avoid using a tanning bed, and 321 (90.2%) that it motivated them to improve their sun protection; 20 pupils (5.6%) disagreed with both items. The perceived effect on motivation was higher in female pupils in both tanning bed avoidance (n=198, 92.6% agreement in females vs n=123, 87.2% agreement in males) and increased use of sun protection (n=197, 92.1% agreement in females vs n=123, 87.2% agreement in males) and independent of age or skin type. All medical students involved filled in a process evaluation revealing that they all perceived the intervention as effective and unproblematic, and that all pupils tried the app in their presence. Conclusions The photoaging intervention was effective in changing behavioral predictors for UV protection in Brazilian adolescents. The predictors measured indicated an even higher prospective effectiveness in southeast Brazil than in Germany (>90% agreement in Brazil vs >60% agreement in Germany to both items that measured motivation to reduce UV exposure) in accordance with the theory of planned behavior. Medical students are capable of complete implementation. A randomized controlled trial measuring prospective effects in Brazil is planned as a result of this study.
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Affiliation(s)
- Titus Josef Brinker
- Department of Dermatology, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany.,Department of Translational Oncology, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany
| | - Marlene Heckl
- Department of Dermatology, University Medical Center Munich, University of Munich, Munich, Germany
| | - Martina Gatzka
- Department of Dermatology and Allergic Diseases, Ulm University Hospital, University of Ulm, Ulm, Germany
| | - Markus V Heppt
- Department of Dermatology, University Medical Center Munich, University of Munich, Munich, Germany
| | | | - Sven Schneider
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Wiebke Sondermann
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | | | - Michael C Kirchberger
- Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Joachim Klode
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Alexander H Enk
- Department of Dermatology, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Sarah Knispel
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Christof von Kalle
- Department of Translational Oncology, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany
| | - Ingo Stoffels
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Dirk Schadendorf
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Yasuhiro Nakamura
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Germany
| | - Stefan Esser
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Aisllan Assis
- School of Medicine, Federal University of Ouro Preto, Ouro Preto, Brazil
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46
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Marion JW, Lee J, Rosenblum JS, Buckley TJ. Assessment of temperature and ultraviolet radiation effects on sunburn incidence at an inland U.S. Beach: A cohort study. ENVIRONMENTAL RESEARCH 2018; 161:479-484. [PMID: 29220801 DOI: 10.1016/j.envres.2017.11.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 11/19/2017] [Accepted: 11/21/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Increases in outdoor temperature may lead to increases in sunburn, outdoor exposure, and skin cancer in human populations. OBJECTIVE This study aimed to quantify sunburn incidence and risk for Ohio beachgoers exposed to varying outdoor conditions. METHODS Sunburn incidence data were obtained through a prospective cohort study at East Fork Lake (Cincinnati, Ohio, USA). Recruitment occurred over 26 weekend days. Beach interviews and follow-up telephone interviews obtained exposure and health information. New sunburns were self-reported 8-9 days post-enrollment. Survey data were paired with ultraviolet radiation (UVR) index and temperature data for statistical analysis. RESULTS Among 947 beachgoers, new sunburns were reported in 18% of swimmers. Sunburn incidence was associated with temperature (odds ratio = 1.2; 95% CI: 1.1 - 1.4) and UVR index (odds ratio = 1.6; 95% CI: 1.0 - 2.5) in models adjusted for water exposure, arrival time, and beach visit frequency. Some evidence of a temperature+UVR interaction was observed. LIMITATIONS Exposure and sunburn data were self-reported without clinical diagnosis and date of onset. The follow-up period enabled sunburns to be reported from a variety of days rather than only the beach visit day thereby limiting interpretation. Sun protection behaviors were not evaluated. CONCLUSIONS Temperature and UVR influence sunburn frequency. Temperature, however was more strongly associated with sunburn in beachgoers than the nearest measured UVR index, suggesting future investigations are needed to better understand how temperature effects sunburn development. Interventions for decreasing sunburn are needed.
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Affiliation(s)
- Jason W Marion
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, 1841 Neil Ave., 406 Cunz Hall, Columbus, OH 43210, USA; Department of Environmental Health Science, Eastern Kentucky University, 521 Lancaster Ave., 220 Dizney Bldg., Richmond, KY 40475, USA.
| | - Jiyoung Lee
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, 1841 Neil Ave., 406 Cunz Hall, Columbus, OH 43210, USA; Department of Food Science and Technology, The Ohio State University, 2015 Fyffe Road, Columbus, OH 43210, USA.
| | - James S Rosenblum
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, 1841 Neil Ave., 406 Cunz Hall, Columbus, OH 43210, USA.
| | - Timothy J Buckley
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, 1841 Neil Ave., 406 Cunz Hall, Columbus, OH 43210, USA.
