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Chen CC, Luo CW, Tsai SCS, Huang JY, Yang SF, Lin FCF. Synergistic Effect of Human Papillomavirus and Environmental Factors on Skin Squamous Cell Carcinoma, Basal Cell Carcinoma, and Melanoma: Insights from a Taiwanese Cohort. Cancers (Basel) 2024; 16:2284. [PMID: 38927988 PMCID: PMC11201942 DOI: 10.3390/cancers16122284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/12/2024] [Accepted: 06/19/2024] [Indexed: 06/28/2024] Open
Abstract
Human papillomavirus (HPV) has been implicated in various cancers, including those affecting the skin. The study assessed the long-term risk of skin cancer associated with HPV infection in Taiwan region, using data from the National Health Insurance Research Database between 2007 and 2015. Our analysis revealed a significant increase in skin cancer risk among those with HPV, particularly for squamous cell carcinoma (SCC), the subtype with the highest observed adjusted hazard ratio (aHR) = 5.97, 95% CI: 4.96-7.19). The overall aHR for HPV-related skin cancer was 5.22 (95% CI: 4.70-5.80), indicating a notably higher risk in the HPV-positive group. The risk of skin cancer was further stratified by type, with basal cell carcinoma (aHR = 4.88, 95% CI: 4.14-5.74), and melanoma (aHR = 4.36, 95% CI: 2.76-6.89) also showing significant associations with HPV. The study also highlighted regional variations, with increased risks in southern Taiwan and the Kaohsiung-Pingtung area. Key findings emphasize the importance of sun protection, particularly in regions of high UV exposure and among individuals in high-risk occupations. This research contributes to a better understanding of the complex interactions between HPV and skin cancer risk, reinforcing the importance of preventive strategies in public health.
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Affiliation(s)
- Chun-Chia Chen
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; (C.-C.C.); (J.-Y.H.); (S.-F.Y.)
- Division of Plastic Surgery, Department of Surgery, Chi Mei Medical Center, Tainan 71004, Taiwan
| | - Ci-Wen Luo
- Department of Medical Research, Tungs’ Taichung MetroHarbor Hospital, Taichung 43503, Taiwan;
| | - Stella Chin-Shaw Tsai
- Superintendent Office, Tungs’ Taichung MetroHarbor Hospital, Taichung 43503, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Shin University, Taichung 402202, Taiwan
| | - Jing-Yang Huang
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; (C.-C.C.); (J.-Y.H.); (S.-F.Y.)
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; (C.-C.C.); (J.-Y.H.); (S.-F.Y.)
| | - Frank Cheu-Feng Lin
- School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
- Department of Surgery, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
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Yan MK, Orchard SG, Adler NR, Wolfe R, McLean C, Rodríguez LM, Woods RL, Gibbs P, Chan AT, Haydon A, Mar VJ. Association between hypertension and cutaneous melanoma, and the effect of aspirin: extended follow-up of a large randomised controlled trial. Cancer Epidemiol 2022; 79:102173. [PMID: 35567859 PMCID: PMC10026004 DOI: 10.1016/j.canep.2022.102173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/24/2022] [Accepted: 04/28/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND The association between hypertension and melanoma is unclear, and previous analyses of data from the ASPirin in Reducing Events in the Elderly (ASPREE) study demonstrated a reduced number of invasive melanoma events amongst aspirin-exposed hypertensive individuals. METHODS Data from the ASPREE study which included (1) the intervention period with a median follow-up of 4.7 years, and (2) the observational period with an additional 2 years follow-up, were combined for this analysis. Logistic regression analyses examined the association between baseline hypertension and treatment status and past melanoma history. Survival analyses examined the association between hypertension and melanoma risk, and the effect of aspirin across hypertension groups. Cox proportional hazards models were used to compare incidence across groups. RESULTS 19,114 participants (median age of 74 years) were randomised to daily 100 mg aspirin or placebo. At baseline, hypertension and past melanoma history were recorded in 14,195 and 685 individuals, respectively. After adjustment for confounders, hypertension was significantly associated with past melanoma history (OR=1.34, 95%CI: 1.11-1.62). In a prospective analysis, baseline hypertension was not associated with melanoma risk. However, aspirin was associated with a reduced risk of incident melanoma amongst individuals with uncontrolled hypertension (blood pressure ≥140/90 mmHg; HR=0.63, 95%CI 0.44-0.89), but not in those with controlled hypertension (HR=1.04, 95%CI 0.74-1.46). CONCLUSION Our results support a reduced melanoma incidence amongst individuals with uncontrolled hypertension exposed to aspirin. Additional studies are required to confirm these findings.
