1
|
Steadman JA, Glasgow AE, Neequaye NN, Habermann EB, Hieken TJ. Distinct presentation of melanoma in Black patients may inform strategies to improve outcomes. J Surg Oncol 2024; 129:1041-1050. [PMID: 38436625 DOI: 10.1002/jso.27608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/18/2024] [Accepted: 02/10/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Melanoma guidelines stem largely from data on non-Hispanic White (NHW) patients. We aimed to identify features of melanoma within non-Hispanic Black (NHB) patients to inform strategies for earlier detection and treatment. METHODS From 2004 to 2019 Surveillance, Epidemiology, and End Results (SEER) data, we identified nonmetastatic melanoma patients with known TN category and race. Kaplan-Meier cancer-specific survival (CSS) estimates and multivariable Cox proportional hazard modeling analyses were performed. RESULTS Of 492 597 patients, 1499 (0.3%) were NHB, who were younger (21% vs. 17% age <50) and more commonly female (54% vs. 41%) than NHW, both p < 0.0005. For NHBs, lower extremity was the most common site (52% vs. 15% for NHWs, p < 0.0001), T category was higher (55% Tis-T1 vs. 82%; 27% T3-T4 vs. 8%, p < 0.0001) and stage at presentation was higher (19% Stage III, vs. 6%, p < 0.0001). Within the NHB cohort, males were older, and more often node-positive than females. Five-year Stage III CSS was 42% for NHB males versus 71% for females, adjusting for age and clinical nodal status (hazard ratio 2.48). CONCLUSIONS NHB melanoma patients presented with distinct tumor characteristics. NHB males with Stage III disease had inferior CSS. Focus on this high-risk patient cohort to promote earlier detection and treatment may improve outcomes.
Collapse
Affiliation(s)
- Jessica A Steadman
- Division of Breast and Melanoma Surgical Oncology, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Amy E Glasgow
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
| | - Nikki N Neequaye
- Division of Breast and Melanoma Surgical Oncology, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Elizabeth B Habermann
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
| | - Tina J Hieken
- Division of Breast and Melanoma Surgical Oncology, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| |
Collapse
|
2
|
Taylor MA, Mishra A, Sharma D. Sex differences in American Indian and Alaska Native melanoma patients: a retrospective cohort analysis of the 2000-2020 SEER database. Int J Dermatol 2024; 63:682-684. [PMID: 38291783 DOI: 10.1111/ijd.17052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/07/2024] [Accepted: 01/12/2024] [Indexed: 02/01/2024]
Affiliation(s)
- Mitchell A Taylor
- Creighton University School of Medicine, Omaha, NE, USA
- Department of Dermatology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Anjali Mishra
- Creighton University School of Medicine, Omaha, NE, USA
| | - Divya Sharma
- Department of Dermatology, University of Nebraska Medical Center, Omaha, NE, USA
| |
Collapse
|
3
|
Kim DY, Dee EC, Cheng I, Hartman RI. Advanced melanoma presentation and disease-specific survival disparities among disaggregated Asian American, Native Hawaiian, and Pacific Islander populations. J Am Acad Dermatol 2024; 90:623-626. [PMID: 37923219 DOI: 10.1016/j.jaad.2023.10.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 09/21/2023] [Accepted: 10/22/2023] [Indexed: 11/07/2023]
Affiliation(s)
- Daniel Y Kim
- Harvard-MIT Health Sciences and Technology Program, Harvard Medical School, Boston, Massachusetts
| | - Edward C Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California
| | - Rebecca I Hartman
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts; Dermatology Section, VA Integrated Service Network 1 (VISN-1), Jamaica Plain, Massachusetts.
