1
|
George CD, Lee T, Hollestein LM, Asgari MM, Nijsten T. Global epidemiology of actinic keratosis in the general population: a systematic review and meta-analysis. Br J Dermatol 2024; 190:465-476. [PMID: 37890083 DOI: 10.1093/bjd/ljad371] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/11/2023] [Accepted: 09/21/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Actinic keratosis (AK) is a common dermatological condition, and among the most common dermatological diagnoses in older populations. Although the prevalence of AK depends on demographic and environmental factors, little is known about the global context of AK. OBJECTIVES To provide a comprehensive and updated analysis of the global prevalence rate and incidence of AK in the general population through a systematic review and meta-analysis, and - through subgroup analyses - to identify high-risk phenotypes, demographic and lifestyle risk factors and regional variations in disease prevalence. METHODS A systematic search of Embase, MEDLINE, Web of Science and Google Scholar was performed on 20 May 2022. Two reviewers independently screened and assessed the quality of each study using a validated critical appraisal checklist. Epidemiological measurements (e.g. prevalence) from individual studies performed in the general population were then pooled in a random-effects meta-analysis. Subgroup analyses (i.e. population age, geographical region, occupation, sex and study quality) were conducted. RESULTS Of the 65 articles that made it through the full-text screening, 60 reported a point prevalence. A meta-analysis of these articles yielded an overall point prevalence of 14% [95% confidence interval (CI) 14-15]. In further analyses, the calculated prevalence rate varied depending on subgroup. The pooled incidence rate from the seven eligible studies analysed was 1928 per 100 000 person-years (PY; 95% CI -439 to 4294). CONCLUSIONS This comprehensive meta-analysis provides an updated global prevalence rate of AK of 14%, indicating a significant worldwide disease burden. The incidence rate of AK was found to be 1928 per 100 000 PY, emphasizing a growing public health concern. However, high heterogeneity among studies suggests that various factors influence the AK prevalence rate, necessitating further research to understand the observed differences.
Collapse
Affiliation(s)
- Christopher D George
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Dermatology, Rotterdam, the Netherlands
| | - Truelian Lee
- Harvard Medical School, Department of Dermatology, Boston, MA, USA
| | - Loes M Hollestein
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Dermatology, Rotterdam, the Netherlands
| | - Maryam M Asgari
- University of Colorado Anschutz Medical Campus, Department of Dermatology, Aurora, CO, USA
| | - Tamar Nijsten
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Dermatology, Rotterdam, the Netherlands
| |
Collapse
|
2
|
Huang J, Zhang L, Shi L, Wu M, Lv T, Zhang Y, Lai Y, Tu Q, Wang X, Wang H. An epidemiological study on skin tumors of the elderly in a community in Shanghai, China. Sci Rep 2023; 13:4441. [PMID: 36932111 PMCID: PMC10023674 DOI: 10.1038/s41598-023-29012-1] [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: 03/11/2021] [Accepted: 01/30/2023] [Indexed: 03/19/2023] Open
Abstract
The morbidity of skin tumors (ST) in China is a great concern as the population ages. No epidemiological survey on ST in elderly communities in China has been reported. A questionnaire survey was conducted among the residents over 60 years old in a community in Shanghai, China from May 1, 2011 to November 30, 2011. The prevalence of cutaneous tumors and associated factors were analyzed. Among 2038 valid cases, a total of 78 (3.8%, 95% CI 3.0-4.7) skin cancers (SC) were confirmed. According to the final multivariate regression analysis, age, gender and previous occupation were the significantly influential factors for SC. Actinic keratosis (AK) accounted for the largest proportion (63, 3.1%) in SC. The head and neck was the physiological site with the highest incidence of SC (64, 82.1%), and AK was the most common (55, 87.3%) in head and neck SC. The common concomitant diseases of SC were hypertension (26, 33.3%) and diabetes mellitus (9, 11.5%). Seborrheic keratosis (SK) was the most common benign skin tumor with a prevalence of 100%. Men and women developed SK in significantly different parts of the body (P < 0.0001). The incidence of ST in the elderly population in Shanghai community increased with age. ST preferred to occur in the head and neck, which might be attributed to excessive ultraviolet (UV) exposure in these areas. Therefore, early diagnosis and sun-protection education are essential interventions for ST in the elderly.
