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Gefeller O, Kaiser I, Brockmann EM, Uter W, Pfahlberg AB. The Level of Agreement between Self-Assessments and Examiner Assessments of Melanocytic Nevus Counts: Findings from an Evaluation of 4548 Double Assessments. Curr Oncol 2024; 31:2221-2232. [PMID: 38668067 PMCID: PMC11048774 DOI: 10.3390/curroncol31040164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/04/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Cutaneous melanoma (CM) is a candidate for screening programs because its prognosis is excellent when diagnosed at an early disease stage. Targeted screening of those at high risk for developing CM, a cost-effective alternative to population-wide screening, requires valid procedures to identify the high-risk group. Self-assessment of the number of nevi has been suggested as a component of such procedures, but its validity has not yet been established. We analyzed the level of agreement between self-assessments and examiner assessments of the number of melanocytic nevi in the area between the wrist and the shoulder of both arms based on 4548 study subjects in whom mutually blinded double counting of nevi was performed. Nevus counting followed the IARC protocol. Study subjects received written instructions, photographs, a mirror, and a "nevometer" to support self-assessment of nevi larger than 2 mm. Nevus counts were categorized based on the quintiles of the distribution into five levels, defining a nevus score. Cohen's weighted kappa coefficient (κ) was estimated to measure the level of agreement. In the total sample, the agreement between self-assessments and examiner assessments was moderate (weighted κ = 0.596). Self-assessed nevus counts were higher than those determined by trained examiners (mean difference: 3.33 nevi). The level of agreement was independent of sociodemographic and cutaneous factors; however, participants' eye color had a significant impact on the level of agreement. Our findings show that even with comprehensive guidance, only a moderate level of agreement between self-assessed and examiner-assessed nevus counts can be achieved. Self-assessed nevus information does not appear to be reliable enough to be used in individual risk assessment to target screening activities.
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Affiliation(s)
- Olaf Gefeller
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (I.K.); (W.U.); (A.B.P.)
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2
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Fazzari V, Moo-Choy A, Panoyan MA, Abbatangelo CL, Polimanti R, Novroski NM, Wendt FR. Multi-ancestry tandem repeat association study of hair colour using exome-wide sequencing. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.02.24.581865. [PMID: 38464141 PMCID: PMC10925195 DOI: 10.1101/2024.02.24.581865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Hair colour variation is influenced by hundreds of positions across the human genome but this genetic contribution has only been narrowly explored. Genome-wide association studies identified single nucleotide polymorphisms (SNPs) influencing hair colour but the biology underlying these associations is challenging to interpret. We report 16 tandem repeats (TRs) with effects on different models of hair colour plus two TRs associated with hair colour in diverse ancestry groups. Several of these TRs expand or contract amino acid coding regions of their localized protein such that structure, and by extension function, may be altered. We also demonstrate that independent of SNP variation, these TRs can be used to great an additive polygenic score that predicts darker hair colour. This work adds to the growing body of evidence regarding TR influence on human traits with relatively large and independent effects relative to surrounding SNP variation.
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Beaulieu D, Tsao H, Michaud DS, Okhovat JP, Halpern AC, Geller AC. Factors associated with suspected nonmelanoma skin cancers, dysplastic nevus, and cutaneous melanoma among first-time SpotMe screening program participants during 2009-2010. J Am Acad Dermatol 2023; 88:60-70. [PMID: 30543833 DOI: 10.1016/j.jaad.2018.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/30/2018] [Accepted: 12/02/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND There have been no studies of the American Academy of Dermatology's SpotMe skin cancer screening program to collectively analyze and determine the factors associated with suspected basal cell carcinoma (BCC), squamous cell carcinoma (SCC), dysplastic nevus (DN), and cutaneous melanoma (CM) diagnoses. OBJECTIVE Describe the demographics, risk factors, and access to care profiles associated with suspected diagnoses of BCC, SCC, DN, and CM among first-time SpotMe screenees during 2009-2010. METHODS We conducted a cross-sectional analysis of data from the SpotMe skin cancer screenings conducted in 2009 and 2010. We performed multivariable logistic regression analysis for each diagnosis, incorporating standard demographic, access to care, and risk factor variables in the models. RESULTS Men, those without a regular dermatologist, persons reporting recently changing moles, and those with a personal history of melanoma were at increased risk for each of the suspected diagnoses analyzed. Uninsured persons were at increased risk for suspected malignancies (BCC, SCC, and CM). LIMITATIONS Lack of histologic confirmation for diagnoses and cross-sectional design. CONCLUSION Among first-time SpotMe participants, suspected diagnoses of BCC, SCC, DN, and CM shared several associated factors, which may be considered when planning outreach and screening for populations at risk for skin cancer.