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Affiliation(s)
- Mabel K Yan
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia; Victorian Melanoma Service, Alfred Health, 55 Commercial Road, Melbourne, VIC 3004, Australia.
| | - Suzanne G Orchard
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Nikki R Adler
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Catriona McLean
- Department of Anatomical Pathology, Alfred Health, 55 Commercial Road, Melbourne, VIC 3004, Australia
| | - Luz María Rodríguez
- Gastrointestinal and Other Cancers Research Group, Division of Cancer Prevention, National Cancer Institute, NIH, Bethesda, MD, USA; Walter Reed National Military Medical Center (WRNMM) Uniformed Services University (USU) Department of Surgery, Bethesda, MD, USA
| | - Robyn L Woods
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Peter Gibbs
- The Walter & Eliza Hall Institute of Medical Research, University of Melbourne,1 G Royal Parade, Parkville, Victoria 3052, Australia
| | - Andrew T Chan
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Massachusetts, USA
| | - Andrew Haydon
- Department of Medical Oncology, Alfred Health, 55 Commercial Road, Melbourne, VIC 3004, Australia
| | - Victoria J Mar
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia; Victorian Melanoma Service, Alfred Health, 55 Commercial Road, Melbourne, VIC 3004, Australia
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Hambisa MT, Dolja-Gore X, Byles J. Application of Andersen-Newman model to assess cataract surgery uptake among older Australian women: findings from the Australian Longitudinal Study on Women's Health (ALSWH). Aging Clin Exp Res 2022; 34:1673-1685. [PMID: 35184260 PMCID: PMC9246771 DOI: 10.1007/s40520-022-02091-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/02/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Although Cataract Surgery Rate is increasing, the availability of surgery is outstripped by the increasing number of cataract cases as populations age. AIM The study aimed to identify factors associated with cataract surgery uptake in terms of predisposing, enabling, and need factors in very old Australian women. METHOD This study used ALSWH data included 6229 women aged 79-84 to 85-90 years. Women were asked whether they had undergone eye surgery (including cataracts) three years prior to each survey. Generalised estimating equation modelling was used to determine factors associated with these surgeries. RESULT At baseline (2005), more than half of the participants either had undergone surgery (43.5%) or had unoperated cataracts (7.6%). Increasing age (AOR = 1.11, 95% CI = 1.07, 1.15) and being current or ex-smokers (AOR = 1.15, 95% CI = 1.03, 1.29) were associated with higher odds of cataract surgery (predisposing factors). Women who had private health insurance had 27% higher odds of having surgery (AOR = 1.27, 95% CI = 1.16, 1.39) (enabling factor). Need factors of more General Practitioner visits (AOR = 1.16, 95% CI = 1.09, 1.25) and skin cancer (AOR = 1.09, 95% CI = 1.01, 1.17) also increased the odds of cataract surgery. Women who had no difficulty seeing newspaper print were more likely to have had cataract surgery (AOR = 1.35, 95% CI = 1.23, 1.48). CONCLUSION Need factors are the major drivers of cataract surgery; however, predisposing and enabling factors also play a role, including access to private health insurance. This finding indicates some inequity regarding access to cataract surgery in the Australian setting.
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Affiliation(s)
- Mitiku Teshome Hambisa
- Centre for Women's Health Research, University of Newcastle, Callaghan, NSW, 2308, Australia.
- Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Callaghan, NSW, 2308, Australia.
- School of Public Health, Haramaya University College of Health and Medical Sciences, P. O. Box 235, Harar, Ethiopia.
| | - Xenia Dolja-Gore
- Centre for Women's Health Research, University of Newcastle, Callaghan, NSW, 2308, Australia
- Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Julie Byles
- Centre for Women's Health Research, University of Newcastle, Callaghan, NSW, 2308, Australia
- Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Callaghan, NSW, 2308, Australia
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