| |
Collapse
|
4
|
Fane LS, Wei AH, Tripathi R, Bordeaux JS. Asian American and Pacific Islander patients with melanoma have increased odds of treatment delays: A cross-sectional study. J Am Acad Dermatol 2023; 89:529-536. [PMID: 37224968 DOI: 10.1016/j.jaad.2023.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/26/2023] [Accepted: 05/06/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Asian American and Pacific Islander (AAPI) melanoma patients have higher mortality than non-Hispanic White (NHW) patients. Treatment delays may contribute, but whether AAPI patients have longer time from diagnosis to definitive surgery (TTDS) is unknown. OBJECTIVES Investigate TTDS differences between AAPI and NHW melanoma patients. METHODS Retrospective review of AAPI and NHW melanoma patients in the National Cancer Database (NCD) (2004-2020). The association of race with TTDS was evaluated by multivariable logistic regression, controlling for sociodemographic characteristics. RESULTS Of 354,943 AAPI and NHW melanoma patients identified, 1155 (0.33%) were AAPI. AAPI patients had longer TTDS for stage I, II, and III melanoma (P < .05 for all). Adjusting for sociodemographic factors, AAPI patients had 1.5 times the odds of a TTDS between 61 and 90 days and twice the odds of a TTDS >90 days. Racial differences in TTDS persisted in Medicare and private insurance types. Uninsured AAPI patients had the longest TTDS (mean, 53.26 days), while those with private insurance had the shortest TTDS (mean, 34.92 days; P < .001 for both). LIMITATION AAPI patients comprised 0.33% of the sample. CONCLUSIONS AAPI melanoma patients have increased odds of treatment delays. Associated socioeconomic differences should inform efforts to reduce disparities in treatment and survival.
Collapse
Affiliation(s)
- Lauren S Fane
- School of Medicine, Case Western Reserve University, Cleveland, Ohio.
| | - Angela H Wei
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Raghav Tripathi
- Department of Dermatology, Johns Hopkins, Baltimore, Maryland
| | - Jeremy S Bordeaux
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
| |
Collapse
|
5
|
Smith B, Matsumoto M, Wang H, Baskin ML, Kirkwood JM, Ferris LK. Melanoma Detection in Alaska Native, American Indian, Asian, Black, Hispanic, and Pacific Islander Patients in a Large Skin Cancer Screening Initiative. JAMA Dermatol 2023; 159:1004-1006. [PMID: 37494017 PMCID: PMC10372752 DOI: 10.1001/jamadermatol.2023.2067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/16/2023] [Indexed: 07/27/2023]
Abstract
This cohort study investigates patterns in melanoma detection in racial and ethnic minority populations as part of a large, primary care–based screening initiative.
Collapse
Affiliation(s)
- Brandon Smith
- Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Martha Matsumoto
- Department of Dermatology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Hong Wang
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Monica L. Baskin
- UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - John M. Kirkwood
- UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Laura K. Ferris
- Department of Dermatology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| |
Collapse
|
6
|
Yoo H, Park S, Kim SW. Nodular type predominance of head and neck cutaneous malignant melanoma in Asian populations leads to poor outcome and low survival. Melanoma Res 2023; 33:326-331. [PMID: 37199704 DOI: 10.1097/cmr.0000000000000901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Cutaneous malignant melanomas of the head and neck (HNM) are proposed to have notable histological and clinical differences from those at other sites (other melanoma); however, HNMs among Asians have remained poorly understood. This study aimed to investigate the clinicopathological features and prognostic factors of HNM in Asians. Asian melanoma patients who underwent surgical treatment from January 2003 to December 2020 were retrospectively reviewed. The clinicopathological features and risk factors for local recurrence, lymph node metastasis, and distant metastasis were analyzed. Among 230 patients, 28 (12.2%) were diagnosed with HNM, and 202 (87.8%) with other melanoma. The histologic subtype significantly differed as the nodular type was predominant in HNM whereas the acral lentiginous type was predominant in other melanoma ( P < 0.001). HNM was significantly associated with higher local recurrence ( P = 0.045), lymph node metastasis ( P = 0.048), distant metastasis ( P = 0.023), and lower 5-year disease-free survival ( P = 0.022) than other melanoma. Ulceration was the risk factor for lymph node metastasis based on multivariable analysis ( P = 0.013). A high proportion of HNM present as the nodular subtype in Asians, leading to poor outcomes and low survival. Therefore, more cautious surveillance, evaluation, and aggressive treatment are required.