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Affiliation(s)
- Derek Beaulieu
- Tufts University School of Medicine, Tufts Clinical and Translational Science Institute, Boston, Massachusetts; Signature Healthcare Brockton Hospital, Beth Israel Deaconess Medical Center, Brockton, Massachusetts
| | - Hensin Tsao
- Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Dominique S Michaud
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Tufts Clinical and Translational Science Institute, Boston, Massachusetts
| | - Jean-Phillip Okhovat
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Allan C Halpern
- Dermatology Service of the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Alan C Geller
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
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'Guess who'? An Italian multicentric study on pigmentation traits prevalence in endometriosis localizations. Eur J Obstet Gynecol Reprod Biol 2022; 274:5-12. [PMID: 35561567 DOI: 10.1016/j.ejogrb.2022.05.001] [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: 03/29/2022] [Revised: 04/27/2022] [Accepted: 05/01/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Previous evidence seems to support the more common presence of certain pigmentation types in women with endometriosis. The aim of this study was to assess the association of certain somatic phenotypes with specific localizations of the disease. The genetic makeup of those somatic traits may will help in better define the disease pathogenesis. STUDY DESIGN Multicentric, retrospective study of women aged 18 to 45 with histologically confirmed endometriosis. 575 patients were recruited at eleven different Italian endometriosis clinics from March 2015 to January 2021. Data regarding clinical and surgical features were recorded following the self-administered endometriosis patient questionnaire and the surgical standard of reports approved by the World Endometriosis Research Foundation (WERF). Pigmentation types/somatic phenotypes frequencies among endometriosis localizations were reported. A logistic regression analysis was performed to determine somatic types independently associated with disease' localizations. RESULTS Having green eyes increased by ∼4 folds (OR 3.7; 95% CI: 1.42-9.61; p = 0.007) the risk of having a ureteral nodule, whereas brown/black eyes decreased this risk (OR 0.34; 95% CI: 0.13-0.87; p = 0.025). Consistently, the combination of green eyes and blonde/light brown hairs increased the odds of ureteral endometriosis by more than 5 folds (OR 5.40; 95%CI: 2.02-14.49; p = 0.001), even after correction for anthropometric confounders (aOR 5.85; 95% CI: 2.13-16.09; p < 0.001). CONCLUSIONS The association between endometriosis and pigmentary traits has been herein confirmed, with the novel finding of the possible predisposition of ureteral endometriosis in patients with green eyes and blonde/light brown hairs. Further investigation on the genetic makeup of somatic traits may provide new inroads also into the molecular aspects of endometriosis leading to a better understanding of this complex disease.
