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Keatley J, Law MH, Seviiri M, Olsen CM, Pandeya N, Ong JS, MacGregor S, Whiteman DC, Dusingize JC. Genetic predisposition to childhood obesity does not influence the risk of developing skin cancer in adulthood. Sci Rep 2024; 14:7854. [PMID: 38570581 PMCID: PMC10991302 DOI: 10.1038/s41598-024-58418-8] [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: 10/27/2023] [Accepted: 03/28/2024] [Indexed: 04/05/2024] Open
Abstract
The relationship between body mass index (BMI) and melanoma and other skin cancers remains unclear. The objective of this study was to employ the Mendelian randomization (MR) approach to evaluate the effects of genetically predicted childhood adiposity on the risk of developing skin cancer later in life. Two-sample MR analyses were conducted using summary data from genome-wide association study (GWAS) meta-analyses of childhood BMI, melanoma, cutaneous squamous cell carcinoma (cSCC), and basal cell carcinoma (BCC). We used the inverse-variance-weighted (IVW) methods to obtain a pooled estimate across all genetic variants for childhood BMI. We performed multiple sensitivity analyses to evaluate the potential influence of various assumptions on our findings. We found no evidence that genetically predicted childhood BMI was associated with risks of developing melanoma, cSCC, or BCC in adulthood (OR, 95% CI: melanoma: 1.02 (0.93-1.13), cSCC 0.94 (0.79-1.11), BCC 0.97 (0.84-1.12)). Our findings do not support the conclusions from observational studies that childhood BMI is associated with increased risks of melanoma, cSCC, or BCC in adulthood. Intervening on childhood adiposity will not reduce the risk of common skin cancers later in life.
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Affiliation(s)
- Jay Keatley
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Matthew H Law
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Departments of Population Health and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Mathias Seviiri
- Departments of Population Health and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Catherine M Olsen
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Departments of Population Health and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Nirmala Pandeya
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Departments of Population Health and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Jue-Sheng Ong
- Departments of Population Health and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Stuart MacGregor
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Departments of Population Health and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - David C Whiteman
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Departments of Population Health and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Jean Claude Dusingize
- Departments of Population Health and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
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2
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Wu YP, Tercyak KP, Wankier AP, Brunsgaard EK, Parsons BG, Devine KA, Stump TK, Boucher KM, Hay JL. Moderating influences on parents' fatalistic beliefs about cancer and their association with sun safety behaviors among children of melanoma survivors: Implications for treatment. J Health Psychol 2024; 29:481-491. [PMID: 37968969 DOI: 10.1177/13591053231209167] [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] [Indexed: 11/17/2023] Open
Abstract
The purpose of this study is to examine the association between parents' fatalism about melanoma and their children's sun protection, and the potential moderating role of parent-child communication. In this observational study of N = 69 melanoma-surviving parents of children ages 8-17, parents reported on their own melanoma fatalism, as well as their children's sun safety behaviors and parent-child discussion about sun safety. Parent gender, family history of melanoma, and frequency of parent-child discussions moderated the relationship between parents' fatalism and children's sun safety behaviors. Among mothers and parents with a family history of melanoma, high fatalism was associated with lower child sunscreen use, especially when discussions were less frequent. Melanoma surviving parents' fatalistic beliefs about cancer indirectly influence their children's health behavior and are a risk factor for unsafe sun behavior. Attending to parent gender, family history, and their communications about protective behaviors as co-factors of this risk could inform future intervention targeting.