Collapse
Affiliation(s)
- Hyokyung Yoo
- Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | | | | |
Collapse
|
7
|
Syder NC, Elbuluk N. Rising Interest in Sunscreen for Skin of Color: An Analysis of Google Trends. J Drugs Dermatol 2023; 22:712-713. [PMID: 37410040 DOI: 10.36849/jdd.7373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Syder NC, Elbuluk N. rising interest in sunscreen for skin of color: an analysis of Google trends. J Drugs Dermatol. 2023;22(7):712-713. doi:10.36849/JDD.7373.
Collapse
|
8
|
Adjei S, Temiz LA, Miller AC, Sadek R, Grush AE, Tyring SK. Leukemia Cutis in Skin of Color. J Drugs Dermatol 2023; 22:687-689. [PMID: 37410053 DOI: 10.36849/jdd.7020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
The various presentations of many dermatologic conditions among various skin types are slowly being elucidated throughout the recent years. These differences present as an issue as it leads to delayed diagnosis, treatment, and poorer quality of life. Herein, we present the characteristics of leukemia cutis in a skin of color patient with diagnosed chronic myelomonocytic leukemia. Adjei S, Temiz LA, Miller AC, et al. Leukemia cutis in skin of color. J Drugs Dermatol. 2023;22(7):687-689. doi:10.36849/JDD.7020.
Collapse
|
9
|
Fernandez JM, Dahak S, Wysong A, Whitley MJ. Differences between Asian Americans and Pacific Islanders with cutaneous melanoma: A retrospective cohort analysis of 1339 cases. J Am Acad Dermatol 2023; 88:885-889. [PMID: 36244550 DOI: 10.1016/j.jaad.2022.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/05/2022] [Accepted: 10/09/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Jennifer M Fernandez
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Sabrina Dahak
- University of Arizona College of Medicine - Phoenix, Phoenix, Arizona
| | - Ashley Wysong
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Melodi Javid Whitley
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska; Department of Dermatology, Duke University School of Medicine, Durham, North Carolina.
| |
Collapse
|
10
|
Wright C, Kapwata T, Albers P. Melanoma crude incidence rates among White South Africans climbing as in other countries: urgent call for targeted skin cancer prevention and awareness campaigns. S Afr Med J 2023; 113:110-112. [PMID: 36876358 DOI: 10.7196/samj.2023.v113i3.325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 10/26/2022] [Indexed: 03/06/2023] Open
Abstract
[We have not prepared an abstract for the editorial but we can do so if required.].
Collapse
|
11
|
Morquette AJ, Waples ER, Heath CR. The importance of cosmetically elegant sunscreen in skin of color populations. J Cosmet Dermatol 2022; 21:1337-1338. [PMID: 35373536 DOI: 10.1111/jocd.14409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 06/27/2021] [Accepted: 08/16/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Alexandra J Morquette
- Department of Dermatology, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania, USA
| | - Erica R Waples
- Department of Dermatology, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania, USA
| | - Candrice R Heath
- Department of Dermatology, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania, USA
| |
Collapse
|
12
|
van Niekerk CC, Groenewoud HM, Verbeek AL. Trends and projections in cutaneous melanoma death in the Netherlands from 1950 to 2045. Medicine (Baltimore) 2021; 100:e27784. [PMID: 35049174 PMCID: PMC9191606 DOI: 10.1097/md.0000000000027784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 09/28/2021] [Accepted: 10/28/2021] [Indexed: 11/30/2022] Open
Abstract
ABSTRACT Child sun protection has recently been linked to the future disappearance of fatal melanoma in adults in successive generations. In the Netherlands, however, mortality rates from melanoma have increased gradually from the 1950s, with some indication of stabilisation since 2010, which may be compatible with a birth cohort effect by sun-protective measures and screening. To study the trajectories ahead a trend analysis was applied. Numbers of people with cutaneous melanoma as underlying cause of death from 1950 to 2018 and population data were derived from Statistics Netherlands. A graphical approach was used to explore trends in mortality by age, calendar period, and cohorts born in the successive periods of 1889 to 1979. Age-period-cohort modelling outcomes and population forecasts provided projections of mortality until 2045. Based on 24,151 cases of melanoma death (13,256 men, 10,895 women), age-standardised mortality rates were similar from 1950 to 1989 for both genders, and increased thereafter more in men. The age-curve patterns changed gradually towards higher death rates at older age, implying the existence of a birth cohort effect. The age-period-cohort models showed an increase in melanoma mortality rates in successive generations. For women, the birth cohort effect plateaued for generations born since the mid-1980s. The projected total mortality number was predicted to rise in the next 3 decades.It is concluded that a small future decline of mortality in younger generations can be expected in the Netherlands, but mortality is still rising for the total population.