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Naik PP, Farrukh SN. Influence of Ethnicities and Skin Color Variations in Different Populations: A Review. Skin Pharmacol Physiol 2021; 35:65-76. [PMID: 34515229 DOI: 10.1159/000518826] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/30/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND In the world scientific tradition, skin color is the primary physical characteristic used to divide humans into groups. Human skin has a wide range of tones and colors, which can be seen in a wide range of demographic populations. Many factors influence the color of people's skin, but the pigment melanin is by far the most important. Melanin is produced by cells called melanocytes in the skin and is the primary determinant of skin color in people with darker skin. Indeed, >150 genes have now been identified as having a direct or indirect effect on skin color. Vitamin D has recently been discovered to regulate cellular proliferation and differentiation in a variety of tissues, including the skin. The mechanisms through which the active vitamin D metabolite 1,25 dihydroxyvitamin D3 (or calcitriol) affects keratinocyte development are numerous and overlap with the mechanisms by which calcium influences keratinocyte differentiation. Ultraviolet (UV) is the most major modifiable risk factor for skin cancer and many other environmental-influenced skin disorders when it is abundant in the environment. Although the UV component of sunlight is known to cause skin damage, few researches have looked at the impact of non-UV solar radiation on skin physiology in terms of inflammation, and there is less information on the role of visible light in pigmentation. SUMMARY The quantity and quality of melanin are regulating by the expression of genes. The enzyme tyrosinase is primarily responsible for the genetic mechanism that controls human skin color. Genetics determines constitutive skin color, which is reinforced by facultative melanogenesis and tanning reactions. High quantities of melanin and melanogenic substances are typically accepted in darker skin to protect against UV radiation-induced molecular damage. Previous research has proposed that skin color variation is caused by a dynamic genetic mechanism, contributing to our understanding of how population demographic history and natural selection shape human genetic and phenotypic diversity. However, the most significant ethnic skin color difference is determined by melanin content. This current review aimed to assess the influence of skin color variations in skin structure and functions as well as difference in dermatological disease patterns. Also, this article reviewed several cases of skin color adaptation in different populations. Key Messages: Skin color impacts the composition and activity. Therefore, the contrast of dermatological ailments between distinct race-related categories is remarkable. Skin color adaptation is a challenging procedure. Refinement of skin color is an age-old craving of humans with ever-evolving drifts.
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Affiliation(s)
- Piyu Parth Naik
- Department of Dermatology, Saudi-German Hospital & Clinic, Dubai, United Arab Emirates
| | - Syed Nadir Farrukh
- Department of Internal Medicine, Adam-Vital Hospital, Dubai, United Arab Emirates
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Laskar R, Ferreiro-Iglesias A, Bishop DT, Iles MM, Kanetsky PA, Armstrong BK, Law MH, Goldstein AM, Aitken JF, Giles GG, Cust AE. Risk factors for melanoma by anatomical site: an evaluation of aetiological heterogeneity. Br J Dermatol 2021; 184:1085-1093. [PMID: 33270213 PMCID: PMC9969114 DOI: 10.1111/bjd.19705] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Melanoma aetiology has been proposed to have two pathways, which are determined by naevi and type of sun exposure and related to the anatomical site where melanoma develops. OBJECTIVES We examined associations with melanoma by anatomical site for a comprehensive set of risk factors including pigmentary and naevus phenotypes, ultraviolet radiation exposure and polygenic risk. METHODS We analysed harmonized data from 2617 people with incident first invasive melanoma and 975 healthy controls recruited through two population-based case-control studies in Australia and the UK. Questionnaire data were collected by interview using a single protocol, and pathway-specific polygenic risk scores were derived from DNA samples. We estimated adjusted odds ratios using unconditional logistic regression that compared melanoma cases at each anatomical site with all controls. RESULTS When cases were compared with control participants, there were stronger associations for many naevi vs. no naevi for melanomas on the trunk, and upper and lower limbs than on the head and neck (P-heterogeneity < 0·001). Very fair skin (vs. olive/brown skin) was more weakly related to melanoma on the trunk than to melanomas at other sites (P-heterogeneity = 0·04). There was no significant difference by anatomical site for polygenic risk. Increased weekday sun exposure was positively associated with melanoma on the head and neck but not on other sites. CONCLUSIONS We found evidence of aetiological heterogeneity for melanoma, supporting the dual pathway hypothesis. These findings enhance understanding of risk factors for melanoma and can guide prevention and skin examination education and practices.