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Affiliation(s)
- Yelena P Wu
- University of Utah, USA
- Huntsman Cancer Institute, USA
| | | | | | | | | | | | - Tammy K Stump
- University of Utah, USA
- Huntsman Cancer Institute, USA
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3
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Ricci AM, Emeny RT, Bagley PJ, Blunt HB, Butow ME, Morgan A, Alford-Teaster JA, Titus L, Walston RR, Rees JR. Causes of Childhood Cancer: A Review of the Recent Literature: Part I-Childhood Factors. Cancers (Basel) 2024; 16:1297. [PMID: 38610975 PMCID: PMC11011156 DOI: 10.3390/cancers16071297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/15/2024] [Accepted: 03/15/2024] [Indexed: 04/14/2024] Open
Abstract
PURPOSE To review the childhood risk factors for pediatric cancer (diagnosis before age 20). METHODS We conducted literature searches using Ovid Medline and Scopus to find primary research studies, review articles, and meta-analyses published from 2014 to 3 March 2021. RESULTS Strong evidence indicates that an array of genetic and epigenetic phenomena, structural birth defects, and chromosomal anomalies are associated with an increased risk of various childhood cancers. Increased risk is also associated with prior cancer, likely due to previous treatment agents and therapeutic ionizing radiation. Convincing evidence supports associations between several pediatric cancers and ionizing radiation, immunosuppression, and carcinogenic virus infection both in healthy children and in association with immune suppression following organ transplantation. Breastfeeding and a childhood diet rich in fruits and vegetables appears to reduce the risk of pediatric leukemia but the evidence is less strong. Childhood vaccination against carcinogenic viruses is associated with a lower risk of several cancers; there is less strong evidence that other childhood vaccinations more broadly may also lower risk. Ultraviolet (UV) radiation is associated with increased melanoma risk, although most melanomas following childhood UV exposure occur later, in adulthood. Evidence is weak or conflicting for the role of body mass index, other childhood infections, allergies, and certain treatments, including immunomodulator medications and human growth therapy.
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Affiliation(s)
- Angela M. Ricci
- Department of Pediatrics, Division of Pediatric Hematology-Oncology, Dartmouth Health Childrens, Lebanon, NH 03756, USA
| | - Rebecca T. Emeny
- Department of Internal Medicine, Division of Molecular Medicine, UNM Comprehensive Cancer Center, Cancer Control & Population Sciences Research Program, University of New Mexico Health Sciences, Albuquerque, NM 87131, USA;
| | - Pamela J. Bagley
- Biomedical Libraries, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA; (P.J.B.); (H.B.B.)
| | - Heather B. Blunt
- Biomedical Libraries, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA; (P.J.B.); (H.B.B.)
| | - Mary E. Butow
- New Hampshire Department of Environmental Services, Concord, NH 03302, USA
| | - Alexandra Morgan
- Department of Obstetrics and Gynecology, Dartmouth Health, Lebanon, NH 03756, USA
| | | | - Linda Titus
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Dartmouth Cancer Center, Hanover, NH 03755, USA
| | - Raymond R. Walston
- Department of Pediatric Hematology Oncology, Children’s Hospital Colorado, Aurora, CO 80045, USA;
| | - Judy R. Rees
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Dartmouth Cancer Center, Hanover, NH 03755, USA
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Rousi EK, Kallionpää RA, Kallionpää RE, Juteau SM, Talve LAI, Hernberg MM, Vihinen PP, Kähäri VM, Koskivuo IO. Increased incidence of melanoma in children and adolescents in Finland in 1990-2014: nationwide re-evaluation of histopathological characteristics. Ann Med 2022; 54:244-252. [PMID: 35037531 PMCID: PMC8765276 DOI: 10.1080/07853890.2022.2026001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Changes in the incidence of melanoma in children and adolescents have been reported in Europe and in the USA in the recent decades. AIMS The aim of this study was to examine the incidence of paediatric and adolescent melanomas in Finland in 1990-2014, and the associated clinical and histopathological characteristics to reveal temporal trends, such as changes in diagnostic sensitivity of Spitzoid melanomas. METHODS Information on 122 patients diagnosed with cutaneous melanoma at 0-19 years of age in Finland in 1990-2014 were retrieved from the Finnish Cancer Registry. 