Collapse
Affiliation(s)
- Jianhua Huang
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai, China
| | - Linglin Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lei Shi
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai, China
| | - Minfeng Wu
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai, China
| | - Ting Lv
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai, China
| | - Yunfeng Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yongxian Lai
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qingfeng Tu
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Hongwei Wang
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai, China.
| |
Collapse
|
3
|
KLÖSTERS FM, VAN WINDEN MEC, ANGENENT FR, VAN BERGEN LH, VAN STEVENINCK-WENSING M, ZWEERS MC, GALIMONT-COLLEN AFS, BRONKHORST EM, KOOPMANS RTCM, LUBEEK SFK. Reasons for Dermatology Consultations in Nursing Homes and the Estimated Potential of Teledermatology as a Triage Tool. Acta Derm Venereol 2022; 102:adv00827. [PMID: 36317859 PMCID: PMC9811285 DOI: 10.2340/actadv.v102.4459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Considering the limited availability of dermatologists to perform live consultations in nursing homes, teledermatology could be used as a triage tool for selection of cases for which live consultations are considered to be of added value compared with teledermatology. This prospective, multicentre observational study aimed to determine the reasons for dermatology consultations in nursing homes and the estimated value of teledermatology as a triage tool, including potential predictors. Skin tumours were the most common reason (n = 161/270; 59.6%) for dermatology consultations in nursing homes. Dermatologists estimated that live consultations added value compared with teledermatology in 67.8% of cases (n = 183). Multivariable logistic regression showed that predictors for this added value of live consultations were: consultations because of a skin tumour; consultations during which a diagnostic or treatment procedure was performed; consultations during which a secondary diagnosis was made; and the dermatologist involved. These results indicate that using teledermatology as a triage tool potentially reduces the need for additional live consultations in one-third of patients, whereas live consultations are estimated to have added value over teledermatology in two-thirds of cases. To make optimal use of the limited capacity for live consultations by dermatologists, it could therefore be helpful if elderly care physicians use teledermatology more frequently.
Collapse
Affiliation(s)
| | | | - Freya R. ANGENENT
- De Waalboog “Joachim en Anna”, Center for Specialized Geriatric Care, Nijmegen,Department of Primary and Community Care, Radboud University Medical Center,Brabantzorg, Nursing Home Care, Oss
| | | | | | | | | | - Ewald M. BRONKHORST
- Department of Health Evidence/Biostatistics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Raymond T. C. M. KOOPMANS
- De Waalboog “Joachim en Anna”, Center for Specialized Geriatric Care, Nijmegen,Department of Primary and Community Care, Radboud University Medical Center
| | | |
Collapse
|
4
|
Exposome and Skin. Part 2. The Influential Role of the Exposome, Beyond UVR, in Actinic Keratosis, Bowen's Disease and Squamous Cell Carcinoma: A Proposal. Dermatol Ther (Heidelb) 2022; 12:361-380. [PMID: 35112326 PMCID: PMC8850498 DOI: 10.1007/s13555-021-00644-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Indexed: 02/07/2023] Open
Abstract
Actinic keratosis (AK) is the main risk factor for the development of cutaneous invasive squamous cell carcinoma (SCC). It represents the first sign of severe chronic ultraviolet radiation exposure, which has a clear significant effect. Nevertheless, the skin is exposed to many other exposome factors which should be thoroughly considered. Our aim was to assess the impact of exposome factors other than ultraviolet radiation (UVR) on the etiopathology of AK and Bowen's disease (BD) and progression of AK to SCC and to design tailored prevention strategies. We performed an exhaustive literature search in September 2021 through PubMed on the impact of exposome factors other than UVR on AK, BD and SCC. We conducted several parallel searches combining terms of the following topics: AK, BD, SCC and microbiome, hormones, nutrition, alcohol, tobacco, viral infections, chemical contaminants and air pollution. Notably, skin microbiome studies have shown how Staphylococcus aureus infections are associated with AK and AK-to-SCC progression by the production of chronic inflammation. Nutritional studies have demonstrated how a caloric restriction in fat intake, oral nicotinamide and moderate consumption of wine significantly reduce the number of premalignant keratoses and SCC. Regarding lifestyle factors, both alcohol and smoking are associated with the development of SCC in a dose-dependent manner. Relevant environmental factors are viral infections and chemical contaminants. Human papillomavirus infections induce deregulation of cellular proliferation and are associated with AK, BD and SCC. In addition to outdoor jobs, occupations such as industrial processing and farming also increase the risk of developing keratoses and SCC. The exposome of AK will undoubtedly help the understanding of its etiopathology and possible progression to SCC and will serve as a basis to design tailored prevention strategies.