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Affiliation(s)
- Ruhina Laskar
- International Agency for Research on Cancer, Lyon, France
| | | | - D Timothy Bishop
- Leeds Institute of Haematology and Immunology, University of Leeds, Leeds, UK
| | - Mark M Iles
- Division of Haematology and Immunology, Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds, UK
- Leeds Institute of Data Analytics, University of Leeds, Leeds, UK
| | - Peter A Kanetsky
- Cancer Epidemiology Program, Moffitt Cancer Center, Tampa, FL, USA
| | - Bruce K Armstrong
- Cancer Epidemiology and Prevention Research Group, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Matthew H Law
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Queensland University of Technology (QUT), Brisbane, Australia
| | - Alisa M Goldstein
- Human Genetics Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Joanne F Aitken
- Viertel Centre for Research in Cancer Control, the Cancer Council Queensland, Brisbane, Australia
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria 3004, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | | | | | | | - Anne E Cust
- International Agency for Research on Cancer, Lyon, France
- Cancer Epidemiology and Prevention Research Group, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- The Melanoma Institute Australia, The University of Sydney, Sydney, Australia
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Ly BCK, Dyer EB, Feig JL, Chien AL, Del Bino S. Research Techniques Made Simple: Cutaneous Colorimetry: A Reliable Technique for Objective Skin Color Measurement. J Invest Dermatol 2020; 140:3-12.e1. [PMID: 31864431 DOI: 10.1016/j.jid.2019.11.003] [Citation(s) in RCA: 120] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/05/2019] [Accepted: 11/05/2019] [Indexed: 11/15/2022]
Abstract
Skin color evaluation contributes to assessment of an individual's cutaneous phenotype. Skin color changes provide important clues to disease progression or treatment response. Skin color is also a predictor of skin cancer risk. Melanin pigment, blood flow, skin thickness, and photoaging contribute to skin color. Melanin, hemoglobin, bilirubin, and carotene are the primary chromophores of skin color. Their concentrations vary depending on the individual's phenotype, anatomic location, external insults of chemical irritants and UVR, and physiological changes. The evaluation and perception of skin color are often subjective. Objective quantification of skin color can be achieved with colorimetric devices such as tristimulus colorimeters. These devices compute the intensity of light reflected from skin and correlate with pigmentation and erythema. Cutaneous color and color changes can be quantified under color organization systems, such as the CIELAB color space, which is standardized by the Commission Internationale de l'Eclairage (CIE). The CIELAB expresses color's lightness, red/green intensity, and yellow/blue intensity, as L*, a*, and b* values, respectively. Additionally, skin color's full spectral characteristics and cutaneous physiology can be measured with spectrophotometers. This article outlines basic principles of the CIELAB color system and how to optimally use colorimetric devices as a skin research tool.
