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Mashele SA, Zwane TB, Kuonza L, Muchengeti MM, Motsuku L. Risk factors for breast cancer among women in Ekurhuleni Metropolitan Municipality, Gauteng province of South Africa, 2017‒2020: a case-control study. Ecancermedicalscience 2023; 17:1593. [PMID: 37799951 PMCID: PMC10550293 DOI: 10.3332/ecancer.2023.1593] [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: 06/02/2023] [Indexed: 10/07/2023] Open
Abstract
Introduction Breast cancer (BC) is the most common cancer among women in South Africa (SA), with an age-standardised incidence rate of 52.6 and an age-standardised mortality rate of 16.0 per 100,000 population. There is a paucity of evidence on the risk factors for BC among women of all races in SA. Given the rising prevalence of BC in SA, literature-based evidence is critical for the appropriate dissemination of preventative measures. This study aimed to identify the risk factors associated with the development of BC among women in Ekhuruleni Metropolitan Municipality. Methods An unmatched case-control study was conducted from 1 January 2017 to 31 December 2020 using secondary data extracted from the Ekurhuleni Population-Based Cancer Registry. Unconditional multivariable logistic regression analysis was carried out using the adjusted odds ratio (aOR). The variables race, employment, human immunodeficiency virus (HIV), smoking and alcohol status were included in the multivariable logistic regression model while the model was adjusted for age. Results A total of 2,217 cases and 851 controls were enrolled in the study. The mean age (±SD) in years was 55.7 (±15.2). The White population group, being self-employed and being HIV positive was significantly associated with reduced odds of BC development. HIV-positive women were 61% less likely to have BC than women who were HIV-negative (aOR 0.39; 95% confidence interval (CI): 0.27‒0.57). White women were 65% less likely to have BC than women of other races (aOR 0.35; 95% CI: 0.29‒0.43). Self-employed women were 59% less likely to have BC than women who were formally employed (aOR 0.41; 95% CI: 0.18‒0.97). No evidence of association was observed between tobacco smoking and BC as well as alcohol consumption and BC. Conclusion There was a 65% reduction in BC risk among White women compared to other races. HIV-positive women demonstrated a 61% lower likelihood of BC while self-employed women showed a 59% reduced risk of developing BC. These findings suggest that being White, self-employed or HIV-positive may provide some protection against BC. However, additional research is needed to validate these results and establish the underlying reasons behind these associations.
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Affiliation(s)
- Sizeka A Mashele
- South African Field Epidemiology Training Program, National Institute for Communicable Diseases, National Health Laboratory Services, 1 Modderfontein Road, Sandringham, Johannesburg 2192, South Africa
- National Cancer Registry, National Health Laboratory Services, 1 Modderfontein Road, Sandringham, Johannesburg 2192, South Africa
- School of Public Health, University of the Witwatersrand, 27 St Andrews Rd, Parktown, Johannesburg 2193, South Africa
| | - Thembekile B Zwane
- South African Field Epidemiology Training Program, National Institute for Communicable Diseases, National Health Laboratory Services, 1 Modderfontein Road, Sandringham, Johannesburg 2192, South Africa
| | - Lazarus Kuonza
- South African Field Epidemiology Training Program, National Institute for Communicable Diseases, National Health Laboratory Services, 1 Modderfontein Road, Sandringham, Johannesburg 2192, South Africa
| | - Mazvita M Muchengeti
- National Cancer Registry, National Health Laboratory Services, 1 Modderfontein Road, Sandringham, Johannesburg 2192, South Africa
- School of Public Health, University of the Witwatersrand, 27 St Andrews Rd, Parktown, Johannesburg 2193, South Africa
- South African DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, 19 Jonkershoek Road, Stellenbosch 7600, South Africa
| | - Lactatia Motsuku
- National Cancer Registry, National Health Laboratory Services, 1 Modderfontein Road, Sandringham, Johannesburg 2192, South Africa
- South African DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, 19 Jonkershoek Road, Stellenbosch 7600, South Africa
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Stenzel AE, Miller J, Holtan SG, Brown K, Ahmed RL, Lazovich D, Vogel RI. Cross-sectional study of physical activity among long-term melanoma survivors and population controls. Arch Dermatol Res 2023; 315:1011-1016. [PMID: 35201419 PMCID: PMC9399312 DOI: 10.1007/s00403-022-02334-2] [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: 07/06/2021] [Revised: 01/24/2022] [Accepted: 02/10/2022] [Indexed: 11/02/2022]
Abstract
Physical activity has been associated with improved outcomes among cancer survivors of various malignancies; however, this topic is understudied among melanoma survivors. Our objective was to determine whether long-term melanoma survivors are less likely to meet American Cancer Society physical activity guidelines than non-melanoma population controls. We conducted a cross-sectional survey in 2015 to follow up participants from a case-control study of melanoma and population controls in Minnesota. The primary outcome was meeting American Cancer Society recommendations for healthy physical activity levels. Physical activity, sun protection practices and time spent outside were compared between survivors and controls using generalized linear regression models. Melanoma survivors (N = 724) and controls (N = 639) were similar with the exceptions of daily hours spent outside, sun protection scores, skin tone, and smoking status. Half (50.8%) of melanoma survivors reported meeting the physical activity guidelines, compared to 39.7% of controls (p < 0.0001), with an 11% (95% CI 0.05-0.17) difference after adjusting for potential confounders. While long-term melanoma survivors were more likely to meet American Cancer Society physical activity guidelines than population controls, nearly 50% did not meet recommendations. This finding is concerning given the known improvements in quality of life and survival among physically active cancer survivors. Opportunities remain to promote physical activity among melanoma survivors. Health communications that promote outdoor exercise, in particular, should include advice about sun protection.
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Affiliation(s)
- Ashley E Stenzel
- Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota, Minneapolis, MN, USA
- Program in Health Disparities Research, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Jonathan Miller
- Program in Health Disparities Research, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
- Hennepin Health Research Institute, Minneapolis, MN, USA
| | - Shernan G Holtan
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Katherine Brown
- Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota, Minneapolis, MN, USA
| | - Rehana L Ahmed
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
- Department of Dermatology, University of Minnesota, Minneapolis, MN, USA
| | - DeAnn Lazovich
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Rachel I Vogel
- Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota, Minneapolis, MN, USA.
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA.
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3
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ÇELİK BA, KOÇ V. Skin Cancer-Related Health Behavior Interventions in the Context of the Health Belief Model. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1112210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
The incidence of skin cancer is increasing around the world every year. Although there are many reasons for the occurrence of skin cancer, UV radiation caused by sunlight is seen as the most important factor. Therefore, reducing exposure to UV radiation should be a top priority for skin cancer prevention. In addition, different demographic features also affect the amount of UV exposure. These include age, gender and professional groups. On the other hand, people can be exposed to UV radiation voluntarily. Sunbathing or using tanning devices can be shown as examples for this. For these reasons, interventions to reduce exposure to UV radiation should focus on demographic features and the desire to tan. At the same time, it is emphasized in the literature that theory-based and systematic interventions are more effective than others. In this context, we think that the Health Belief Model, which is an effective psychosocial model for health behaviors, will be useful in developing sun protection behaviors. In this review, interventions based on the Health Belief Model in the context of tanning behavior, age, gender, and outdoor activities for the prevention of skin cancer and the improvement of sun protection behaviors have been discussed.
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4
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Abstract
The incidence of cutaneous melanoma has been increasing worldwide, and melanoma disproportionately contributes to skin cancer mortality. The pathogenesis of melanoma involves genetic and environmental factors, and while the effects of ultraviolet B radiation on melanoma development are well researched, fewer studies have investigated the role of ultraviolet A (UVA) radiation. We comprehensively reviewed cell, animal and epidemiology studies on the association between UVA exposure and melanomagenesis. UVA radiation has been found to have negative effects on melanocytes due to the induction of oxidative stress, dysregulation of gene transcription and creation of mutagenic photoproducts in DNA. Animal studies demonstrate adverse effects of UVA on melanocytes, including the development of melanoma. Epidemiology studies, of varying quality, that examined participants' exposure to tanning devices which use UVA radiation primarily found that UVA exposure increased the risk for melanoma. Some studies reported larger associations with increased frequency of device use, suggestive of a dose-response relationship. Overall, we found that many studies supported a positive association between UVA exposure and melanoma on both molecular and population levels. Understanding the role of UVA in the development of melanoma will inform the implementation of preventive health interventions, such as those related to sunscreen development and use and increasing restrictions on indoor tanning.
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Affiliation(s)
- Raj P Fadadu
- Department of Dermatology, University of California
- Dermatology Service, San Francisco Veterans Affairs Health Care Center, San Francisco, California, USA
| | - Maria L Wei
- Department of Dermatology, University of California
- Dermatology Service, San Francisco Veterans Affairs Health Care Center, San Francisco, California, USA
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Novacescu D, Cut TG, Cumpanas AA, Bratosin F, Ceausu RA, Raica M. Novel Expression of Thymine Dimers in Renal Cell Carcinoma, Demonstrated through Immunohistochemistry. Biomedicines 2022; 10:2673. [PMID: 36359193 PMCID: PMC9687240 DOI: 10.3390/biomedicines10112673] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/25/2022] [Accepted: 10/20/2022] [Indexed: 08/26/2023] Open
Abstract
Despite significant developments in renal cell carcinoma (RCC) detection and molecular pathology, mortality has been steadily rising. Advanced RCC remains an incurable disease. Better clinical management tools, i.e., RCC biomarkers, have yet to emerge. Thymine-dimers (TDs) were traditionally considered photo-dependent pre-mutagenic lesions, occurring exclusively during ultra-violet light exposure. Non-oxidative, direct, and preferential byproducts of DNA photochemical reactions, TDs, have recently shown evidence regarding UVR-independent formation. In this study, we investigate, for the first time, TD expression within RCC tumor tissue and tumor-adjacent healthy renal parenchyma using a TD-targeted IHC monoclonal antibody, clone KTM53. Remarkably, out of the 54 RCCs evaluated, 77.8% showed nuclear TD-expression in RCC tumor tissue and 37% in the tumor-adjacent healthy renal parenchyma. A comprehensive report regarding quantitative/qualitative TD-targeted immunostaining was elaborated. Two main distribution models for TD expression within RCC tumor tissue were identified. Statistical analysis showed significant yet moderate correlations regarding TD-positivity in RCC tissue/tumor-adjacent healthy renal parenchyma and TNM stage at diagnosis/lymphatic dissemination, respectively, indicating possible prognostic relevance. We review possible explanations for UVR-independent TD formation and molecular implications regarding RCC carcinogenesis. Further rigorous molecular analysis is required in order to fully comprehend/validate the biological significance of this newly documented TD expression in RCC.