Collapse
|
5
|
O'Bryen J. Barriers to diagnosis and management of skin cancer affecting Australian aged care residents. Australas J Ageing 2021; 40:223-224. [PMID: 33885178 DOI: 10.1111/ajag.12920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 12/24/2022]
Affiliation(s)
- John O'Bryen
- Griffith University and University of Queensland, Qld, Australia
| |
Collapse
|
6
|
Lifestyle behaviors and sun exposure among individuals diagnosed with skin cancer: a cross-sectional analysis of 2018 BRFSS data. J Cancer Surviv 2020; 15:792-798. [PMID: 33230725 DOI: 10.1007/s11764-020-00971-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/17/2020] [Indexed: 01/22/2023]
Abstract
PURPOSE With the continued increase in skin cancer incidence rates, the population of skin cancer survivors continues to grow. Understanding skin cancer survivors' lifestyle behaviors, including ultraviolet radiation exposure, is important in reducing skin cancer recurrences and improving health outcomes. The objective of this study is to compare the differences in lifestyle behaviors among skin cancer survivors or individuals who currently have skin cancer versus individuals who have never had a skin cancer diagnosis. METHODS To investigate these lifestyle behaviors, we performed a cross-sectional analysis comparing lifestyle behaviors in persons diagnosed with skin cancer and those without a history of skin cancer among US citizens using publicly available data from the 2018 Behavior Risk Factor Surveillance System (BRFSS). RESULTS In total, there were 437,436 respondents. No significant difference existed between the two cohorts in sunburn frequency, use of sun protection, or indoor tanning; in fact, males were more likely to be afflicted with sunburns following diagnosis. Skin cancer survivors were less likely to be current smokers and sedentary. Female survivors were more likely to binge and heavily drink alcohol. CONCLUSION Our findings highlight important areas for reducing risk factors, which could reduce the recurrence of skin malignancies in skin cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS Our study provides insight to lifestyle behaviors among skin cancer survivors. Being aware of these behaviors has the potential to reduce skin cancer recurrence.
Collapse
|
7
|
Fors M, González P, Viada C, Falcón K, Palacios S. Actinic keratoses in subjects from la Mitad del Mundo, Ecuador. BMC DERMATOLOGY 2020; 20:11. [PMID: 33109125 PMCID: PMC7590729 DOI: 10.1186/s12895-020-00109-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 10/14/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Quito, the capital of Ecuador due to its geographical location, has a high skin cancer incidence. Actinic keratoses, as premalignant lesions, are precursors of nonmelanoma skin cancer, and the prevalence of this medical condition in the country is unknown. METHODS An observational, cross-sectional study was performed to assess the prevalence of actinic keratoses (AKs) in a rural area of Quito. Visual skin exams, dermoscopy and biopsy of suspicious lesions were performed. RESULTS A total of 254 subjects older than 40 years old (71.3% female) were enrolled. The general AK prevalence was 22.4%; in women, the prevalence was 23.6%, while in men, it was 19.4%. The prevalence rates of basocellular and squamous cell carcinomas and Bowen disease were 1.6, 0.8 and 0.4%, respectively. No statistical associations were found between AKs and the studied variables. CONCLUSIONS This study was the first reporting the prevalence of premalignant lesions in Ecuador. We could not demonstrate a relationship between the presence of AKs and any of the known risk factors for their development.
Collapse
Affiliation(s)
- Martha Fors
- Universidad de Las Américas (UDLA), Redondel del Ciclista, Antigua Vía a Nayón, Quito, Ecuador. .,Universidad de Las Américas, Avenida de los Granados y Vía a Nayón, Quito, Pichincha, Ecuador.
| | - Paloma González
- Universidad de Las Américas (UDLA), Redondel del Ciclista, Antigua Vía a Nayón, Quito, Ecuador
| | | | - Kirsten Falcón
- Universidad de Las Américas (UDLA), Redondel del Ciclista, Antigua Vía a Nayón, Quito, Ecuador
| | | |
Collapse
|
8
|
Akdeniz M, Hahnel E, Ulrich C, Blume-Peytavi U, Kottner J. Correction: Prevalence and associated factors of skin cancer in aged nursing home residents: A multicenter prevalence study. PLoS One 2019; 14:e0220488. [PMID: 31344127 PMCID: PMC6657894 DOI: 10.1371/journal.pone.0220488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
[This corrects the article DOI: 10.1371/journal.pone.0215379.].
Collapse
|