73 primary melanoma archival samples were re-evaluated by two dermatopathologists to allow comparability over time. RESULTS A 5.6% annual increase was observed in the incidence of melanoma among children and adolescents during the study period. Fifty-six tumours were confirmed as malignant melanomas in the re-evaluation. After correction for tumour misclassification in the Cancer Registry, the age-adjusted annual incidence was estimated to have increased from 1.4/1 000 000 in 1990-1994 to 5.8/1 000 000 in 2010-2014. The change in incidence was most prominent among adolescents and in Spitzoid melanoma subtype. Melanomas diagnosed 1990-2002 and 2003-2014 did not differ in terms of their clinicopathological characteristics or prognosis (hazard ratio for melanoma-related death 1.53, 95% CI 0.30 to 7.88). Spitzoid melanomas were diagnosed at a younger age, were of higher stage and had higher Clark level than other melanomas, yet the hazard ratio for death was 0.52 (95% CI 0.10 to 2.58) for Spitzoid versus other melanomas. CONCLUSIONS The incidence of cutaneous melanoma has clearly increased among the young in Finland, especially among adolescents. No evidence for overdiagnosis of Spitzoid melanomas as the underlying cause of the increased incidence was observed.Key messageA nationwide retrospective re-evaluation of the cutaneous melanomas recorded in the Finnish Cancer Registry among patients aged 0-19 years in Finland in 1990-2014 revealed an approximately 4-fold increase in the incidence. The increase in the incidence was most prominent among adolescents and in the Spitzoid melanoma subtype. Our results contrast those reported in other countries, where the incidence of melanoma among adolescents has declined.
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Affiliation(s)
- Emma K Rousi
- Department of Plastic and General Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Roope A Kallionpää
- Institute of Biomedicine, University of Turku, University of Turku, Turku, Finland
| | - Roosa E Kallionpää
- Auria Biobank, Turku University Hospital and University of Turku, Turku, Finland
| | - Susanna M Juteau
- Central Laboratory of Pathology, Helsinki University Hospital, Helsinki, Finland
| | - Lauri A I Talve
- Department of Pathology, Turku University Hospital, Turku, Finland
| | - Micaela M Hernberg
- Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland
| | - Pia P Vihinen
- Tyks Cancer Centre and FICAN West, University of Turku and Turku University Hospital, Turku, Finland
| | - Veli-Matti Kähäri
- Department of Dermatology, University of Turku and Turku University Hospital, Turku, Finland.,FICAN West Cancer Centre Laboratory, University of Turku and Turku University Hospital, Turku, Finland
| | - Ilkka O Koskivuo
- Department of Plastic and General Surgery, Turku University Hospital and University of Turku, Turku, Finland
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5
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Gao YS, Lai DH, Cheng SW, Li Q, Hao JC. Investigation on the Awareness and Behavior of Primary School Students on Sunscreen Use in Beijing. Clin Cosmet Investig Dermatol 2022; 15:887-894. [PMID: 35601539 PMCID: PMC9121882 DOI: 10.2147/ccid.s365856] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/05/2022] [Indexed: 11/23/2022]
Abstract
Objective This study aims to understand primary school students’ behavior and awareness of sun exposure and sunscreen in Beijing, China. Methods A questionnaire survey was conducted of 232 students in grades 4–6 at a public primary school in Beijing, including 129 boys (55.6%) and 103 girls (44.4%). The contents of the questionnaire included awareness about ultraviolet rays, sun exposure, sunscreen habits, and the understanding and use of sunscreen. Results The majority of the subjects (75.0%) said they had never been sunburned, and 26.3% had never been tanned. Only 7.3% of the primary school students had a comprehensive and correct understanding that sunlight will burn, cause cancer, tan, and age the skin. Sunscreen (47.8%), sunshades (47.4%), sun hats (44.4%), avoiding going out at noon (37.5%), and sunglasses (30.2%) were the most frequently used sunscreen means. Furthermore, 47.8% of primary school students used topical sunscreen for light protection, higher than other measures. The proportion of girls using sunscreen at least once a day was more than boys. Conclusion Primary school students in Beijing, China, do not have a comprehensive understanding of ultraviolet rays, and there are deficiencies in protective behavior. Their awareness and use of sunscreen need to be improved.