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Affiliation(s)
- Dorin Novacescu
- Doctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
| | - Talida Georgiana Cut
- Doctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
- Department XIII, Discipline of Infectious Diseases, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
- Center for Ethics in Human Genetic Identifications, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
| | - Alin Adrian Cumpanas
- Department XV, Discipline of Urology, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
| | - Felix Bratosin
- Department XIII, Discipline of Infectious Diseases, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
- Methodological and Infectious Diseases Research Center, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
| | - Raluca Amalia Ceausu
- Department II, Discipline of Histology, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
- Angiogenesis Research Center, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
| | - Marius Raica
- Department II, Discipline of Histology, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
- Angiogenesis Research Center, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
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Research progress of microneedles in the treatment of melanoma. J Control Release 2022; 348:631-647. [PMID: 35718209 DOI: 10.1016/j.jconrel.2022.06.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/11/2022] [Accepted: 06/12/2022] [Indexed: 11/24/2022]
Abstract
Melanoma is an aggressive malignancy deriving from melanocytes, which is characterized by high tendency of metastases and mortality rate. Current therapies for melanoma, like chemotherapy, immunotherapy and targeted therapy, have the problem of systemic exposure of drugs, which will lead to many side effects and premature degradation of drugs. The resulting low drug accumulation at the lesion limits the therapeutic effect on melanoma and makes the cure rate low. As an emerging drug delivery system, microneedles (MNs) can efficiently deliver drugs through the skin, increase the drug distribution in deeper tumor sites and minimize the leakage of therapeutic drugs into adjacent tissues, thus improving the therapeutic effect. In addition, compared with traditional drug delivery methods, MN-based drug delivery system has the advantages of simplicity, safety and little pain. So MNs can be developed for the treatment of melanoma, which can relieve the pain of patients and improve the survival rate. This review aims to introduce an update on the progress of MNs as an innovative strategy for melanoma, especially when MNs combining with different therapies against melanoma, such as chemotherapy, targeted therapy, immunotherapy, photothermal therapy (PTT), photodynamic therapy (PDT) and synergic therapy.
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Faraj Y, Beltrani VP. Introduction to Head and Neck Melanoma. Oral Maxillofac Surg Clin North Am 2022; 34:213-220. [DOI: 10.1016/j.coms.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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8
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Morais P. Artificial tanning devices (Sunbeds): where do we stand? Cutan Ocul Toxicol 2022; 41:123-128. [PMID: 35298329 DOI: 10.1080/15569527.2022.2050748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Exposure to ultraviolet radiation emitted by indoor tanning devices (sunbeds) has well-documented negative effects on human health, but no clear benefit beyond cosmetic outcomes. Sunbed use is responsible for a significant proportion of both melanoma and non-melanoma skin cancers, especially in patients exposed to this practice in early life, premature skin ageing, immunosuppression, skin burns, and eye damage. Artificial tanning is now seen as a public health issue. In this review we discuss the potential additive effect of indoor tanning, misleading facts regarding sunbed benefit, safety concerns and negative effects on human health, indoor tanning legislation and current position of several international organisations, and the impact of some policies adopted in order to mitigate the effects of this dangerous practice.
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Affiliation(s)
- Paulo Morais
- Dermatology Unit, Hospital da Luz Clínica de Amarante, Amarante, Portugal.,Dermatology Unit, Trofa Saúde Hospital de Alfena, Valongo, Portugal
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9
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Cumulative Sun Exposure and Melanoma in a Population-Based Case–Control Study: Does Sun Sensitivity Matter? Cancers (Basel) 2022; 14:cancers14041008. [PMID: 35205756 PMCID: PMC8870683 DOI: 10.3390/cancers14041008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/23/2022] [Accepted: 02/08/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary Melanoma has been clearly shown to be related to sunburns and other types of intermittent sun exposure. It is less clear how cumulative sun exposure is related to melanoma. In this case–control study, the cumulative hours of sun exposure per day were examined between spring and fall each year over periods or decades of life to estimate lifetime hours of sun exposure. No associations were found before the age of 60. However, when stratified by fair skin color, we found little or no association with hours of sun exposure among fair-skinned individuals, but found an increased risk for higher hours of sun exposure among medium- or darker-skinned individuals for lifetime exposure. Abstract Cutaneous melanoma (CM) has consistently been associated with intermittent sun exposure, while the association with chronic sun exposure is debated. The goal of this research was to examine the complex relationship between CM, sun sensitivity and sun exposure based on theoretical concepts of how these factors may be associated. Detailed sun exposure histories across life periods and various measures of sun sensitivity were collected in a population-based case–control study of melanoma in Iowa, USA. Participants were asked about their hours of sun exposure per day between March and October each year over periods or decades of life to estimate cumulative lifetime hours of sun exposure. Increased odds ratios (ORs) for CM were seen for most standard measures of sun sensitivity except for the tendency to sunburn. Minimal associations were seen with total hours of sun exposure early in life. However, an interaction was seen between fair skin color and lifetime hours of sun exposure, where the strongest associations with CM were seen among medium-skinned and dark-skinned participants. This suggests that cumulative sun exposure at high levels may increase CM among non-sun-sensitive individuals typically at lower risk of CM. Such a finding has implications for the prevention effort for melanoma regarding time in the sun among darker-skinned individuals.
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10
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Skin Cancer Risk Perception and Tanning Bed Use: A Population-Based Survey to Identify Persons at Risk for Melanoma in Olmsted County, Minnesota. Dermatol Surg 2022; 48:34-38. [PMID: 34904576 DOI: 10.1097/dss.0000000000003277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cutaneous melanoma is strongly associated with tanning bed use. OBJECTIVE To describe local residents' knowledge, attitudes, and behavior regarding skin cancer and tanning bed use and to estimate prevalence of high risk for melanoma. MATERIALS AND METHODS A survey was mailed to 886 local residents (549, aged 18-39 years; 337, aged ≥40 years). Logistic and linear regression and univariate and multivariable analysis were used to assess perceived risk and skin cancer knowledge. RESULTS The response rate was 21%; 55% of the younger group and 37% of the older group had used indoor tanning, and prevalence of high risk for melanoma according to a skin cancer risk calculator was 18% in the younger group and 33% in the older group. Individuals with high risk scores were more likely to correctly perceive that they were at high risk for skin cancer. Most participants with high risk scores and those who previously used tanning beds reported low likelihood of future indoor tanning. CONCLUSION Female sex, high risk score, and previous indoor tanning were associated with participants' views of higher skin cancer risk. No specific knowledge gaps were identified. Understanding community residents' attitudes about skin cancer and indoor tanning can help guide interventions.
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11
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Vineretsky KA, Domingo-Musibay E, Karagas MR, Lazovich D, Kuriger-Laber JK, Hunter-Schlichting D, Nelson HH. A functional variant in the immune signalling receptor NKG2D alters skin cancer risk. Br J Dermatol 2021; 186:898-899. [PMID: 34878657 PMCID: PMC9064906 DOI: 10.1111/bjd.20943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/03/2021] [Accepted: 12/04/2021] [Indexed: 11/26/2022]
Affiliation(s)
- K A Vineretsky
- Department of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America
| | - E Domingo-Musibay
- Department of Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, United States of America
| | - M R Karagas
- Department of Epidemiology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Hanover, NH, United States of America
| | - D Lazovich
- Division of Epidemiology and Community Health, School of Public Health.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States of America
| | - J K Kuriger-Laber
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States of America
| | - D Hunter-Schlichting
- Division of Epidemiology and Community Health, School of Public Health.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States of America
| | - H H Nelson
- Division of Epidemiology and Community Health, School of Public Health.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States of America
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12
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Bajgar R, Moukova A, Chalupnikova N, Kolarova H. Differences in the Effects of Broad-Band UVA and Narrow-Band UVB on Epidermal Keratinocytes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312480. [PMID: 34886205 PMCID: PMC8656598 DOI: 10.3390/ijerph182312480] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/23/2022]
Abstract
Background: The sun is a natural source of UV radiation. It can be divided into three bands, UVA (315–400 nm), UVB (280–315 nm) and UVC (100–280 nm), where the radiation up to 290 nm is very effectively eliminated by the stratospheric ozone. Although UV radiation can have a beneficial effect on our organism and can be used in the treatment of several skin diseases, it must primarily be considered harmful. Methods: In the presented work, we focused on the study of the longer-wavelength UV components (UVA and UVB) on the human epidermal keratinocyte line HaCaT. As UVA and UVB radiation sources, we used commercially available UVA and UVB tubes from Philips (Philips, Amsterdam, The Netherlands), which are commonly employed in photochemotherapy. We compared their effects on cell viability and proliferation, changes in ROS production, mitochondrial function and the degree of DNA damage. Results: Our results revealed that UVB irradiation, even with significantly lower irradiance, caused greater ROS production, depolarization of mitochondrial membrane potential and greater DNA fragmentation, along with significantly lowering cell viability and proliferative capacity. Conclusions: These results confirm that UV radiation causes severe damages in skin cells, and they need to be protected from it, or it needs to be applied more cautiously, especially if the component used is UVB.
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Affiliation(s)
- Robert Bajgar
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacky University in Olomouc, Hnevotinska 3, 775 15 Olomouc, Czech Republic; (A.M.); (N.C.); (H.K.)
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University in Olomouc, Hnevotinska 3, 775 15 Olomouc, Czech Republic
- Correspondence: ; Tel.: +420-585-632-106
| | - Anna Moukova
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacky University in Olomouc, Hnevotinska 3, 775 15 Olomouc, Czech Republic; (A.M.); (N.C.); (H.K.)
| | - Nela Chalupnikova
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacky University in Olomouc, Hnevotinska 3, 775 15 Olomouc, Czech Republic; (A.M.); (N.C.); (H.K.)
| | - Hana Kolarova
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacky University in Olomouc, Hnevotinska 3, 775 15 Olomouc, Czech Republic; (A.M.); (N.C.); (H.K.)