Collapse
|
13
|
Affiliation(s)
- Melissa A Nickles
- Department of Dermatology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | | |
Collapse
|
14
|
Abstract
Melanoma accounts for approximately 1% of all skin cancers but contributes to almost all skin cancer deaths. The developing picture suggests that melanoma phenotypes are driven by epigenetic mechanisms that reflect a complex interplay between genotype and environment. Furthermore, the growing consensus is that current classification standards, notwithstanding pertinent clinical history and appropriate biopsy, fall short of capturing the vast complexity of the disease. This article summarizes the current understanding of the clinical picture of melanoma, with a focus on the tremendous breakthroughs in molecular classification and therapeutics.
Collapse
Affiliation(s)
- Sarem Rashid
- Department of Dermatology, Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02466, USA; Boston University School of Medicine, Boston, MA, USA
| | - Hensin Tsao
- Department of Dermatology, Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02466, USA.
| |
Collapse
|
15
|
Carter TM, Strassle PD, Ollila DW, Stitzenberg KB, Meyers MO, Maduekwe UN. Does acral lentiginous melanoma subtype account for differences in patterns of care in Black patients? Am J Surg 2021; 221:706-711. [PMID: 33461732 PMCID: PMC8376182 DOI: 10.1016/j.amjsurg.2020.12.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 12/11/2020] [Accepted: 12/21/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Melanoma-specific outcomes for Black patients are worse when compared to non-Hispanic white (NHW) patients. We sought to evaluate whether acral lentiginous melanoma, seen more commonly in Black patients, was associated with racial disparities in outcomes METHODS: The National Cancer Database was analyzed for major subtypes of stage I-IV melanoma diagnosed from 2004 to 2016. The association between Black race and (Siegel et al., Jan) 1 acral melanoma diagnosis and (Bradford et al., Apr) 2 receipt of major amputation for surgical management of melanoma was evaluated using multivariable logistic regression. RESULTS 251,864 patients were included (1453 Black). Black patients had increased odds of acral melanoma (odds ratio [OR] = 27.6, 95% CI]: 24.4, 31.2) compared to NHW patients. Black patients still had higher odds ratios of major amputation across all stages after adjusting for acral histology and other potential confounders CONCLUSIONS: Increased prevalence of acral melanoma in Black patients does not fully account for increased receipt of major amputation.
Collapse
Affiliation(s)
- Taylor M Carter
- Department of Surgery, University of North Carolina, Chapel Hill, NC, USA
| | - Paula D Strassle
- Department of Surgery, University of North Carolina, Chapel Hill, NC, USA
| | - David W Ollila
- Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, University of North Carolina, Chapel Hill, NC, USA
| | - Karyn B Stitzenberg
- Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, University of North Carolina, Chapel Hill, NC, USA
| | - Michael O Meyers
- Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, University of North Carolina, Chapel Hill, NC, USA
| | - Ugwuji N Maduekwe
- Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, University of North Carolina, Chapel Hill, NC, USA.