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Affiliation(s)
- Ying-Shu Gao
- Department of Dermatology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, People's Republic of China
| | - Di-Hui Lai
- Department of Dermatology, Beijing Chuiyangliu Hospital, Beijing, 100022, People's Republic of China
| | - Shao-Wei Cheng
- Department of Dermatology, Beijing Chuiyangliu Hospital, Beijing, 100022, People's Republic of China
| | - Qing Li
- Department of Dermatology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, People's Republic of China
| | - Jian-Chun Hao
- Department of Dermatology, Beijing Chuiyangliu Hospital, Beijing, 100022, People's Republic of China
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6
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Perez M, Abisaad JA, Rojas KD, Marchetti MA, Jaimes N. Skin Cancer: Primary, Secondary, and Tertiary Prevention. Part I. J Am Acad Dermatol 2022; 87:255-268. [DOI: 10.1016/j.jaad.2021.12.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/03/2021] [Accepted: 12/15/2021] [Indexed: 10/19/2022]
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7
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Fortes C, Mastroeni S, Capuano M, Ricozzi I, Bono R, Ricci F, Pagnanelli G, Nudo M. Differences in individual and environmental factors between cutaneous melanoma and atypical Spitz tumour in children and adolescents. Eur J Pediatr 2022; 181:263-269. [PMID: 34275015 DOI: 10.1007/s00431-021-04204-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 11/27/2022]
Abstract
It is not known if children and adolescents with atypical Spitz tumour and cutaneous melanoma differ in terms of etiological factors. The aim of this study was to explain differences in individual and environmental factors between cutaneous melanoma and atypical Spitz tumour. In the context of a study on melanocytic lesions, all subjects aged under 20 years with either cutaneous melanoma or atypical Spitz tumour were included (N = 105). Information on socio-demographic characteristics, individual and environmental factors were collected for both mother and child. The Fisher's exact test and the Mann-Whitney U test were used for categorical variables and continuous variables respectively. A multivariate logistic model was used to explain differences in outcome by differences in explanatory variables. In comparison to patients with cutaneous melanoma, patients with atypical Spitz tumour had less freckles (p = 0.020), lower number of common nevi (p = 0.002), and lower body mass index (p = 0.001) and experienced less sunburns episodes (p = 0.008). However, in the multivariate analysis, only a low number of common nevi remained statistically significant. Children and adolescents with cutaneous melanoma have a high number of nevi in comparison to the same-age group with atypical Spitz tumour.Conclusion: The results of this study suggest that the only difference in individual and environmental risk factors between cutaneous melanoma and atypical Spitz tumour in children and adolescents is the number of nevi. What is Known: •Atypical Spitz tumours and cutaneous melanoma in children and adolescents are clinically similar, but compared with melanoma, they have a good overall prognosis. •Risk factors for cutaneous melanoma in children and adolescents are similar to the ones found in adults in the literature What is New: •Differences in individual and environmental risk factors for atypical Spitz tumour in children and adolescents are described for the first time in this study. •Individual and environmental factors for atypical Spitz tumour in children and adolescents are comparable to cutaneous melanoma, except for the presence of low number of nevi.
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Affiliation(s)
- Cristina Fortes
- Istituto Dermopatico Dell'Immacolata Concezione, IDI-IRCCS, Rome, Italy.