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University in Olomouc, Hnevotinska 3, 775 15 Olomouc, Czech Republic
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13
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Indoor Tanning and the Risk of Overall and Early-Onset Melanoma and Non-Melanoma Skin Cancer: Systematic Review and Meta-Analysis. Cancers (Basel) 2021; 13:cancers13235940. [PMID: 34885049 PMCID: PMC8656707 DOI: 10.3390/cancers13235940] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/21/2021] [Accepted: 11/23/2021] [Indexed: 12/26/2022] Open
Abstract
Simple Summary Motivated by the increasing incidences of skin cancer, in 2015, Australian states banned indoor tanning to prevent exposure to artificial ultraviolet light. However, there has been no study investigating the association between indoor tanning and early-onset melanoma and non-melanoma skin cancer. In this study, we reviewed a total of 54 studies to examine the association between indoor tanning device use and overall and early-onset skin cancer. We found that indoor tanning is associated with increased risk for early-onset melanoma and NMSC, and has a dose–response relationship with first exposure at an early age and the frequency of exposure. Therefore, this study emphasizes the importance of avoiding indoor tanning risk in younger adults. Our findings provide evidence that supports policies regulating the excessive use of tanning devices, especially in the vulnerable younger population, to reduce the additional risk of skin cancer. Abstract The aim of this study was to examine the association between indoor tanning use and the risk of overall and early-onset (age < 50) melanoma and non-melanoma skin cancer (NMSC). To evaluate the association between indoor tanning and skin cancer, a systematic review of the literature published until July 2021 was performed using PubMed, EMBASE, and MEDLINE. Summary relative risk (RR) from 18 studies with 10,406 NMSC cases and 36 studies with 14,583 melanoma cases showed significant association between skin cancer and indoor tanning (melanoma, RR= 1.27, 95% CI 1.16–1.39; NMSC, RR = 1.40, 95% CI 1.18–1.65; squamous cell carcinoma (SCC), RR = 1.58, 95% CI 1.38–1.81; basal cell carcinoma (BCC), RR = 1.24, 95% CI 1.00–1.55). The risk was more pronounced in early-onset skin cancer (melanoma, RR = 1.75, 95% CI 1.14–2.69; NMSC, RR = 1.99, 95% CI 1.48–2.68; SCC, RR = 1.81, 95% CI 1.38–2.37; BCC, RR = 1.75, 95% CI 1.15–2.77). Moreover, first exposure at an early age (age ≤ 20 years) and higher exposure (annual frequency ≥ 10 times) to indoor tanning showed increasing risk for melanoma (RR = 1.47, 95% CI 1.16–1.85; RR = 1.52, 1.22–1.89) and NMSC (RR = 2.02, 95% CI 1.44–2.83; RR = 1.56, 95% CI 1.31–1.86). These findings provide evidence supporting primary prevention policies regulating modifiable behaviors to reduce the additional risk of skin cancer among younger adults.
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Zhang M, Wang M, Guo Y, Shi Y, Wang J, Chen Y, Zhao C, Zhou Y, Xiao Y, Zhang H, Zhao G. Unveiling the nonadiabatic photoisomerization mechanism of hemicyanines for UV photoprotection. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2021; 260:119949. [PMID: 34023551 DOI: 10.1016/j.saa.2021.119949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/15/2021] [Accepted: 05/08/2021] [Indexed: 06/12/2023]
Abstract
In this work, the nonadiabatic energy relaxation mechanism of hemicyanines for UV photoprotection were investigated by using the density functional theory (DFT) and time-dependent density functional theory (TDDFT) method for the first time. The absorption spectra and potential energy surfaces (PESs) of four hemicyanines with different positions of substituents were presented. The maximum absorption peaks of the four hemicyanines are located in the UVA region. In addition, all these hemicyanine molecules also have light absorption in both the UVB and UVC regions. At the same time, we found that the trans-cis photoisomerization PESs of all these hemicyanines have a significant conical intersection (CI) point between the first excited state and the ground state. Herein, it was first demonstrated that the UV energy absorbed by the hemicyanines could be dissipated nonadiabatically through the CI point by using the trans-cis photoisomerization dynamics mechanism. This work proves that hemicyanines have the possibility to be applied for UV photoabsorbers, and provides important basis for designing new type of hemicyanines for UV photoprotection.
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Affiliation(s)
- Mingshui Zhang
- College of Chemistry and Chemical Engineering, Northeast Petroleum University, Daqing, Heilongjiang Province 163318, China
| | - Mengqi Wang
- Tianjin Key Laboratory of Molecular Optoelectronic Sciences, Department of Chemistry, School of Science, Tianjin University, Tianjin 300354, China
| | - Yurong Guo
- Tianjin Key Laboratory of Molecular Optoelectronic Sciences, Department of Chemistry, School of Science, Tianjin University, Tianjin 300354, China
| | - Yanan Shi
- Tianjin Key Laboratory of Molecular Optoelectronic Sciences, Department of Chemistry, School of Science, Tianjin University, Tianjin 300354, China
| | - Jun Wang
- College of Chemistry and Chemical Engineering, Northeast Petroleum University, Daqing, Heilongjiang Province 163318, China.
| | - Yibing Chen
- Tianjin Key Laboratory of Molecular Optoelectronic Sciences, Department of Chemistry, School of Science, Tianjin University, Tianjin 300354, China
| | - Chenyang Zhao
- Tianjin Key Laboratory of Molecular Optoelectronic Sciences, Department of Chemistry, School of Science, Tianjin University, Tianjin 300354, China
| | - Yi Zhou
- Tianjin Key Laboratory of Molecular Optoelectronic Sciences, Department of Chemistry, School of Science, Tianjin University, Tianjin 300354, China
| | - Yongze Xiao
- Tianjin Key Laboratory of Molecular Optoelectronic Sciences, Department of Chemistry, School of Science, Tianjin University, Tianjin 300354, China
| | - Haoyue Zhang
- Tianjin Key Laboratory of Molecular Optoelectronic Sciences, Department of Chemistry, School of Science, Tianjin University, Tianjin 300354, China
| | - Guangjiu Zhao
- Tianjin Key Laboratory of Molecular Optoelectronic Sciences, Department of Chemistry, School of Science, Tianjin University, Tianjin 300354, China.
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15
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Untiveros G, Dezi L, Gillette M, Sidor J, Strizzi L. Normal Skin Cells Increase Aggressiveness of Cutaneous Melanoma by Promoting Epithelial-to-Mesenchymal Transition via Nodal and Wnt Activity. Int J Mol Sci 2021; 22:11719. [PMID: 34769150 PMCID: PMC8583838 DOI: 10.3390/ijms222111719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/20/2021] [Accepted: 10/26/2021] [Indexed: 01/17/2023] Open
Abstract
Melanoma is a lethal form of skin cancer triggered by genetic and environmental factors. Excision of early-stage, poorly aggressive melanoma often leads to a successful outcome; however, left undiagnosed these lesions can progress to metastatic disease. This research investigates whether the exposure of poorly aggressive melanoma to certain normal skin cells can explain how non-metastatic melanoma becomes more aggressive while still confined to the skin. To this end, we used a serial co-culture approach to sequentially expose cells from two different, poorly aggressive human melanoma cell lines against normal cells of the skin beginning with normal melanocytes, then epidermal keratinocytes, and finally dermal fibroblasts. Protein extraction of melanoma cells occurred at each step of the co-culture sequence for western blot (WB) analysis. In addition, morphological and functional changes were assessed to detect differences between the serially co-cultured melanoma cells and non-co-cultured cells. Results show that the co-cultured melanoma cells assumed a more mesenchymal morphology and displayed a significant increase in proliferation and invasiveness compared to control or reference cells. WB analysis of protein from the co-cultured melanoma cells showed increased expression of Snail and decreased levels of E-cadherin suggesting that epithelial-to-mesenchymal transition (EMT) is occurring in these co-cultured cells. Additional WB analysis showed increased levels of Nodal protein and signaling and signs of increased Wnt activity in the co-cultured melanoma cells compared to reference cells. These data suggest that interaction between poorly aggressive melanoma cells with normal cells of the skin may regulate the transition from localized, poorly aggressive melanoma to invasive, metastatic disease via Nodal and/or Wnt induced EMT.
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Affiliation(s)
- Gustavo Untiveros
- Department of Pathology, College of Graduate Studies, Midwestern University, Downers Grove, IL 60515, USA;
| | - Lindsay Dezi
- Department of Biomedical Sciences, College of Graduate Studies, Midwestern University, Downers Grove, IL 60515, USA;
| | - Megan Gillette
- Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, IL 60515, USA; (M.G.); (J.S.)
| | - Julia Sidor
- Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, IL 60515, USA; (M.G.); (J.S.)
| | - Luigi Strizzi
- Department of Pathology, College of Graduate Studies, Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, IL 60515, USA
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Saginala K, Barsouk A, Aluru JS, Rawla P, Barsouk A. Epidemiology of Melanoma. Med Sci (Basel) 2021; 9:63. [PMID: 34698235 PMCID: PMC8544364 DOI: 10.3390/medsci9040063] [Citation(s) in RCA: 157] [Impact Index Per Article: 52.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/26/2021] [Accepted: 10/18/2021] [Indexed: 12/19/2022] Open
Abstract
Melanoma accounts for 1.7% of global cancer diagnoses and is the fifth most common cancer in the US. Melanoma incidence is rising in developed, predominantly fair-skinned countries, growing over 320% in the US since 1975. However, US mortality has fallen almost 30% over the past decade with the approval of 10 new targeted or immunotherapy agents since 2011. Mutations in the signaling-protein BRAF, present in half of cases, are targeted with oral BRAF/MEK inhibitor combinations, while checkpoint inhibitors are used to restore immunosurveillance likely inactivated by UV radiation. Although the overall 5-year survival has risen to 93.3% in the US, survival for stage IV disease remains only 29.8%. Melanoma is most common in white, older men, with an average age of diagnosis of 65. Outdoor UV exposure without protection is the main risk factor, although indoor tanning beds, immunosuppression, family history and rare congenital diseases, moles, and obesity contribute to the disease. Primary prevention initiatives in Australia implemented since 1988, such as education on sun-protection, have increased sun-screen usage and curbed melanoma incidence, which peaked in Australia in 2005. In the US, melanoma incidence is not projected to peak until 2022-2026. Fewer than 40% of Americans report practicing adequate protection (sun avoidance from 10 a.m.-4 p.m. and regular application of broad-spectrum sunscreen with an SPF > 30). A 2-4-fold return on investment is predicted for a US sun-protection education initiative. Lesion-directed skin screening programs, especially for those at risk, have also cost-efficiently reduced melanoma mortality.