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Affiliation(s)
- Bao Chau K Ly
- Department of Dermatology, John Hopkins University School of Medicine, Baltimore, Maryland
| | - Ethan B Dyer
- Department of Dermatology, John Hopkins University School of Medicine, Baltimore, Maryland
| | - Jessica L Feig
- Department of Dermatology, John Hopkins University School of Medicine, Baltimore, Maryland
| | - Anna L Chien
- Department of Dermatology, John Hopkins University School of Medicine, Baltimore, Maryland
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Toland A. Developing risk prediction models for melanoma: balancing better predictive value with ease of clinical implementation. Br J Dermatol 2020; 182:1089-1090. [DOI: 10.1111/bjd.18531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- A.E. Toland
- Departments of Cancer Biology and Genetics and Internal Medicine Ohio State University Comprehensive Cancer Center The Ohio State University Columbus OH 43210 U.S.A
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9
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Vuong K, Armstrong BK, Drummond M, Hopper JL, Barrett JH, Davies JR, Bishop DT, Newton-Bishop J, Aitken JF, Giles GG, Schmid H, Jenkins MA, Mann GJ, McGeechan K, Cust AE. Development and external validation study of a melanoma risk prediction model incorporating clinically assessed naevi and solar lentigines. Br J Dermatol 2020; 182:1262-1268. [PMID: 31378928 PMCID: PMC6997040 DOI: 10.1111/bjd.18411] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Melanoma risk prediction models could be useful for matching preventive interventions to patients' risk. OBJECTIVES To develop and validate a model for incident first-primary cutaneous melanoma using clinically assessed risk factors. METHODS We used unconditional logistic regression with backward selection from the Australian Melanoma Family Study (461 cases and 329 controls) in which age, sex and city of recruitment were kept in each step, and we externally validated it using the Leeds Melanoma Case-Control Study (960 cases and 513 controls). Candidate predictors included clinically assessed whole-body naevi and solar lentigines, and self-assessed pigmentation phenotype, sun exposure, family history and history of keratinocyte cancer. We evaluated the predictive strength and discrimination of the model risk factors using odds per age- and sex-adjusted SD (OPERA) and the area under curve (AUC), and calibration using the Hosmer-Lemeshow test. RESULTS The final model included the number of naevi ≥ 2 mm in diameter on the whole body, solar lentigines on the upper back (a six-level scale), hair colour at age 18 years and personal history of keratinocyte cancer. Naevi was the strongest risk factor; the OPERA was 3·51 [95% confidence interval (CI) 2·71-4·54] in the Australian study and 2·56 (95% CI 2·23-2·95) in the Leeds study. The AUC was 0·79 (95% CI 0·76-0·83) in the Australian study and 0·73 (95% CI 0·70-0·75) in the Leeds study. The Hosmer-Lemeshow test P-value was 0·30 in the Australian study and < 0·001 in the Leeds study. CONCLUSIONS This model had good discrimination and could be used by clinicians to stratify patients by melanoma risk for the targeting of preventive interventions. What's already known about this topic? Melanoma risk prediction models may be useful in prevention by tailoring interventions to personalized risk levels. For reasons of feasibility, time and cost many melanoma prediction models use self-assessed risk factors. However, individuals tend to underestimate their naevus numbers. What does this study add? We present a melanoma risk prediction model, which includes clinically-assessed whole-body naevi and solar lentigines, and self-assessed risk factors including pigmentation phenotype and history of keratinocyte cancer. This model performs well on discrimination, the model's ability to distinguish between individuals with and without melanoma, and may assist clinicians to stratify patients by melanoma risk for targeted preventive interventions.
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Affiliation(s)
- K Vuong
- School of Public Health and Community Medicine, Westmead Institute for Medical Research, The University of New South Wales, Sydney, Australia
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - B K Armstrong
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - M Drummond
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - J L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - J H Barrett