| |
Collapse
|
16
|
Eworuke E, Haug N, Bradley M, Cosgrove A, Zhang T, Dee EC, Adimadhyam S, Petrone A, Lee H, Woodworth T, Toh S. Risk of Nonmelanoma Skin Cancer in Association With Use of Hydrochlorothiazide-Containing Products in the United States. JNCI Cancer Spectr 2021; 5:pkab009. [PMID: 33733052 PMCID: PMC7947823 DOI: 10.1093/jncics/pkab009] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/16/2020] [Accepted: 01/28/2021] [Indexed: 12/31/2022] Open
Abstract
Background European studies reported an increased risk of nonmelanoma skin cancer associated with hydrochlorothiazide (HCTZ)-containing products. We examined the risks of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) associated with HCTZ compared with angiotensin-converting enzyme inhibitors (ACEIs) in a US population. Methods We conducted a retrospective cohort study in the US Food and Drug Administration's Sentinel System. From the date of HCTZ or ACEI dispensing, patients were followed until a SCC or BCC diagnosis requiring excision or topical chemotherapy treatment on or within 30 days after the diagnosis date or a censoring event. Using Cox proportional hazards regression models, we estimated the hazard ratios (HRs), overall and separately by age, sex, and race. We also examined site- and age-adjusted incidence rate ratios (IRRs) by cumulative HCTZ dose within the matched cohort. Results Among 5.2 million propensity-score matched HCTZ and ACEI users, the incidence rate (per 1000 person-years) of BCC was 2.78 and 2.82, respectively, and 1.66 and 1.60 for SCC. Overall, there was no difference in risk between HCTZ and ACEIs for BCC (HR = 0.99, 95% confidence interval [CI] = 0.97 to 1.00), but there was an increased risk for SCC (HR = 1.04, 95% CI = 1.02 to 1.06). HCTZ use was associated with higher risks of BCC (HR = 1.09, 95% CI = 1.07 to 1.11) and SCC (HR = 1.15, 95% CI = 1.12 to 1.17) among Caucasians. Cumulative HCTZ dose of 50 000 mg or more was associated with an increased risk of SCC in the overall population (IRR = 1.19, 95% CI = 1.05 to 1.35) and among Caucasians (IRR = 1.27, 95% CI = 1.10 to 1.47). Conclusions Among Caucasians, we identified small increased risks of BCC and SCC with HCTZ compared with ACEI. Appropriate risk mitigation strategies should be taken while using HCTZ.
Collapse
Affiliation(s)
- Efe Eworuke
- Office of Pharmacovigilance and Epidemiology, Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
| | - Nicole Haug
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Marie Bradley
- Office of Pharmacovigilance and Epidemiology, Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
| | - Austin Cosgrove
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Tancy Zhang
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Elizabeth C Dee
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Sruthi Adimadhyam
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Andrew Petrone
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Hana Lee
- Office of Biostatistics, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
| | - Tiffany Woodworth
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Sengwee Toh
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| |
Collapse
|
17
|
Gaufin M, DiLorenzo A, Deng M, DeWitt C, Cardis M. Symmetric facial macules in an Asian woman. Dermatol Online J 2021; 27:13030/qt65k8874r. [PMID: 33865287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 04/12/2021] [Indexed: 06/12/2023] Open
Abstract
Hori nevus, also known as acquired bilateral nevus of Ota-like macules, is a form of dermal melanocytosis found most commonly in women of East Asian heritage. It presents as discrete brown macules on the bilateral cheeks which later coalesce into confluent grey-brown macules and small patches. Herein, we report a classic case of Hori nevus and discuss the histologic findings and differential diagnosis. We also review the proposed pathophysiology, genetic considerations, and treatment options.