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Affiliation(s)
- Kalyan Saginala
- Plains Regional Medical Group Internal Medicine, Clovis, NM 88101, USA;
| | - Adam Barsouk
- Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA 15232, USA;
| | - John Sukumar Aluru
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02212, USA;
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17
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Chaudhry SB, Armbrecht ES, Gibbons M, Council ML, Knutson A, Lickerman S. Sun Protection Outreach Teaching by Students (SPOTS)-Evaluating the Efficacy of Skin Cancer Prevention Education for Adolescents. Dermatol Surg 2021; 47:926-930. [PMID: 34167128 DOI: 10.1097/dss.0000000000003093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The Sun Protection Outreach Teaching by Students (SPOTS) program addresses an unmet need by training medical students to teach adolescents about skin cancer prevention and early detection. OBJECTIVE To measure (1) changes in adolescents' knowledge, attitudes, and behaviors regarding sun protection and (2) the impact on medical students' confidence in skin cancer preventive counseling. METHODS Pre-SPOTS and 1-month post-SPOTS program surveys were completed by adolescent participants and medical student instructors. RESULTS Amongst adolescent students, analysis of 1,142 pre-program surveys and 618 post-program surveys revealed statistically significant improvements in knowledge, attitudes, and behaviors. Among the favorable results, 26%, 41%, and 20% improvements over baseline were observed in SPF knowledge, preference for natural untanned skin, and intent to wear sunscreen, respectively (p < .001). One-third of adolescents reported having tried to increase sunscreen use. Amongst medical students, analysis of 78 pre-teaching and 74 post-teaching surveys revealed an increase in feeling "very confident" in counseling patients, from 23% pre-teaching to 82% post-teaching (p < .001). CONCLUSION SPOTS demonstrated a dual benefit to adolescents and medical students. The program is available for dermatologists to implement in their communities.
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Affiliation(s)
- Sofia B Chaudhry
- Department of Dermatology, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Eric S Armbrecht
- Saint Louis University Center for Outcomes Research, St. Louis, Missouri
| | | | - M Laurin Council
- The Division of Dermatology, Washington University School of Medicine, St. Louis, Missouri
| | - Alex Knutson
- Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania
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18
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Muzumdar S, Lin G, Kerr P, Grant-Kels JM. Evidence concerning the accusation that melanoma is overdiagnosed. J Am Acad Dermatol 2021; 85:841-846. [PMID: 34116095 DOI: 10.1016/j.jaad.2021.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 06/02/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Melanoma is one of the most commonly diagnosed malignancies in the United States and is responsible for the majority of deaths from skin cancer. OBJECTIVE Since the 1970s, the incidence of melanoma has risen appreciably while melanoma-specific mortality has remained stable. This has raised a debate about potential overdiagnosis of melanoma. Herein, we review temporal trends in melanoma incidence and mortality and explore factors that may contribute to observed trends, including an aging population in the United States, ultraviolet exposure, increased numbers of biopsies by dermatologists and physician extenders, skin cancer screenings, histopathology criteria, and historic underdiagnosis. Additionally, we discuss melanoma overdiagnosis and the extent to which it may contribute to current trends. METHODS The literature was reviewed. RESULTS Several factors may contribute to an increased incidence of melanoma, including an aging population, ultraviolet exposure, increased skin biopsies, skin cancer screenings, histopathologic criteria, historic underdiagnosis, and current overdiagnosis. LIMITATIONS Further studies are required to determine exactly which tumors are being overdiagnosed, and how to improve patient outcomes with adjustment to physician's practice. CONCLUSION The rise in the incidence of melanoma observed since the 1970s is likely multifactorial.
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Affiliation(s)
- Sonal Muzumdar
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Gloria Lin
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Philip Kerr
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut; University of Florida Dermatology Department, Gainesville, Florida.
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19
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Qutob SS, McNamee JP, Brion O. Prevalence of tanning equipment use among Canadians. Prev Med Rep 2021; 22:101356. [PMID: 33850696 PMCID: PMC8022241 DOI: 10.1016/j.pmedr.2021.101356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 02/22/2021] [Accepted: 02/26/2021] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to collect prevalence estimates of indoor tanning usage and associated injuries in Canada. The rapid response component of the 2019 Canadian Community Health Survey collected data on the use of tanning equipment in the previous 12 months, including reasons for use, frequency/duration of use, precautions taken and adverse reactions or injuries. The 2019 research findings were as follows, an estimated 3.0% (95% CI: 2.5-3.4%) of Canadians reported that they had used indoor tanning equipment in the past year. Among users, 71.1% (95% CI: 63.9-78.3%) were female and females aged 18-34 were significantly more prevalent users compared to females aged 45 or older. The prevalence of indoor tanning was higher among people without a university degree; however, there were no differences in prevalence by household income or region. Most users indicated they used indoor tanning equipment within a tanning salon (75.3%: 95% CI: 69.1-81.6%) and the most common reason for usage was to develop a "protective" base tan (72.1%: 95% CI: 65.2-78.9%). Over one third (39.2%: 95% CI: 31.1-47.2%) of all users reported 10 or more sessions in the past year. The prevalence of indoor UV tanning usage is declining in Canada. Similar to results in 2014, the majority of users continue to be female, with a large number in the 18 to 34 age group.
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Affiliation(s)
- Sami S. Qutob
- Consumer and Clinical Radiation Protection Bureau, Health Effects and Assessment Division at Health Canada, Canada
| | - James P. McNamee
- Consumer and Clinical Radiation Protection Bureau, Health Effects and Assessment Division at Health Canada, Canada
| | - Orly Brion
- Environmental Health Science and Research Bureau, Population Studies Division at Health Canada, Canada
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20
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Moreno MA, Jenkins MC, Lazovich D. Tanning Misinformation Posted by Businesses on Social Media and Related Perceptions of Adolescent and Young Adult White Non-Hispanic Women: Mixed Methods Study. JMIR DERMATOLOGY 2021; 4:e25661. [PMID: 37632797 PMCID: PMC10501515 DOI: 10.2196/25661] [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: 11/10/2020] [Revised: 03/05/2021] [Accepted: 04/04/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Indoor ultraviolet (UV) tanning is common and consequential, increasing the risk for cancers including melanoma and basal cell carcinoma. At-risk groups include adolescents and young adults, who often report beliefs about benefits of tanning. Adolescent and young adults are also among the most ubiquitous social media users. As previous studies support that content about tanning is common on social media, this may be a way that young women are exposed to influential content promoting tanning, including health misinformation. OBJECTIVE The purpose of this study was to evaluate health misinformation promoted by indoor tanning businesses via social media and to understand young women's perceptions of this misinformation. METHODS This mixed methods study included (1) retrospective observational content analysis of indoor tanning salons' content on Facebook over 1 year and (2) qualitative interviews with a purposeful national sample of 46 White non-Hispanic women, age 16 to 23 years, who had recently tanned indoors. We assessed experiences with tanning businesses' posted content on social media through interviews. We used the constant comparative approach for qualitative analyses. RESULTS Content analysis findings included data from indoor tanning businesses (n=147) across 50 states, yielding 4956 total posts. Among 9 health misinformation topics identified, the most common was the promotion of UV tanning as a safe way to get Vitamin D (n=73, 1.5%). An example post was "Stop by Body and Sol to get your daily dose of Vitamin D." Another misinformation topic was promoting tanning for health benefits (n=31, 0.62%), an example post was "the flu is not a season, it's an inability to adapt due to decreased sun exposure…" A total of 46 participants completed interviews (age: mean 20 years, SD 2). Almost all participants (45/46, 98%) used Facebook, and 43.5% (20/46) followed an indoor tanning business on social media. Approximately half of participants reported seeing social media posts from tanning salons about Vitamin D, an example of a participant comment was "I have [seen that] a few times..." Among the participants, approximately half believed it was safe to get Vitamin D from indoor UV tanning; a participant stated: "I think it is a valid benefit to UV tanning." CONCLUSIONS Despite the low frequency (range 0.5%-1.5%) of social media posts promoting health misinformation, participants commonly reported viewing these posts, and their perceptions aligned with health misinformation. Health education campaigns, possibly using social media to target at-risk populations, may be an innovative approach for tanning prevention messages.
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Affiliation(s)
- Megan Andreas Moreno
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, United States
| | - Marina C Jenkins
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, United States
| | - DeAnn Lazovich
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, United States
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21
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Karapetyan L, Yang X, Wang H, Sander CA, Moyer A, Wilson M, Karunamurthy A, Kirkwood JM. Indoor tanning exposure in association with multiple primary melanoma. Cancer 2021; 127:560-568. [PMID: 33170961 DOI: 10.1002/cncr.33307] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/17/2020] [Accepted: 10/04/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Patients with primary cutaneous melanoma are at increased risk for subsequent new primary melanomas. Indoor tanning is a recognized risk factor for melanoma. This study was aimed at determining the association between indoor tanning and the occurrence of multiple primary melanoma. METHODS This was a retrospective case-control study of cases with multiple primary melanoma and sex-matched controls with single primary melanoma retrieved at a 1:2 ratio from the Biological Sample and Nevus Bank of the Melanoma Center of the University of Pittsburgh Cancer Institute. Logistic regression models were used to examine the association between multiple primary melanoma and risk factors. RESULTS In total, 330 patients (39.1% men) with a median age of 51 years were enrolled. Compared with patients who had a single primary melanoma, patients with multiple melanomas were younger at the diagnosis of their first primary melanoma and were more likely to be discovered at stage 0 or I and to have had indoor tanning exposure, a family history of melanoma, atypical moles, dysplastic nevi, and a Breslow thickness less than 1 mm. Compared with patients' first melanomas, subsequent melanomas were more likely to be thinner or in situ. The estimated probability of the locus for the second primary being the same as that for the first primary melanoma was 34%. In a multivariate analysis after adjustments for age, a family history of melanoma, the presence of atypical and dysplastic nevi, and recreational sun exposure, indoor tanning remained significantly associated with the occurrence of multiple primary melanoma (odds ratio, 2.75; 95% confidence interval, 1.07-7.08; P = .0356). CONCLUSIONS Indoor tanning is associated with an increased risk of second primary melanoma. Subsequent melanomas are more likely to be thin or in situ and to occur in different anatomic locations.