| | - Simona Mastroeni
- Istituto Dermopatico Dell'Immacolata Concezione, IDI-IRCCS, Rome, Italy
| | - Maria Capuano
- Istituto Dermopatico Dell'Immacolata Concezione, IDI-IRCCS, Capranica, Viterbo, Italy
| | - Ilaria Ricozzi
- Istituto Dermopatico Dell'Immacolata Concezione, IDI-IRCCS, Rome, Italy
| | - Riccardo Bono
- Istituto Dermopatico Dell'Immacolata Concezione, IDI-IRCCS, Rome, Italy
| | - Francesco Ricci
- Istituto Dermopatico Dell'Immacolata Concezione, IDI-IRCCS, Rome, Italy
| | | | - Maurizio Nudo
- Dermatology Department, Humanitas Castelli, Bergamo, Italy
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8
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Thompson LK, Langholz B, Goldberg DW, Wilson JP, Ritz B, Tayour C, Cockburn M. Area-Based Geocoding: An Approach to Exposure Assessment Incorporating Positional Uncertainty. GEOHEALTH 2021; 5:e2021GH000430. [PMID: 34859166 PMCID: PMC8612311 DOI: 10.1029/2021gh000430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 11/01/2021] [Accepted: 11/05/2021] [Indexed: 06/13/2023]
Abstract
While the spatial resolution of exposure surfaces has greatly improved, our ability to locate people in space remains a limiting factor in accurate exposure assessment. In this case-control study, two approaches to geocoding participant locations were used to study the impact of geocoding uncertainty on the estimation of ambient pesticide exposure and breast cancer risk among women living in California's Central Valley. Residential and occupational histories were collected and geocoded using a traditional point-based method along with a novel area-based method. The standard approach to geocoding uses centroid points to represent all geocoded locations, and is unable to adapt exposure areas based on geocode quality, except through the exclusion of low-certainty locations. In contrast, area-based geocoding retains the complete area to which an address matched (the same area from which the centroid is returned), and therefore maintains the appropriate level of precision when it comes to assessing exposure by geography. Incorporating the total potential exposure area for each geocoded location resulted in different exposure classifications and resulting odds ratio estimates than estimates derived from the centroids of those same areas (using a traditional point-based geocoder). The direction and magnitude of these differences varied by pesticide, but in all cases odds ratios differed by at least 6% and up to 35%. These findings demonstrate the importance of geocoding in exposure estimation and suggest it is important to consider geocode certainty and quality throughout exposure assessment, rather than simply using the best available point geocodes.
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Affiliation(s)
- Laura K. Thompson
- Department of Population and Public Health SciencesKeck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Bryan Langholz
- Department of Population and Public Health SciencesKeck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Daniel W. Goldberg
- Department of GeographyCollege of GeosciencesTexas A&M UniversityCollege StationTXUSA
- Department of Computer Science and EngineeringCollege of GeosciencesTexas A&M UniversityCollege StationTXUSA
| | - John P. Wilson
- Spatial Sciences InstituteUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Beate Ritz
- Department of Epidemiology and Environmental SciencesFielding School of Public HealthUniversity of CaliforniaLos AngelesCAUSA
| | - Carrie Tayour
- Los Angeles County Department of Public HealthLos AngelesCAUSA
| | - Myles Cockburn
- Department of Population and Public Health SciencesKeck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA
- Spatial Sciences InstituteUniversity of Southern CaliforniaLos AngelesCAUSA
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9
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Lopes FCPS, Sleiman MG, Sebastian K, Bogucka R, Jacobs EA, Adamson AS. UV Exposure and the Risk of Cutaneous Melanoma in Skin of Color: A Systematic Review. JAMA Dermatol 2021; 157:213-219. [PMID: 33325988 DOI: 10.1001/jamadermatol.2020.4616] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance While current evidence supports UV exposure as an important risk factor for cutaneous melanoma in fair-skinned populations, the evidence for this association in skin of color is less certain. Objective To critically assess and synthesize the published data regarding the association between UV exposure and the risk of cutaneous melanoma in skin of color. Evidence Review A search was conducted including PubMed, Cochrane, and Web of Science databases from database origin to June 3, 2020. Only peer-reviewed original studies were screened in full text. Eligible studies analyzed UV exposure as a risk factor for cutaneous melanoma in people with skin of color, which was defined broadly as any race/ethnicity other than non-Hispanic White, Fitzpatrick skin types IV through VI, or tanning ability of rarely or never burns. Measures of UV exposure included UV index, irradiance, latitude, history of phototherapy, and history of sunburn. Evidence quality was assessed using criteria from the Oxford Centre for Evidence-Based Medicine. Findings After duplicate removal, 11 059 database records were screened, 548 full-text articles were assessed, and 13 met inclusion criteria. Study types included 7 ecological studies, 5 cohort studies, and 1 case-control study. All studies used race and/or ethnicity to categorize the participants, and more than 7700 melanomas in skin of color were included. Of the 13 studies that met inclusion criteria, 11 found no association between UV exposure and melanoma in skin of color, 1 study showed a small positive relationship in Black males, and 1 showed a weak association in Hispanic males. All studies were of moderate to low quality (Oxford Centre ratings 2b to 4). Conclusions and Relevance In this systematic review, the evidence suggests that UV exposure may not be an important risk factor for melanoma development in people with skin of color. Current recommendations promoting UV protection for melanoma prevention in skin of color are not supported by most current studies. However, evidence is of moderate to low quality, and further research is required to fully elucidate this association.