Collapse
|
18
|
Koblinski JE, Maykowski P, Zeitouni NC. Disparities in melanoma stage at diagnosis in Arizona: A 10-year Arizona Cancer Registry study. J Am Acad Dermatol 2021; 84:1776-1779. [PMID: 33621605 DOI: 10.1016/j.jaad.2021.02.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 01/20/2021] [Accepted: 02/16/2021] [Indexed: 11/18/2022]
Affiliation(s)
| | | | - Nathalie C Zeitouni
- University of Arizona College of Medicine, Phoenix, Arizona; Medical Dermatology Specialists, Phoenix, Arizona.
| |
Collapse
|
19
|
Nelson B. How dermatology is failing melanoma patients with skin of color: Unanswered questions on risk and eye-opening disparities in outcomes are weighing heavily on melanoma patients with darker skin. In this article, part 1 of a 2-part series, we explore the deadly consequences of racism and inequality in cancer care. Cancer Cytopathol 2020; 128:7-8. [PMID: 31905269 DOI: 10.1002/cncy.22229] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
20
|
Ljung R, Talbäck M, Khanolkar AR, Feychting M. Birth month and risk of skin tumors-Follow up of six million Caucasians born from 1950 to 2014 in Sweden. Cancer Med 2020; 9:6062-6068. [PMID: 33283482 PMCID: PMC7433807 DOI: 10.1002/cam4.3286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 05/27/2020] [Accepted: 06/11/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Some studies hypothesize that birth month-as a proxy of exposure to ultraviolet radiation in early infancy-is associated with increased risk of skin tumors. METHODS We studied a national cohort of all 5 874 607 individuals born in Sweden to parents of Swedish or Nordic origin as a proxy for Caucasian origin, 1950 to 2014. The cohort was followed for incident skin tumors, including squamous cell carcinomas and melanomas but not basal cell carcinomas, through 2015 from birth up to age 65 for the oldest cohort. Cox regression estimated the association between month of birth and risk of skin tumors in models adjusted for sex, calendar period, and education. Crude observed to expected ratios were also calculated. RESULTS There were 33 914 cases of skin tumors, of these, 3025 were squamous cell cancer, 16 968 malignant melanoma and 8493 melanoma in situ/other and 5 428 squamous cell in situ/other in 192 840 593 person-years of follow-up. Observed to expected ratios by month of birth showed no association between month of birth and risk of skin tumors, and the same result was seen when Cox regression analysis was used. Subgroup analyses by sex, educational level, calendar period, or age at follow-up similarly showed no association. CONCLUSION This large register-based cohort study showed no evidence of a higher risk of skin tumors in those born during the spring. Thus, this study lends no support to the hypothesis that birth during spring is a major risk factor for later skin tumors.
Collapse
Affiliation(s)
- Rickard Ljung
- Unit of EpidemiologyInstitute of Environmental MedicineKarolinska InstitutetStockholmSweden
| | - Mats Talbäck
- Unit of EpidemiologyInstitute of Environmental MedicineKarolinska InstitutetStockholmSweden
| | - Amal R. Khanolkar
- Unit of EpidemiologyInstitute of Environmental MedicineKarolinska InstitutetStockholmSweden
- GOS Institute of Child HealthUniversity College LondonLondonUK
| | - Maria Feychting
- Unit of EpidemiologyInstitute of Environmental MedicineKarolinska InstitutetStockholmSweden
| |
Collapse
|
21
|
Huang K, Fan J, Misra S. Acral Lentiginous Melanoma: Incidence and Survival in the United States, 2006-2015, an Analysis of the SEER Registry. J Surg Res 2020; 251:329-339. [PMID: 32208196 DOI: 10.1016/j.jss.2020.02.