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, Leeds University, Leeds, U.K
| | - J R Davies
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, Leeds University, Leeds, U.K
| | - D T Bishop
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, Leeds University, Leeds, U.K
| | - J Newton-Bishop
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, Leeds University, Leeds, U.K
| | - J F Aitken
- Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Brisbane, Australia
| | - G G Giles
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
| | - H Schmid
- Centre for Cancer Research, Westmead Institute for Medical Research, The University of New South Wales, Sydney, Australia
| | - M A Jenkins
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - G J Mann
- Centre for Cancer Research, Westmead Institute for Medical Research, The University of New South Wales, Sydney, Australia
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia
| | - K McGeechan
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - A E Cust
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia
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10
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Wu Y, Ghaly S, Kerr S, Jackson B, Hanigan K, Martins D, Krishnaprasad K, Mountifield RE, Whiteman DC, Bampton PA, Gearry RB, Radford-Smith GL, Lawrance IC. Level of UV Exposure, Skin Type, and Age Are More Important than Thiopurine Use for Keratinocyte Carcinoma Development in IBD Patients. Dig Dis Sci 2020; 65:1172-1179. [PMID: 31493039 DOI: 10.1007/s10620-019-05818-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 08/23/2019] [Indexed: 12/09/2022]
Abstract
BACKGROUND Retrospective studies observe an increased risk of keratinocyte carcinomas (KCs) in patients with inflammatory bowel disease (IBD) on thiopurine (TP) medication. The role of traditional risk factors such as skin type and sun protection behavior has not been studied in this population. This study aimed to examine traditional KC risk factors and thiopurine use on skin cancer development in an IBD cohort. METHODS Consecutive IBD patients were recruited from four specialist centers in Australia and New Zealand, each with varying UV exposure indices. Data pertaining to race, skin color, freckling and sun protection behavior, dose of TP therapy, and skin cancer development were elicited through a self-reported questionnaire. RESULTS A total of 691 IBD patients were included with 62 reporting KC development. Thiopurine usage was similar among patients who developed skin cancer compared with those who did not (92% vs. 89%, p = 0.3). There was no statistically significant association between KC development and TP dose or 6-thioguanine nucleotide levels. In multivariate modeling, four factors were independently and significantly associated with KC: age over 61 years old versus less than 30 years old (OR 6.76; 95% CI 2.38-19.18), residing in Brisbane versus Christchurch (OR 3.3; 95% CI 1.6-6.8), never staying in the shade versus staying in the shade ≥ 50% of the time (OR 3.8; 95% CI 1.4-10.5), and having a skin type that never tanned versus other skin types (OR 6.9; 95% CI 2.9-16.0). CONCLUSION Skin type, age, and sun protection behavior are more important risk factors for KC development than thiopurine medication use in this IBD population.
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Affiliation(s)
- Yang Wu
- Department of Gastroenterology, St Vincent's Hospital, 390 Victoria St, Darlinghurst, Sydney, NSW, 2010, Australia.
| | - Simon Ghaly
- Department of Gastroenterology, St Vincent's Hospital, 390 Victoria St, Darlinghurst, Sydney, NSW, 2010, Australia
| | | | - Bryce Jackson
- Department of Gastroenterology, Christchurch Hospital, Christchurch, New Zealand
| | - Katherine Hanigan
- IBD Research Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Deborah Martins
- IBD Research Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,Division of Plastic and Reconstructive Surgery, University of California San Francisco, 505 Parnassus Ave, Suite M-593, San Francisco, CA, 94143-0932, USA
| | - Krupa Krishnaprasad
- IBD Research Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Reme E Mountifield
- Department of Gastroenterology, Flinders Medical Centre, Adelaide, SA, Australia
| | - David C Whiteman
- Cancer Control Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Peter A Bampton
- Department of Gastroenterology, Flinders Medical Centre, Adelaide, SA, Australia
| | - Richard B Gearry