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Affiliation(s)
- Fabiana C P S Lopes
- Division of Dermatology, Department of Internal Medicine, Dell Medical School, The University of Texas at Austin
| | - Marc G Sleiman
- LIVESTRONG Cancer Institutes, Dell Medical School, The University of Texas at Austin
- Pritzker School of Medicine, The University of Chicago, Chicago, Illinois
| | - Kate Sebastian
- Division of Dermatology, Department of Internal Medicine, Dell Medical School, The University of Texas at Austin
| | - Roxanne Bogucka
- Life Science Library, University of Texas Libraries, The University of Texas at Austin
| | - Elizabeth A Jacobs
- Department of Internal Medicine, Dell Medical School, The University of Texas at Austin
| | - Adewole S Adamson
- Division of Dermatology, Department of Internal Medicine, Dell Medical School, The University of Texas at Austin
- LIVESTRONG Cancer Institutes, Dell Medical School, The University of Texas at Austin
- Associate Editor and Web Editor, JAMA Dermatology
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10
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Paulson KG, Gupta D, Kim TS, Veatch JR, Byrd DR, Bhatia S, Wojcik K, Chapuis AG, Thompson JA, Madeleine MM, Gardner JM. Age-Specific Incidence of Melanoma in the United States. JAMA Dermatol 2020; 156:57-64. [PMID: 31721989 DOI: 10.1001/jamadermatol.2019.3353] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Importance Melanoma is epidemiologically linked to UV exposure, particularly childhood sunburn. Public health campaigns are increasing sun-protective behavior in the United States, but the effect on melanoma incidence is unknown. Objective To examine the incidence of melanoma in the United States and whether any age-specific differences are present. Design, Setting, and Participants Observational, population-based registry data were extracted on July 3, 2018, from the combined National Program of Cancer Registries-Surveillance Epidemiology and End Results United States Cancer Statistics database for 2001-2015. Deidentified data for 988 103 cases of invasive melanoma, with International Classification of Diseases for Oncology histologic categorization codes 8720 to 8790, were used for analysis. Data analysis was performed from July 1, 2018, to March 1, 2019. Main Outcomes and Measures The annual rates of melanoma in pediatric, adolescent, young adult, and adult age groups were determined. Analyses were stratified by sex, and incidence rates were age-adjusted to the 2000 US standard population. Annual percentage change (APC) in incidence rate was calculated over the most recent decade for which data were available (2006-2015) using the weighted least squares method. Results In 2015, 83 362 cases of invasive melanoma were reported in the United States, including 67 in children younger than 10 years, 251 in adolescents (10-19 years), and 1973 in young adults (20-29 years). Between 2006 and 2015, the overall incidence rate increased from 200.1 to 229.1 cases per million person-years. In adults aged 40 years or older, melanoma rates increased by an APC of 1.8% in both men (95% CI, 1.4%-2.1%) and women (95% CI, 1.4%-2.2%). In contrast, clinically and statistically significant decreases were seen in melanoma incidence for adolescents and young adults. Specifically, incidence rates decreased by an APC of -4.4% for male adolescents (95% CI, -1.7% to -7.0%), -5.4% for female adolescents (95% CI, -3.3% to -7.4%), -3.7% for male young adults (95% CI, -2.5% to -4.8%), and -3.6% for female young adults (95% CI, -2.8% to -4.5%). Data on skin pigmentation and sun protection history were unavailable; similar trends were observed with data limited to non-Hispanic whites. Young adult women appeared to have twice the risk of melanoma as young adult men. Conclusions and Relevance The incidence of invasive melanoma in the United States appeared to decrease in adolescents and young adults from 2006 to 2015, and this finding contrasted with increases in older populations. These incidence trends suggest that public health efforts may be favorably influencing melanoma incidence in the United States.