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Affiliation(s)
- Lilit Karapetyan
- Department of Medicine, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Xi Yang
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Hong Wang
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Cindy A Sander
- Department of Medicine, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Ashley Moyer
- Department of Medicine, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Melissa Wilson
- Department of Medicine, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | - John M Kirkwood
- Department of Medicine, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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22
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Cross-sectional study of sex differences in psychosocial quality of life of long-term melanoma survivors. Support Care Cancer 2021; 29:5663-5671. [PMID: 33580285 DOI: 10.1007/s00520-021-06046-7] [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: 10/13/2020] [Accepted: 02/04/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE A cancer diagnosis and subsequent treatment can have a significant impact on an individual's quality of life. Differences in quality of life by sex among long-term melanoma survivors remain unclear. The objective of this study was to describe sex differences in cancer-specific psychosocial quality of life of long-term melanoma survivors. METHODS Melanoma survivors 7-10 years post-diagnosis from a previously conducted population-based case-control study were recruited for a cross-sectional survey. Validated measures of psychosocial quality of life related to melanoma diagnosis were assessed. Outcomes were compared by sex using linear regression models adjusting for age, education, income, and marital status. RESULTS The survey response rate was 62% (433 females, 291 males; 86% stage I disease). Females were more likely to report changes in their appearance (p = 0.006) and being more fearful of recurrence (p = 0.001) or a second melanoma (p = 0.001) than males but were also more likely to report that melanoma had a positive impact on their lives (p < 0.0001). Males were more likely to agree with statements that emphasized that life's duration is limited (p < 0.0001). CONCLUSION Long-term melanoma survivors reported generally favorable measures of psychosocial quality of life related to their diagnosis. Females and males reported unique quality of life concerns and may require varied methods of support following a melanoma diagnosis.
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Improving the prevention and diagnosis of melanoma on a national scale: A comparative study of performance in the United Kingdom and Australia. J Public Health Policy 2020; 41:28-38. [PMID: 31477796 DOI: 10.1057/s41271-019-00187-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
We undertook this study in light of an uncontrolled rise of melanoma incidence and mortality rates in the United Kingdom (UK). We aim to assess the effectiveness of prevention and early melanoma diagnosis in the UK's National Health Service (NHS) in comparison to the Australian system that has limited the melanoma rise. We compare the prevention campaigns against skin cancer and the stage at which melanoma is diagnosed. We analyse key drivers of early diagnosis. Overall, Australia has performed better than the UK and provides an example for the UK's NHS for better preventing melanoma and diagnosing it. Technologies under development, such as tele-dermatology and artificial intelligence applications, could aid in making melanoma early diagnosis easier, more cost-efficient, and lessen the burden on health systems. Diagnoses also provide the data to help public health officials target prevention programs.
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Solazzo AL, Geller AC, Hay JL, Ziyadeh NJ, Charlton BM, Frazier AL, Austin SB. Indoor Ultraviolet Tanning Among U.S. Adolescents and Young Adults: Results From a Prospective Study of Early Onset and Persistence. J Adolesc Health 2020; 67:609-611. [PMID: 32387094 PMCID: PMC7508899 DOI: 10.1016/j.jadohealth.2020.03.027] [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: 11/21/2019] [Revised: 02/03/2020] [Accepted: 03/07/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of the study was to test whether those who initiate tanning during adolescence are more likely to continue tanning in young adulthood, potentially increasing their risk for melanoma. METHODS The study included prospective data from the Growing Up Today Study, a cohort study started in 1996 (N = 5,882). RESULTS Among men and women who ever indoor UV tanned, those who indoor UV tan by age 17 years consistently indoor tanned at least twice the prevalence as those who did not indoor UV tan by age 17 years. Indoor tanning prevalence at age 27 years was nearly 4 times as high (18.8% vs. 4.8%) among men who started indoor tanning by age 17 years than those who did not indoor tan by age 17 years. These differences persisted through age 27 years and are more pronounced in men (18.8% vs. 4.8%) than in women (30.5% vs. 13.0%). CONCLUSION Adolescents who indoor UV tan by age 17 years are more likely to continue to indoor tan through young adulthood than those who begin indoor UV tanning at age 18 years or older. Our findings suggest that interventions to prevent indoor UV tanning among minors may substantially reduce years of exposure to this carcinogenic behavior in young adults.
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Affiliation(s)
- Alexa L. Solazzo
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital,Department of Epidemiology, Harvard T.H. Chan School of Public Health
| | - Alan C. Geller
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health
| | - Jennifer L. Hay
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center
| | - Najat J. Ziyadeh
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital,Epidemiology, Optum
| | - Brittany M. Charlton
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital,Department of Epidemiology, Harvard T.H. Chan School of Public Health,Department of Pediatrics, Harvard Medical School,Department of Medicine, Channing Division of Network Medicine, Brigham and Women’s Hospital
| | | | - S. Bryn Austin
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital,Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health,Department of Pediatrics, Harvard Medical School,Department of Medicine, Channing Division of Network Medicine, Brigham and Women’s Hospital,Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital
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Burgard B, Reichrath J. Solarium Use and Risk for Malignant Melanoma: Many Open Questions, Not the Time to Close the Debate. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1268:155-170. [PMID: 32918218 DOI: 10.1007/978-3-030-46227-7_8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
To shed further light on the ongoing debate whether sunbed use may increase melanoma risk, we have critically assessed the scientific literature that is at present available, focussing on a meta-analysis that we published recently. Our literature search identified several meta-analyses that report a weak association for ever-exposure to UV radiation from a solarium with melanoma risk. However, the quality of studies included in these meta-analyses and the resulting evidence levels and grades of recommendation were very low due to the lack of interventional trials and because of severe limitations of many of the observational studies. The results of cohort and case-control studies published until today do not prove causality, not even by the Hill criteria. The overall quality of these observational studies and the resulting evidence levels are low due to severe limitations (including unobserved or unrecorded confounding), which leads to bias. It must be recognized that in the majority of studies, published to date, many of the confounding factors, including sun exposure, sunburns and skin type, have not been adequately and systematically recorded and adjusted for. We conclude that the many limitations of the individual studies and the resulting low levels of evidence and grades of recommendation do at present not allow postulation of a causal relationship between solarium use and melanoma risk. At present, there is no convincing evidence that moderate/responsible solarium use increases melanoma risk.
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Affiliation(s)
- Barbara Burgard
- Center for Clinical and Experimental Photodermatology, The Saarland University Hospital, Homburg, Germany.,Center for Clinical and Experimental Photodermatology and Department of Dermatology, Saarland University Medical Center, Homburg, Germany
| | - Jörg Reichrath
- Center for Clinical and Experimental Photodermatology and Department of Dermatology, Saarland University Medical Center, Homburg, Germany.
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Abstract
Abstract
Purpose of Review
Skin cancers account for more than 40% of all cancers in the USA and continue to rise in incidence. It is prudent to understand the current burden and pathogenesis of photocarcinogenesis and preventive measures.
Recent Findings
Insights into recently discovered mechanisms have paved way for potential targets for prevention and therapeutics. Nicotinamide has shown promising results as an oral chemopreventive agent. UVB affects the DHODH pathway of pyrimidine synthesis via STAT 3. DHODH inhibition by leflunomide may be a potential targeted chemoprevention strategy. A photolyase containing sunscreen, which repairs UV-damaged DNA, effectively reduced new precancerous lesions. Several antioxidants and anti-inflammatory agents including many phytochemicals ameliorate the process of photocarcinogenesis in preclinical and clinical studies, e.g., green tea polyphenols, Polypodium leucotomos extract, and Timosaponin A III. Diet can potentially affect skin cancer risk by its ability to modify oxidative stress and cell signaling pathways.
Summary
Photocarcinogenesis is a multi-step process. An in-depth understanding is instrumental in development of novel agents for prevention and treatment of skin cancers.
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Abstract
Sunscreens are an important tool used to protect the skin against harmful effects of ultraviolet (UV) radiation. Many different formulations of sunscreen exist today, which can be confusing to the consumer. In this article, we highlight and address many sunscreen myths that exist today including the benefits of higher SPF sunscreen, use of sunscreen in darker skin types, and the effects of sunscreen on vitamin D production.
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Affiliation(s)
| | - Amor Khachemoune
- Department of Dermatology, Veterans Affairs Medical Center, and State University of New, York, New York, NY, USA
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Goding Sauer A, Siegel RL, Jemal A, Fedewa SA. Current Prevalence of Major Cancer Risk Factors and Screening Test Use in the United States: Disparities by Education and Race/Ethnicity. Cancer Epidemiol Biomarkers Prev 2020; 28:629-642. [PMID: 30944145 DOI: 10.1158/1055-9965.epi-18-1169] [Citation(s) in RCA: 111] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 01/11/2019] [Accepted: 02/21/2019] [Indexed: 11/16/2022] Open
Abstract
Overall cancer death rates in the United States have declined since 1990. The decline could be accelerated by eliminating socioeconomic and racial disparities in major risk factors and screening utilization. We provide an updated review of the prevalence of modifiable cancer risk factors, screening, and vaccination for U.S. adults, focusing on differences by educational attainment and race/ethnicity. Individuals with lower educational attainment have higher prevalence of modifiable cancer risk factors and lower prevalence of screening versus their more educated counterparts. Smoking prevalence is 6-fold higher among males without a high school (HS) education than female college graduates. Nearly half of women without a college degree are obese versus about one third of college graduates. Over 50% of black and Hispanic women are obese compared with 38% of whites and 15% of Asians. Breast, cervical, and colorectal cancer screening utilization is 20% to 30% lower among those with <HS education compared with college graduates. Screening for breast, cervical, and colorectal cancers is also lower among Hispanics, Asians, and American Indians/Alaska Natives relative to whites and blacks. Enhanced, multilevel efforts are needed to further reduce the prevalence of modifiable risk factors and improve screening and vaccination, particularly among those with lower socioeconomic status and racial/ethnic minorities.