- Department of Gastroenterology, Christchurch Hospital, Christchurch, New Zealand
| | - Graham L Radford-Smith
- IBD Research Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,Department of Gastroenterology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.,University of Queensland School of Medicine, Brisbane, QLD, Australia
| | - Ian C Lawrance
- Centre of Inflammatory Bowel Diseases, St John of God Hospital, Subiaco, WA, Australia.,School of Medicine and Pharmacology, Harry Perkins Institute of Medical Research, University of Western Australia, Murdoch, WA, Australia
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11
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Betz-Stablein B, Koh U, Plasmeijer EI, Janda M, Aitken JF, Soyer HP, Green AC. Self-reported naevus density may lead to misclassification of melanoma risk. Br J Dermatol 2020; 182:1488-1490. [PMID: 31833052 DOI: 10.1111/bjd.18802] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- B Betz-Stablein
- Cancer and Population studies, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,Dermatology Research Centre, The University of Queensland, The University of Queensland Diamantina Institute, Brisbane, QLD, Australia
| | - U Koh
- Dermatology Research Centre, The University of Queensland, The University of Queensland Diamantina Institute, Brisbane, QLD, Australia
| | - E I Plasmeijer
- Department of Dermatology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - M Janda
- Centre of Health Services Research, Faculty of Medicine, The University of Queensland, The University of Queensland Diamantina Institute, Brisbane, QLD, Australia.,School of Public Health and Social Work, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - J F Aitken
- Cancer Council Queensland, Brisbane, QLD, Australia.,Institute for Resilient Regions, University of Southern Queensland, Brisbane, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia.,School of Public Health, The University of Queensland, The University of Queensland Diamantina Institute, Brisbane, QLD, Australia
| | - H P Soyer
- Dermatology Research Centre, The University of Queensland, The University of Queensland Diamantina Institute, Brisbane, QLD, Australia.,Dermatology Department, Princess Alexandra Hospital, Brisbane, QLD, Australia.,Australian Skin and Skin Cancer Research Centre, Brisbane, Queensland, Australia
| | - A C Green
- Cancer and Population studies, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,Australian Skin and Skin Cancer Research Centre, Brisbane, Queensland, Australia.,CRUK Manchester Institute and University of Manchester, Manchester Academic Health Sciences Centre, Manchester, U.K
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12
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Bieliauskiene G, Philipsen PA, Ørsted-Jordy L, Køster B, Wulf HC. Visual scales are superior to questionnaires in skin phototype self-assessment by children. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2019; 35:238-245. [PMID: 30809865 DOI: 10.1111/phpp.12458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 01/25/2019] [Accepted: 02/25/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND/PURPOSE There are no suitable methods for skin phototype self-assessment by children. Our study investigated several skin phototype self-assessment methods in children to identify the best correlation to objectively measure skin phototype. METHODS Danish schoolchildren (ages 6-19) participated in a nation-wide study that assessed skin, eye, hair colour and sun behaviour. Skin phototype self-assessment was performed by children using two visual colour scales (cartoon faces and colour cards), question-based colour scale and questions about tendency to burn and ability to tan. For objective skin phototype measurements, 483 children from all age groups were selected and their pigment protection factor (PPF) was measured at three skin sites using a skin reflectance spectrophotometer. RESULTS Cartoon faces (r2 = 0.654) and colour cards (r2 = 0.659) were better at predicting PPF on the inner forearm than the question-based colour method (r2 = 0.520). PPF prediction from questions on skin reaction to sun exposure was markedly inferior (r2 ≤ 0.142) to both visual colour scales and question-based colour method. CONCLUSION Both visual colour scales proved to be superior to question-based skin phototype self-assessment in schoolchildren. In contrast, questions on skin reaction to sun exposure were shown to be an unsuitable tool for self-assessment of skin phototype in children.