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47
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Islami F, Goding Sauer A, Miller KD, Siegel RL, Fedewa SA, Jacobs EJ, McCullough ML, Patel AV, Ma J, Soerjomataram I, Flanders WD, Brawley OW, Gapstur SM, Jemal A. Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States. CA Cancer J Clin 2018; 68:31-54. [PMID: 29160902 DOI: 10.3322/caac.21440] [Citation(s) in RCA: 857] [Impact Index Per Article: 142.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 10/10/2017] [Accepted: 10/11/2017] [Indexed: 12/12/2022] Open
Abstract
Contemporary information on the fraction of cancers that potentially could be prevented is useful for priority setting in cancer prevention and control. Herein, the authors estimate the proportion and number of invasive cancer cases and deaths, overall (excluding nonmelanoma skin cancers) and for 26 cancer types, in adults aged 30 years and older in the United States in 2014, that were attributable to major, potentially modifiable exposures (cigarette smoking; secondhand smoke; excess body weight; alcohol intake; consumption of red and processed meat; low consumption of fruits/vegetables, dietary fiber, and dietary calcium; physical inactivity; ultraviolet radiation; and 6 cancer-associated infections). The numbers of cancer cases were obtained from the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute; the numbers of deaths were obtained from the CDC; risk factor prevalence estimates were obtained from nationally representative surveys; and associated relative risks of cancer were obtained from published, large-scale pooled analyses or meta-analyses. In the United States in 2014, an estimated 42.0% of all incident cancers (659,640 of 1570,975 cancers, excluding nonmelanoma skin cancers) and 45.1% of cancer deaths (265,150 of 587,521 deaths) were attributable to evaluated risk factors. Cigarette smoking accounted for the highest proportion of cancer cases (19.0%; 298,970 cases) and deaths (28.8%; 169,180 deaths), followed by excess body weight (7.8% and 6.5%, respectively) and alcohol intake (5.6% and 4.0%, respectively). Lung cancer had the highest number of cancers (184,970 cases) and deaths (132,960 deaths) attributable to evaluated risk factors, followed by colorectal cancer (76,910 cases and 28,290 deaths). These results, however, may underestimate the overall proportion of cancers attributable to modifiable factors, because the impact of all established risk factors could not be quantified, and many likely modifiable risk factors are not yet firmly established as causal. Nevertheless, these findings underscore the vast potential for reducing cancer morbidity and mortality through broad and equitable implementation of known preventive measures. CA Cancer J Clin 2018;68:31-54. © 2017 American Cancer Society.
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Affiliation(s)
- Farhad Islami
- Strategic Director, Cancer Surveillance Research, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Ann Goding Sauer
- Epidemiologist, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Kimberly D Miller
- Epidemiologist, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Rebecca L Siegel
- Strategic Director, Surveillance Information, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Stacey A Fedewa
- Strategic Director, Risk Factors and Screening Surveillance, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Eric J Jacobs
- Strategic Director, Pharmacoepidemiology, Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | - Marjorie L McCullough
- Strategic Director, Nutritional Epidemiology, Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | - Alpa V Patel
- Strategic Director, Cancer Prevention Study-3, Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | - Jiemin Ma
- Strategic Director, Cancer Interventions Surveillance, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Isabelle Soerjomataram
- Scientist, Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - W Dana Flanders
- Professor, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Otis W Brawley
- Chief Medical and Science Officer, Executive Vice President, Research, American Cancer Society, Atlanta, GA
| | - Susan M Gapstur
- Vice President, Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | - Ahmedin Jemal
- Vice President, Surveillance and Health Services Research Program, American Cancer Society, Atlanta, GA
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48
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Cleaver JE. Transcription coupled repair deficiency protects against human mutagenesis and carcinogenesis. DNA Repair (Amst) 2017; 58:21-28. [DOI: 10.1016/j.dnarep.2017.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 08/07/2017] [Indexed: 11/17/2022]
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49
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Brinker TJ, Brieske CM, Schaefer CM, Buslaff F, Gatzka M, Petri MP, Sondermann W, Schadendorf D, Stoffels I, Klode J. Photoaging Mobile Apps in School-Based Melanoma Prevention: Pilot Study. J Med Internet Res 2017; 19:e319. [PMID: 28887295 PMCID: PMC5610355 DOI: 10.2196/jmir.8661] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 08/30/2017] [Accepted: 08/30/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Around 90% of melanomas are caused by exposure to ultraviolet (UV) radiation and are therefore eminently preventable. Tanning behavior is mostly initiated in early adolescence, often with the belief that it increases attractiveness; the problems related to malignant melanoma and other skin cancers are too far in the future to fathom. Given the substantial amount of time children and adolescents spend in schools, as well as with their mobile phones, addressing melanoma prevention via both of these ways is crucial. However, no school-based intervention using mobile apps has been evaluated to date. We recently released a photoaging mobile app, in which a selfie is altered to predict future appearance dependent on UV protection behavior and skin type. OBJECTIVE In this pilot study, we aimed to use mobile phone technology to improve school-based melanoma prevention and measure its preliminary success in different subgroups of students with regard to their UV protection behavior, Fitzpatrick skin type and age. METHODS We implemented a free photoaging mobile phone app (Sunface) in 2 German secondary schools via a method called mirroring. We "mirrored" the students' altered 3-dimensional (3D) selfies reacting to touch on mobile phones or tablets via a projector in front of their whole grade. Using an anonymous questionnaire capturing sociodemographic data as well as risk factors for melanoma we then measured their perceptions of the intervention on a 5-point Likert scale among 205 students of both sexes aged 13-19 years (median 15 years). RESULTS We measured more than 60% agreement in both items that measured motivation to reduce UV exposure and only 12.5% disagreement: 126 (63.0%) agreed or strongly agreed that their 3D selfie motivated them to avoid using a tanning bed, and 124 (61.7%) to increase use of sun protection. However, only 25 (12.5%) disagreed with both items. The perceived effect on motivation was increased in participants with Fitzpatrick skin types 1-2 in both tanning bed avoidance (n=74, 71.8% agreement in skin types 1-2 vs n=50, 53.8% agreement in skin types 3-6) and increased use of sun protection (n=70, 68.0% agreement in skin types 1-2 vs n=52, 55.3% agreement in skin types 3-6), and also positively correlated with higher age. CONCLUSIONS We present a novel way of integrating photoaging in school-based melanoma prevention that affects the students' peer group, considers the predictors of UV exposure in accordance with the theory of planned behavior, and is particularly effective in changing behavioral predictors in fair-skinned adolescents (Fitzpatrick skin types 1-2). Further research is required to evaluate the intervention's prospective effects on adolescents of various cultural backgrounds.