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Affiliation(s)
- Ann Goding Sauer
- Intramural Research Department, American Cancer Society, Atlanta, Georgia.
| | - Rebecca L Siegel
- Intramural Research Department, American Cancer Society, Atlanta, Georgia
| | - Ahmedin Jemal
- Intramural Research Department, American Cancer Society, Atlanta, Georgia
| | - Stacey A Fedewa
- Intramural Research Department, American Cancer Society, Atlanta, Georgia
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Huang CM, Kirchhof MG. Evaluation of Indoor Tanning Facilities in American Fitness Centers. J Cutan Med Surg 2020; 24:372-379. [PMID: 32441110 DOI: 10.1177/1203475420923645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Indoor tanning (IT) in fitness facilities encourages a misleading positive relationship between tanning and health. While IT in Canadian fitness facilities has been studied, American literature regarding this topic is lacking. OBJECTIVES The objective of this study is to evaluate availability, cost, reported risks, and adherence to legislation of IT in American fitness clubs. METHODS This was a cross-sectional study utilizing a telephone questionnaire to survey gyms across all 50 states. The key term "fitness club" was searched in the Yellow Pages and 20 facilities from each state were randomly included into the study. Data were described descriptively and Pearson χ2 tests were used to compare IT prevalence and rates of noncompliance between population groups. Regression analysis examined potential relationship between cost and prevalence of IT. RESULTS Of the 1000 fitness clubs surveyed, 44.4% (444/1000) offered IT. The overall noncompliance rates for age, rest time, and eye protection were 13.8% (54/390), 26.0% (20/77), and 27.8% (85/225), respectively. The most common risk reported was skin cancer (61.6%), but many facilities were unsure of risks (27.0%) and some described no risk associated with IT (3.2%). The average cost for monthly unlimited tanning was 33 ± 13.96 USD. A state-to-state comparison showed a statistically significant inverse relationship between mean cost and prevalence of IT (P = .013, [r]= -0.35). CONCLUSION The prevalence and noncompliance rates of IT in fitness clubs contradict the healthy lifestyles they are working to promote. To limit harms, legislations should be standardized and more strictly enforced. Additionally, public education on IT risks and the use of higher costs may help minimize IT use.
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Affiliation(s)
- Christina M Huang
- 12365 Division of Dermatology, Department of Medicine, University of Ottawa, ON, Canada.,The Ottawa Hospital, ON, Canada
| | - Mark G Kirchhof
- 12365 Division of Dermatology, Department of Medicine, University of Ottawa, ON, Canada.,The Ottawa Hospital, ON, Canada
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Robsahm TE, Stenehjem JS, Berge LAM, Veierød MB. Prevalence of Indoor Tanning Among Teenagers in Norway Before and After Enforcement of Ban for Ages Under 18 Years. Acta Derm Venereol 2020; 100:adv00127. [PMID: 32285136 PMCID: PMC9128903 DOI: 10.2340/00015555-3482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- Trude E Robsahm
- Department of Research, Cancer Registry of Norway, Institute of Population Based Cancer Research, PB 5313 Majorstuen, NO-0304 Oslo, Norway. E-mail:
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Abstract
Ultraviolet (UV) irradiation causes various types of DNA damage, which leads to specific mutations and the emergence of skin cancer in humans, often decades after initial exposure. Different UV wavelengths cause the formation of prominent UV-induced DNA lesions. Most of these lesions are removed by the nucleotide excision repair pathway, which is defective in rare genetic skin disorders referred to as xeroderma pigmentosum. A major role in inducing sunlight-dependent skin cancer mutations is assigned to the cyclobutane pyrimidine dimers (CPDs). In this review, we discuss the mechanisms of UV damage induction, the genomic distribution of this damage, relevant DNA repair mechanisms, the proposed mechanisms of how UV-induced CPDs bring about DNA replication-dependent mutagenicity in mammalian cells, and the strong signature of UV damage and mutagenesis found in skin cancer genomes.
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Jewett PI, Lazovich D, Wehelie H, Boull C, Vogel RI. Sun exposure and protection behaviors in urban and rural long-term melanoma survivors. Arch Dermatol Res 2019; 312:413-420. [PMID: 31845013 DOI: 10.1007/s00403-019-02023-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 12/03/2019] [Accepted: 12/07/2019] [Indexed: 11/24/2022]
Abstract
Given the increased risk for another occurrence of melanoma among melanoma survivors, safe sun behaviors are important. Little data exist about differences in sun behaviors among melanoma survivors residing in urban versus rural communities. We wanted to describe differences in sun exposure and protection behaviors by urban/rural status among melanoma survivors. We conducted a secondary data analysis of 724 melanoma survivors who participated in a cross-sectional survey. Unadjusted and adjusted logistic regression models assessed urban versus rural differences in sun exposure and protection behaviors. Unadjusted analyses showed evidence that urban melanoma survivors spent less time in the sun on weekdays and were more likely to use sunscreen, however, these differences disappeared when adjusting for confounding factors. Our study provides little evidence that rurality is an independent risk factor for worse sun protection behaviors in melanoma survivors after accounting for sociodemographic differences, but rurality as a broader term may be partially defined by urban versus rural sociodemographic differences. Skin health messaging to rural melanoma survivors should emphasize on ways to protect oneself from UV radiation even when spending time outside.
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Affiliation(s)
- Patricia I Jewett
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, 420 Delaware Street SE, MMC 395, Minneapolis, MN, 55455, USA.,Department of Medicine, Division of Hematology and Oncology, University of Minnesota, Minneapolis, MN, USA
| | - DeAnn Lazovich
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Hibo Wehelie
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, 420 Delaware Street SE, MMC 395, Minneapolis, MN, 55455, USA
| | - Christina Boull
- Department of Dermatology, University of Minnesota, Minneapolis, MN, USA
| | - Rachel I Vogel
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, 420 Delaware Street SE, MMC 395, Minneapolis, MN, 55455, USA.
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Abstract
Sexual and gender minorities have unique risk factors that may increase their risk of developing skin cancer. In particular, sexual minority men report a higher prevalence of skin cancer (including both keratinocytes carcinomas and melanoma), higher rates of indoor tanning, and overall poorer sun protection behaviors. Sexual and gender minorities also have high rates of alcohol and tobacco use, and infection with human immunodeficiency virus and human papillomavirus, which may increase overall risk of developing skin cancer in these populations. In this review, we discuss the evidence surrounding skin cancer and associated risk factors among sexual and gender minorities.
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Heckman CJ, Auerbach MV, Darlow S, Handorf EA, Raivitch S, Manne SL. Association of Skin Cancer Risk and Protective Behaviors with Health Literacy Among Young Adults in the USA. Int J Behav Med 2019; 26:372-379. [PMID: 31147962 DOI: 10.1007/s12529-019-09788-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The goal of this study was to investigate the association of health literacy with skin cancer risk and protective behaviors among young adults at moderate to high risk of skin cancer, the most common cancer. METHOD A US national sample of 958 adults, 18-25 years old, at moderate to high risk of developing skin cancer, completed a survey online. Behavioral outcomes were ultraviolet (UV) radiation exposure (e.g., indoor and outdoor tanning, sunburn) and protective (e.g., sunscreen use, sunless tanning) behaviors. Multivariable regression analyses were conducted to determine whether health literacy (a four-item self-report measure assessing health-related reading, understanding, and writing) was associated with behavioral outcomes while controlling for demographic factors. RESULTS Higher health literacy was independently associated with less sunbathing, odds ratio (OR) = 0.77, 95% confidence interval (CI) = 0.60-0.98; less indoor tanning, OR = 0.38, CI = 0.31-0.48; and less use of tanning oils, OR = 0.54, CI = 0.43-0.69. However, health literacy was also associated with a lower likelihood of wearing long pants, OR = 0.76, CI = 0.58-0.99, or a hat, OR = 0.68, CI = 0.53-0.87, when outdoors. On the other hand, higher health literacy was associated with higher incidental UV exposure, OR = 1.69, CI = 1.34-2.14, and a greater likelihood of ever having engaged in sunless tanning, OR = 1.50, CI = 1.17-1.92. CONCLUSION Interestingly, higher health literacy was associated with lower levels of intentional tanning yet also higher incidental UV exposure and lower skin protection among US young adults. These findings suggest that interventions may be needed for young adults at varying levels of health literacy as well as populations (e.g., outdoor workers, outdoor athletes/exercisers) who may be receiving large amounts of unprotected incidental UV.
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Affiliation(s)
- Carolyn J Heckman
- Rutgers Cancer Institute of New Jersey, 195 Little Albany St, New Brunswick, NJ, 08901, USA.
| | | | - Susan Darlow
- National Comprehensive Cancer Network, Plymouth Meeting, PA, USA
| | | | | | - Sharon L Manne
- Rutgers Cancer Institute of New Jersey, 195 Little Albany St, New Brunswick, NJ, 08901, USA
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Burbidge TE, Bastian BC, Guo D, Li H, Morris DG, Monzon JG, Leung G, Yang H, Cheng T. Association of Indoor Tanning Exposure With Age at Melanoma Diagnosis and BRAF V600E Mutations. J Natl Cancer Inst 2019; 111:1228-1231. [PMID: 30923800 DOI: 10.1093/jnci/djz048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 02/21/2019] [Accepted: 03/26/2019] [Indexed: 02/03/2023] Open
Abstract
There is limited information on how indoor tanning promotes melanoma development. We investigated indoor tanning use in patients with melanomas in sun-exposed skin and studied the clinicopathological and molecular characteristics in relation to indoor tanning exposure. Patients from a multidisciplinary clinic for cutaneous cancers completed standardized questionnaires on risk factors for melanoma as a component of medical history at their initial consultations. For this study, we included patients from December 2013 to May 2015. The 114 patients who reported indoor tanning exposure were younger at diagnosis than the 222 patients who did not (51.5 vs 64.0 years, two-sided P < .001). BRAF V600E genotype was more prevalent in ever-users than in nonusers (42.9% vs 28.3%, two-sided P = .04) and higher in ever-users who initiated indoor tanning prior to age 25 years compared with age 25 years or older (62.2% vs 31.1%, two-sided P = .003). There were more melanomas in intermittently sun-exposed skin in ever-users than nonusers (65.7% vs 51.9%, respectively, two-sided P = .02). Our data suggest indoor tanning may promote melanomas that arise in skin with low-chronic sun-induced damage through BRAF V600E-mediated melanomagenesis.