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Affiliation(s)
- Giedre Bieliauskiene
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.,The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Peter A Philipsen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Hans Christian Wulf
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
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Li WQ, Cho E, Wu S, Li S, Matthews NH, Qureshi AA. Host Characteristics and Risk of Incident Melanoma by Breslow Thickness. Cancer Epidemiol Biomarkers Prev 2019; 28:217-224. [PMID: 30341099 PMCID: PMC6324995 DOI: 10.1158/1055-9965.epi-18-0607] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 08/10/2018] [Accepted: 10/04/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Several host characteristics, including pigmentary traits (hair color, sunburn susceptibility and tanning ability), number of common nevi (moles), and family history of melanoma, have been associated with risk of melanoma. METHODS We prospectively examined the associations between host characteristics and risk of incident melanoma by Breslow thickness (≤1 mm, thin melanoma; or >1 mm, "thicker melanoma") based on the Nurses' Health Study (NHS, n = 86,380 women), NHS II (n = 104,100 women), and Health Professionals Follow-up Study (HPFS, n = 46,934 men). RESULTS During 22-30 years' follow-up, a total of 1,813 incident melanoma cases were identified with information on Breslow thickness, 1,392 (76.8%) of which had thin melanoma. No significant differences were observed for thin and thicker melanoma in associations with hair color, sunburn susceptibility, and tanning ability. However, we found significant differences for the association with family history of melanoma, with a higher risk estimate for thicker melanoma [HR = 2.55; 95% confidence interval (CI): 1.91-3.42] than thin melanoma (HR = 1.59; 95% CI: 1.21-2.08; P heterogeneity = 0.02). Interestingly, women and men displayed differential associations between nevi count and risk of melanoma by Breslow thickness, with the association appearing stronger for thicker melanoma than thin melanoma in men (P heterogeneity = 0.01), but not in women. CONCLUSIONS Individuals with family history of melanoma may be more likely to develop thicker melanoma. Men with high number of common nevi may tend to develop thicker melanoma, which was not found for women. IMPACT The findings further stress the risk of thicker melanoma for individuals with a family history of melanoma and men with a high nevi count.
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Affiliation(s)
- Wen-Qing Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education, Beijing), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing, China.
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island
| | - Eunyoung Cho
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Shaowei Wu
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Suyun Li
- School of Public Health, Institute for Chemical Carcinogenesis, Guangzhou Medical University, Guangzhou, China
| | - Natalie H Matthews
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Abrar A Qureshi
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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Dai H, Sun Q, Zhang C, Zhang X, Li WQ, Manson JE, Hu FB, Song Y. Associations between benign cutaneous nevi and risk of Type 2 diabetes mellitus in men and women: results from two prospective cohort studies. Diabet Med 2017; 34:925-933. [PMID: 27917515 PMCID: PMC5459671 DOI: 10.1111/dme.13297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 10/30/2016] [Accepted: 11/28/2016] [Indexed: 01/10/2023]
Abstract
AIM To examine the association of cutaneous nevi with Type 2 diabetes risk. METHODS We prospectivly examined the associations between nevus count and risk of Type 2 diabetes among 26 240 men (1988-2010) from the Health Professionals Follow-up Study and 67 050 women (1986-2010) from the Nurses' Health Study. Information on the numbers of cutaneous nevi on arms at baseline and incident cases of Type 2 diabetes was collected using validated questionnaires. RESULTS During 1 879 287 person-years of follow-up, we documented 9040 incident cases of Type 2 diabetes. After adjustment for age, BMI and other diabetes risk factors, greater number of nevi was associated with higher risk of Type 2 diabetes. Multivariable-adjusted hazard ratios for <1, 1-5, 6-14 and ≥15 nevi were 1.00 (reference), 1.02 (95% CI 0.93, 1.13), 1.08 (95% CI 0.88, 1.34) and 1.57 (95% CI 1.15, 2.15), respectively, for men (P for linear trend = 0.01), and 1.00 (reference), 1.07 (95% CI 1.02, 1.13), 0.98 (95% CI 0.87, 1.10), and 1.25 (1.01, 1.54), respectively, for women (P for linear trend = 0.05). This positive association remained consistent across subgroups stratified by age, BMI, multivitamin use, smoking status, alcohol, physical activity, history of hypercholesterolaemia, family history of diabetes, history of hypertension and menopausal status (in women). CONCLUSIONS Cutaneous nevus count may represent a novel marker for development of Type 2 diabetes, suggesting a possible unique melanocytic nevus-related mechanism in the pathogenesis of Type 2 diabetes. Further studies are warranted to confirm the findings and to investigate the underlying mechanisms.
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Affiliation(s)
- H Dai
- Department of Epidemiology and Biostatistics, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN
- Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, IN
| | - Q Sun
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - C Zhang
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, MD
| | - X Zhang
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN
| | - W-Q Li
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI
| | - J E Manson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - F B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Y Song
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN
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