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Affiliation(s)
- Titus Josef Brinker
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Department of Dermatology and National Center for Tumor Diseases (NCT), University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Christian Martin Brieske
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,West German Cancer Center, University Duisburg-Essen, Essen, Germany
| | - Christoph Matthias Schaefer
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,West German Cancer Center, University Duisburg-Essen, Essen, Germany
| | - Fabian Buslaff
- Department of Dermatology and National Center for Tumor Diseases (NCT), University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Martina Gatzka
- Department of Dermatology and Allergic Diseases, University of Ulm, Ulm, Germany
| | - Maximilian Philip Petri
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,West German Cancer Center, University Duisburg-Essen, Essen, Germany
| | - Wiebke Sondermann
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,West German Cancer Center, University Duisburg-Essen, Essen, Germany
| | - Dirk Schadendorf
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,West German Cancer Center, University Duisburg-Essen, Essen, Germany
| | - Ingo Stoffels
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,West German Cancer Center, University Duisburg-Essen, Essen, Germany
| | - Joachim Klode
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,West German Cancer Center, University Duisburg-Essen, Essen, Germany
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50
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Kricker A, Weber M, Sitas F, Banks E, Rahman B, Goumas C, Kabir A, Hodgkinson VS, van Kemenade CH, Waterboer T, Armstrong BK. Early Life UV and Risk of Basal and Squamous Cell Carcinoma in New South Wales, Australia. Photochem Photobiol 2017; 93:1483-1491. [PMID: 28710897 DOI: 10.1111/php.12807] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 06/17/2017] [Indexed: 11/28/2022]
Abstract
Sun exposure is the main cause of squamous (SCC) and basal cell carcinoma (BCC) although pattern and amount differ by cancer type, and sun sensitivity is the major host risk factor. Our study investigated risk factors and residential ambient UV in a population-based sample of Australian 45 and Up Study participants: 916 BCC cases, 433 SCC cases, 1224 controls. Unconditional logistic regression models adjusting for key covariates demonstrated 60% increased BCC risk and two-fold increased SCC risk with sun sensitivity, and three- and four-fold increased risk, respectively, with solar keratoses. BCC but not SCC risk increased with higher early-life residential UV in all participants (odds ratio (OR) = 1.54; 95% CI 1.22-1.96 for intermediate; OR = 1.31; 95% CI 1.03-1.68 for high UV at birthplace) and similarly in Australian-born participants (P-values < 0.05). Risk of SCC but not BCC increased with long-term cumulative sun exposure assessed by self-reported outdoor work (OR 1.74, 95% CI 1.21-2.49). In conclusion, sun sensitivity is important for both cancers, early-life UV but not cumulative UV appears to increase BCC risk, the former an apparently novel finding, and SCC risk appears only to be related to long-term cumulative sun exposure.
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Affiliation(s)
- Anne Kricker
- Sydney Medical School, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Marianne Weber
- Sydney Medical School, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Cancer Research Division, Cancer Council New South Wales, Sydney, NSW, Australia
| | - Freddy Sitas
- Sydney Medical School, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia.,Sax Institute, Sydney, NSW, Australia
| | - Bayzidur Rahman
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Chris Goumas
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Ahsanul Kabir
- Department of Environment and Geography, Faculty of Science, Formerly Geographic Information Systems, Macquarie University, Sydney, NSW, Australia
| | - Verity S Hodgkinson
- Cancer Research Division, Cancer Council New South Wales, Sydney, NSW, Australia
| | | | - Tim Waterboer
- Molecular Diagnostics of Oncogenic Infections Division, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Bruce K Armstrong
- Sydney Medical School, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,School of Population Health, University of Western Australia, Perth, WA, Australia
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