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Carcioppolo N, Orrego Dunleavy V, Myrick JG. A Closer Look at Descriptive Norms and Indoor Tanning: Investigating the Intermediary Role of Positive and Negative Outcome Expectations. HEALTH COMMUNICATION 2019; 34:1619-1627. [PMID: 30198759 DOI: 10.1080/10410236.2018.1517632] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Indoor tanning is a risky behavior that dramatically increases skin cancer risk. Researchers from multiple disciplines aim to better understand this behavior to develop interventions and messages to curtail it. As such, we investigated the role of social norms and outcome expectations as predictors of tanning behavior as part of a larger test of constructs included in the Theory of Normative Social Behavior. In addition to offering additional empirical results to support theoretical claims for the importance of social norms and outcome expectations in predicting health behaviors, we offer indoor tanning-specific operationalizations in a conditional process model with the aim of assessing how content-specific measurements predict indoor tanning intentions. Results of a survey of adult indoor tanners from across the U.S. (N = 262) highlight when and how descriptive norms influence tanning intentions through the mediating roles of anticipatory socialization, injunctive norms, and health threat, and through the moderating role of mood-based tanning motivations. Implications for theory building as well as for intervention and message design are discussed.
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Affiliation(s)
- Nick Carcioppolo
- Department of Communication Studies and Affiliate Faculty at the Sylvester Comprehensive Cancer Center, University of Miami
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Abstract
PURPOSE OF REVIEW The goal of this review has been to elucidate the sex differences in cancer incidence and mortality in cutaneous melanoma. We have evaluated biological and behavioral research to determine where the critical questions exist. RECENT FINDINGS The most recent findings, through 2015, are exploratory in nature but seem to indicate that the differences are more likely due to biological variations rather than behavioral. While behavioral studies do show that women are more likely than men to seek health care and practice healthy behaviors, these differences are not sufficiently strong to explain the variation in incidence and mortality in cutaneous melanoma. Evolved differences in the immune systems of females and the role of sex steroid hormones in immunomodulation are two promising avenues for research. Studies in mice demonstrate that the newer immunotherapies are more effective in females and sex steroid hormones, such as estrogen receptor beta are inversely associated with tumor aggressiveness while testosterone increases it. SUMMARY Our analysis indicates that biological factors need to be investigated more thoroughly to understand the variation in incidence and mortality in cutaneous melanoma. Such understanding could lead to reducing incidence and mortality for both males and females (male incidence is 27.4 per 100,000; female 16.8 per 100,000; male mortality is 3.9 per 100,000; female mortality 1.6 per 100,000). It is most likely that behavioral differences between the sexes cannot account for the preponderance of male mortality. In addition to the important role of genetic factors, it is critical to evaluate further additional biological factors and their interactions with genetics and behavior.
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Affiliation(s)
| | - Li Luo
- University of New Mexico Comprehensive Cancer Center, Department of Internal Medicine
| | - Marianne Berwick
- University of New Mexico Comprehensive Cancer Center, Department of Internal Medicine and Department of Dermatology
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38
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Basch CH, Hillyer GC, Kecojevic A, Ku CS, Basch CE. Indoor tanning and poor mental health among adolescents in New York City (2015). J Health Psychol 2019; 26:870-879. [DOI: 10.1177/1359105319852668] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study explored relationships between mental health and indoor tanning among high school students in New York City using 2015 data from the Youth Risk Behavior Surveillance System. Those more likely to use indoor tanning were females (odds ratio = 6.26, 95% confidence interval = 6.08–6.45) and non-Hispanic White (odds ratio = 1.10, 95% confidence interval = 1.06–1.14). Being bullied on school property (odds ratio = 1.30, 95% confidence interval = 1.25–1.34), having attempted suicide (odds ratio = 2.08, 95% confidence interval = 1.99–2.18), and having sought counseling (odds ratio = 1.22, 95% confidence interval = 1.18–1.26) were significantly associated with indoor tanning. This study indicates that engaging in indoor tanning is associated with a number of mental health factors.
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Heckman CJ, Handorf E, Auerbach MV. Prevalence and Correlates of Skin Cancer Screening Among Indoor Tanners and Nontanners. JAMA Dermatol 2019; 154:554-560. [PMID: 29617518 DOI: 10.1001/jamadermatol.2018.0163] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Importance The US Food and Drug Administration recommends that indoor tanners (ITs) be screened regularly for skin cancer (SC). Objective To investigate the association between indoor tanning and SC screening. Design, Setting, and Participants The 2015 National Health Interview Survey was a multistage, clustered, cross-sectional design with 30 352 US adults participating. The response rate for the sample adult data used in this study was 55.20% after excluding 1099 individuals who reported a history of SC and 2221 individuals with unknown SC screening or indoor tanning history. To examine the independent correlates of screening, we conducted multiple logistic regressions separately for ITs and nontanners (NTs), simultaneously including all preselected variables of interest as potential predictors. Formal interaction analyses were also performed to determine if the covariate effects differed significantly between ITs and NTs. Exposures Indoor tanning as well as sociodemographic, health care, and SC risk and sun protection factors. Main Outcomes and Measures The primary outcome was self-reported full-body SC screening by a physician. Univariable and multivariable analyses were conducted to determine the secondary outcome, correlates of SC screening among ITs and NTs. Results A total of 15 777 participants (51.98%) were female, and 23 823 (78.49%) were white; 4987 (16.43%) of the sample had indoor tanned, and 1077 (21.59%) of these had tanned last year. A total of 1505 ITs (30.18%) and 4951 NTs (19.52%) had been screened for SC. Correlates of screening for ITs and NTs were older age (ITs: odds ratio [OR], 4.29 [95% CI, 2.72-6.76]; NTs, OR, 5.14 [95% CI, 4.01-6.58], age ≥65 years vs 18-29 years), higher income (ITs: OR, 2.08 [95% CI, 1.50-2.88]; NTs: OR, 1.79 [95% CI, 1.51-2.12]; >$100 000 vs $0-34 999), seeking online health information (ITs, OR, 0.71 [95% CI. 0.56-0.91; NTs, OR, 0.65 [95% CI, 0.58-0.72], for not looking up health info online), family history of melanoma (ITs: OR, 1.92 [95% CI, 1.26-2.93]; NTs: OR, 1.58 [95% CI, 1.21-2.05]) or SC (ITs: OR, 1.59 [95% CI, 1.17-2.17; NTs: OR, 1.61 [95% CI, 1.33-1.94]), very high SPF sunscreen use (ITs: OR, 0.57 [95% CI, 0.42-0.78]; NTs: OR, 0.71 [95% CI, 0.61-0.82], use of SPF of 1-14 vs SPF of >50), and receipt of a professional spray-on tan (ITs: OR, 0.60 [ 95% CI, 0.41-0.88]; NTs: OR, 0.51 [95% CI, 0.32-0.81], for not receiving a salon spray-on tan). Correlates for NTs only were white race (blacks: OR, 0.45 [95% CI, 0.37-0.54], others: OR, 0.40 [95% CI, 0.33-0.48]), non-Hispanic ethnicity (Hispanics: OR, 0.42 [95% CI, 0.36-0.50]), email use (no email: OR, 0.67 [95% CI, 0.56-0.80]), having a usual clinic/or physician's office (no usual place: OR, 0.56 [95% CI, 0.40-0.78]), emergency department visits (OR, 1.20 [95% CI, 1.06-1.35]), having had a previous cancer diagnosis (no cancer diagnosis: OR, 0.67 [95% CI, 0.57-0.79]), not being worried about medical bills (OR, 1.37 [95% CI, 1.15-1.63] vs very worried), sun protection (rarely/never: OR, 0.43 [95% CI, 0.34-0.56]), and sunless self-tanning (not using: OR, 0.62 [95% CI, 0.47-0.83]). Conclusions and Relevance Few ITs have been screened for SC, although SC rates are higher than among NTs. It is not surprising that SC screening is associated with SC risk factors (eg, family history of SC and age) among ITs. However, some unscreened ITs may be putting themselves at even greater risk of SC by also being more likely to use low SPF sunscreen than ITs who have been screened for SC.
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Zaffran K, Lazovich D, Boull C, Vogel RI. Patient satisfaction with patient-provider interactions at time of diagnosis among early stage melanoma survivors: A cross-sectional survey. J Am Acad Dermatol 2019; 81:1207-1209. [PMID: 30986476 DOI: 10.1016/j.jaad.2019.04.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 03/29/2019] [Accepted: 04/02/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Kailey Zaffran
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - DeAnn Lazovich
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota; Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Christina Boull
- Department of Dermatology, Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Rachel I Vogel
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota; Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Women's Health, Medical School, University of Minnesota, Minneapolis, Minnesota.
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Abstract
Incidence of malignant melanoma has been increasing since the 1980s. For loco-regional stages, surgery is still the best treatment. Melanoma has a high distant metastatic potential and prognosis of advanced stages was until recently very poor. Since 2011 however, a real revolution has taken place in the treatment of metastatic melanoma. This is based upon considerably improved knowledge of the molecular mechanisms of melanoma and cancer immunology. Thus, two new classes of systemic therapeutic agents are now available: immunotherapies (immunological checkpoint inhibitors), which increase the antitumor immune response, and targeted therapies (BRAF and MEK inhibitors) for patients with BRAF V600-mutant melanoma. Overall survival is now 2 years or above, with hope for a cure in some cases. Unfortunately, the efficacy of these treatments is incomplete and many studies are underway to try to identify predictive biomarkers, and multiple combinations are being evaluated to increase response rates. The efficacy of these treatments has also been shown in the adjuvant setting in high-risk melanoma, they should be available shortly.