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Affiliation(s)
- Kelly G Paulson
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, Washington.,Division of Medical Oncology, University of Washington, Seattle.,Melanoma and Skin Oncology, Seattle Cancer Care Alliance, Seattle, Washington
| | - Deepti Gupta
- Seattle Children's Hospital, Seattle, Washington.,Division of Dermatology, University of Washington, Seattle.,Department of Pediatrics, University of Washington, Seattle
| | - Teresa S Kim
- Melanoma and Skin Oncology, Seattle Cancer Care Alliance, Seattle, Washington.,Department of Surgery, University of Washington, Seattle
| | - Joshua R Veatch
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, Washington.,Division of Medical Oncology, University of Washington, Seattle.,Melanoma and Skin Oncology, Seattle Cancer Care Alliance, Seattle, Washington
| | - David R Byrd
- Melanoma and Skin Oncology, Seattle Cancer Care Alliance, Seattle, Washington.,Department of Surgery, University of Washington, Seattle
| | - Shailender Bhatia
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, Washington.,Division of Medical Oncology, University of Washington, Seattle.,Melanoma and Skin Oncology, Seattle Cancer Care Alliance, Seattle, Washington
| | - Katherine Wojcik
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Aude G Chapuis
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, Washington.,Division of Medical Oncology, University of Washington, Seattle.,Melanoma and Skin Oncology, Seattle Cancer Care Alliance, Seattle, Washington
| | - John A Thompson
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, Washington.,Division of Medical Oncology, University of Washington, Seattle.,Melanoma and Skin Oncology, Seattle Cancer Care Alliance, Seattle, Washington
| | - Margaret M Madeleine
- Department of Epidemiology, University of Washington School of Public Health, Seattle.,Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Jennifer M Gardner
- Melanoma and Skin Oncology, Seattle Cancer Care Alliance, Seattle, Washington.,Division of Dermatology, University of Washington, Seattle
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MicroRNA-21-Enriched Exosomes as Epigenetic Regulators in Melanomagenesis and Melanoma Progression: The Impact of Western Lifestyle Factors. Cancers (Basel) 2020; 12:cancers12082111. [PMID: 32751207 PMCID: PMC7464294 DOI: 10.3390/cancers12082111] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/16/2020] [Accepted: 07/24/2020] [Indexed: 02/06/2023] Open
Abstract
DNA mutation-induced activation of RAS-BRAF-MEK-ERK signaling associated with intermittent or chronic ultraviolet (UV) irradiation cannot exclusively explain the excessive increase of malignant melanoma (MM) incidence since the 1950s. Malignant conversion of a melanocyte to an MM cell and metastatic MM is associated with a steady increase in microRNA-21 (miR-21). At the epigenetic level, miR-21 inhibits key tumor suppressors of the RAS-BRAF signaling pathway enhancing proliferation and MM progression. Increased MM cell levels of miR-21 either result from endogenous upregulation of melanocytic miR-21 expression or by uptake of miR-21-enriched exogenous exosomes. Based on epidemiological data and translational evidence, this review provides deeper insights into environmentally and metabolically induced exosomal miR-21 trafficking beyond UV-irradiation in melanomagenesis and MM progression. Sources of miR-21-enriched exosomes include UV-irradiated keratinocytes, adipocyte-derived exosomes in obesity, airway epithelium-derived exosomes generated by smoking and pollution, diet-related exosomes and inflammation-induced exosomes, which may synergistically increase the exosomal miR-21 burden of the melanocyte, the transformed MM cell and its tumor environment. Several therapeutic agents that suppress MM cell growth and proliferation attenuate miR-21 expression. These include miR-21 antagonists, metformin, kinase inhibitors, beta-blockers, vitamin D, and plant-derived bioactive compounds, which may represent new options for the prevention and treatment of MM.
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