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Affiliation(s)
- C Longvert
- Service de dermatologie, EA4340 biomarqueurs en cancérologie et onco-hématologie, UVSQ, université Paris-Saclay, hôpital Ambroise-Paré, AP-HP, 9, avenue Charles-de-Gaulle, 92104 Boulogne-Billancourt cedex, France.
| | - P Saiag
- Service de dermatologie, EA4340 biomarqueurs en cancérologie et onco-hématologie, UVSQ, université Paris-Saclay, hôpital Ambroise-Paré, AP-HP, 9, avenue Charles-de-Gaulle, 92104 Boulogne-Billancourt cedex, France
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42
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Køster B, Meyer MKH, Andersson TML, Engholm G, Dalum P. Skin cancer projections and cost savings 2014-2045 of improvements to the Danish sunbed legislation of 2014. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2019; 35:78-86. [PMID: 30198585 PMCID: PMC7379953 DOI: 10.1111/phpp.12424] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 08/13/2018] [Accepted: 09/02/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND Sunbed use increases the risk of skin cancer. The Danish sunbed legislation (2014) did not include an age limit. AIM To model skin cancer incidences and saved costs from potential effects of structural interventions on prevalence of sunbed use. MATERIALS AND METHODS Survey data from 2015 were collected for 3999 Danes, representative for the Danish population in regards to age, gender and region. Skin cancer incidences were modelled in the Prevent program, using population projections, historic cancer incidence, sunbed use exposure and relative risk of sunbed use on melanoma. RESULTS If structural interventions like an age limit of 18 years for sunbed use or complete ban had been included in the Danish sunbed legislation in 2014, it would have reduced the annual number of skin cancer cases with 455 or 4177, respectively, while for the entire period, 2014-2045 the total reductions would be 3730 or 81 887 fewer cases, respectively. The cost savings from an age limit or ban, respectively, are 9 and 129 millions € during 2014-2045. CONCLUSION Legislative restrictive measures which could reduce the sunbed use exists. Danish politicians have the opportunity, supported by the population, to reduce the skin cancer incidence and thereby to reduce the future costs of skin cancer.
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Affiliation(s)
- Brian Køster
- Department of Prevention and Information, Danish Cancer Society, Copenhagen, Denmark
| | - Maria K H Meyer
- Department of Prevention and Information, Danish Cancer Society, Copenhagen, Denmark
| | - Therese M-L Andersson
- Department of Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Gerda Engholm
- Department of Documentation and Quality, Danish Cancer Society, Copenhagen, Denmark
| | - Peter Dalum
- Department of Prevention and Information, Danish Cancer Society, Copenhagen, Denmark
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Longo M, Bulliard J, Correia O, Maier H, Magnússon S, Konno P, Goad N, Duarte A, Oláh J, Nilsen L, Peris K, Karls R, Forsea A, del Marmol V. Sunbed use legislation in Europe: assessment of current status. J Eur Acad Dermatol Venereol 2019; 33 Suppl 2:89-96. [DOI: 10.1111/jdv.15317] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/20/2018] [Indexed: 12/17/2022]
Affiliation(s)
- M.I. Longo
- Department of Dermatology; University of Florida College of Medicine; Gainesville FL USA
| | - J.L. Bulliard
- Institute of Social and Preventive Medicine (IUMSP); Lausanne University Hospital; Lausanne Switzerland
| | - O. Correia
- Centro Dermatologia Epidermis; Instituto CUF; Porto Portugal
| | - H. Maier
- Department of Dermatology; Medical University of Vienna; Vienna Austria
| | | | - P. Konno
- Department of Dermatology; East Tallinn Central Hospital; Tallinn Estonia
| | - N. Goad
- British Association of Dermatologists; London UK
| | - A.F. Duarte
- Centro Dermatologia Epidermis; Instituto CUF; Porto Portugal
| | - J. Oláh
- Department of Dermatology and Allergology; University of Szeged; Szeged Hungary
| | - L.T.N. Nilsen
- Norwegian Radiation Protection Authority; Østerås Norway
| | - K. Peris
- Department of Dermatology; Catholic University of the Sacred Heart; Milano Italy
| | - R. Karls
- Department of Infectology and Dermatology; Riga Stradins University; Riga Latvia
| | - A.M. Forsea
- Department of Dermatology; Elias University Hospital; Carol Davila University of Medicine and Pharmacy; Bucharest Romania
| | - V. del Marmol
- Department of Dermatology; Hôpital Erasme; Université Libre de Bruxelles; Brussels Belgium
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Li Y, Kulkarni M, Trinkaus K, Cornelius LA. Second primary melanomas: Increased risk and decreased time to presentation in patients exposed to tanning beds. J Am Acad Dermatol 2018; 79:1101-1108. [DOI: 10.1016/j.jaad.2018.06.067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 04/06/2018] [Accepted: 06/20/2018] [Indexed: 10/28/2022]
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Daniel CL, Hay JL, Welles BF, Geller AC. The urgent need to ban youth indoor tanning: evidence from college undergraduates. Transl Behav Med 2018; 7:645-647. [PMID: 28144835 DOI: 10.1007/s13142-017-0469-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- Casey L Daniel
- Mitchell Cancer Institute, University of South Alabama, 1660 Springhill Avenue, Mobile, AL, 36604-1405, USA.
| | - Jennifer L Hay
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | | | - Alan C Geller
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Køster B, Meyer MKH, Andersson TML, Engholm G, Dalum P. Sunbed use 2007-2015 and skin cancer projections of campaign results 2007-2040 in the Danish population: repeated cross-sectional surveys. BMJ Open 2018; 8:e022094. [PMID: 30158228 PMCID: PMC6119446 DOI: 10.1136/bmjopen-2018-022094] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To evaluate the effect of the Danish Sun Safety Campaign 2007-2015 on the prevalence of sunbed use and to model future effects on the skin cancer incidences 2007-2040. DESIGN The study has a repeated, cross-sectional design. SETTING Exposure to ultraviolet radiation is the main risk factor for skin cancer. Denmark has the highest prevalence of sunbed use reported and one of the highest incidences of skin cancer worldwide. PARTICIPANTS During 2007-2015, survey data were collected for 37 766 Danes, representative of the Danish population with regards to age, gender and region. INTERVENTIONS In 2007, an ongoing long-term antisunbed campaign was launched in Denmark. PRIMARY AND SECONDARY OUTCOME MEASURES Sunbed use was evaluated by annual cross-sectional surveys. Skin cancer incidence was modelled in the Prevent programme, using population projections, historic cancer incidence, sunbed use exposure and relative risk of sunbed use on melanoma. RESULTS The prevalence of recent sunbed use in Denmark was reduced from 32% and 18% to 13% and 8% for women and men, respectively. The campaigns results during 2007-2015 are estimated to reduce the number of skin cancer cases from more than 5000 (746malignant melanoma, 1562 SCC, 2673 BCC) totally during 2007-2040. Keeping the 2015 level of sunbed use constant by continued campaign pressure or introduction of structural interventions would potentially prevent more than 750 skin cancer cases annually in 2040 and 16 000 skin cancer cases in total during 2007-2040. CONCLUSION We have shown the value of prevention and of long-term planning in prevention campaigning. Sunbed use was reduced significantly during 2007-2015 and further reductions are possible by structural interventions. Consequently, significantly fewer skin cancer cases are anticipated during 2007-2040. The Danish Parliament has population support to enforce structural interventions to avoid a large burden of this disease.
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Affiliation(s)
- Brian Køster
- Department of Prevention and Information, Danish Cancer Society, Copenhagen, Denmark
| | - Maria KH Meyer
- Department of Prevention and Information, Danish Cancer Society, Copenhagen, Denmark
| | - Therese M-L Andersson
- Department of Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Gerda Engholm
- Department of Documentation and Quality, Danish Cancer Society, Copenhagen, Denmark
| | - Peter Dalum
- Department of Prevention and Information, Danish Cancer Society, Copenhagen, Denmark
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Ferreira T, Santos IDDAO, Oliveira AF, Ferreira LM. Retrospective study of patients with cutaneous melanoma treated at the Federal University of São Paulo. Rev Col Bras Cir 2018; 45:e1715. [PMID: 30088522 DOI: 10.1590/0100-6991e-20181715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 05/17/2018] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE to evaluate the characteristics of the patients with cutaneous melanoma treated at the São Paulo Hospital - UNIFESP. METHODS we conducted a retrospective study of 184 cases of cutaneous melanoma. We analyzed information on gender, age, tumor characteristics, histological characteristics and staging. RESULTS mean age at diagnosis was 58.7 years, with homogeneous age distribution between genders and predominance in white individuals (70.6%). There was a predominance of trunk involvement in men (36.7%) and lower limbs in women (42%). Sun exposure, with sunburns, was more common among males (31.2%) than among females (23.5%). There was an approximately three-fold increase in lymph node involvement when the mitotic index rose from zero (11.9%) to one or more mitosis per field (36.2%). In addition, the greater the Breslow thickness, the greater the lymph node involvement and poor the outcomes: 10.2% when less than 1mm and 59.2% when greater than 4mm. CONCLUSION the characteristics of patients with cutaneous melanoma treated at Hospital São Paulo are similar to those found in the literature.
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Affiliation(s)
- Tácito Ferreira
- Universidade Federal de São Paulo, Disciplina de Cirurgia Plástica, São Paulo, SP, Brasil
| | | | | | - Lydia Masako Ferreira
- Universidade Federal de São Paulo, Disciplina de Cirurgia Plástica, São Paulo, SP, Brasil
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Affiliation(s)
- Alan C Geller
- Alan C. Geller is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA
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Lazovich D. Effect of Parental Permission and Age Restriction Laws on US Adolescent Indoor Tanning Trends. Am J Public Health 2018; 108:851-853. [DOI: 10.2105/ajph.2018.304458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- DeAnn Lazovich
- DeAnn Lazovich is with the Division of Epidemiology and Community Health, School of Public Health, and the Masonic Cancer Center, University of Minnesota, Minneapolis
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Tripp MK. Tanning Addiction in Adolescents: Directions for Measurement and Intervention Development. J Invest Dermatol 2018; 138:1465-1467. [PMID: 29941096 DOI: 10.1016/j.jid.2018.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 05/08/2018] [Accepted: 05/08/2018] [Indexed: 10/28/2022]
Abstract
Little is known about tanning addiction in adolescents. Miller et al. found that 7.0% of 11th grade students met addiction criteria. After adjusting for all other comorbidities, the odds of addiction were two times greater for students who reported problem use of marijuana or obsessive-compulsive disorder symptoms. The likelihood of addiction increased with problem substance use and psychological symptoms.
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Affiliation(s)
- Mary K Tripp
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
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