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 01/13/2020] [Accepted: 02/16/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Acral lentiginous melanoma (ALM) is one of the four major subtypes in cutaneous malignant melanoma (CMM). We aimed to study the incidence and survival of ALM in the United States in recent 10 y and compare the survival between ALM and nonacral CMM. In the meantime, racial disparity and prognostic factors associated with survival were investigated. METHODS All the cases of ALM registered in the Surveillance, Epidemiology, and End Results registry from 2006 to 2015 were retrieved, including non-Hispanic whites (NHW), black Americans (blacks), Asian/Pacific Islanders, and Hispanic whites. Age-adjusted incidence was calculated. Clinicopathologic data, including age, gender, race, geographic location, Breslow thickness, ulceration, pathologic staging, sentinel lymph node status, and surgical approach, were collected and analyzed. Melanoma-specific survival (MSS) was analyzed in patients with ALM and CMM. The Kaplan-Meier method was used to estimate the influence of clinicopathologic data on ALM MSS. Only cases with complete staging and active follow-up were included in prognostic factor analysis. RESULTS A total of 1724 ALM and 87,442 nonacral CMM patients were included in the study. For ALM patients, the age-adjusted incidence rate was 2.0 per million person-years. The proportion of ALM among all melanoma subtypes was greatest in blacks (32.6%). The 5-y MSS rates of ALM were lower than CMM overall (80.6% versus 93.0%, P < 0.001, respectively). When controlled by stage, the difference was significant in patients diagnosed at stages I and III. ALM 5-y MSS rates were highest (84.3%) in NHW, intermediate in Asian/Pacific Islanders (76.6%), Hispanic white (72.0%), and lowest in blacks (66.9%). Blacks were elderly, male predominant, located in East and Middle American, and had thicker, more ulcerated, advanced disease as compared with NHWs. When controlled by stage, survival difference was significant between NHWs and blacks in stage I (P = 0.004) and stage III (P = 0.005) patients. Gender, race, sentinel lymph node status, and pathologic stage were identified as independent risk factors in multivariate analysis. CONCLUSIONS The incidence of ALM has been steady in recent 10 y and more prevalent in aged people. ALM is associated with a worse prognosis than CMM. Black Americans have the worst prognosis, and survival difference is significant between NHW and blacks.
Collapse
Affiliation(s)
- Kai Huang
- General Surgery, Brandon Regional Hospital, HCA West FL Division/USF Health Consortium, Brandon, Florida
| | - Ji Fan
- General Surgery, Brandon Regional Hospital, HCA West FL Division/USF Health Consortium, Brandon, Florida
| | - Subhasis Misra
- General Surgery, Brandon Regional Hospital, HCA West FL Division/USF Health Consortium, Brandon, Florida.
| |
Collapse
|
22
|
Roozbahani N, Kaviani AH, Khorsandi M. Path analysis of skin cancer preventive behavior among the rural women based on protection motivation theory. BMC Womens Health 2020; 20:121. [PMID: 32527329 PMCID: PMC7291759 DOI: 10.1186/s12905-020-00978-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 05/24/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Determining the effective factors on the adoption of preventive behaviors capable of reducing the risk of skin cancer is an important step in designing interventions to promote these behaviors. Based on the protection motivation theory, the present study is aimed to conduct a path analysis of skin cancer preventive behaviors in rural women to explore these factors. METHODS In this cross-sectional study, 243 rural women were randomly selected from the west of Iran to receive a valid and reliable questionnaire assessing constructs from the protection motivation theory, as well as demographic information. Fully completed questionnaires were returned by 230 women and the data were analyzed by SPSS 22 and LISREL8.8. RESULTS Concerning skin cancer preventive behaviors, 27.8% of women wore sun-blocking clothing when working under the sun, 21.7% used sunscreen cream, 5.7% wore a cap, and 4.8% used gloves and sunglasses. Protection motivation theory and per capita income explained 51% of motivation variance and 25% of the variance of skin cancer preventive behaviors. The response efficacy construct was the strongest predictor of the motivation of protection (ß = - 0.44, p < 0/001). Per-capita income (ß = - 0.34, p < 0/001) and motivation (ß = - 0.33, p < 0/001) were the strongest predictors of these behaviors. CONCLUSIONS This study showed that protection motivation theory is efficient in predicting skin cancer preventive behaviors and the interventions can be designed and implemented by this theory. Proper planning is also necessary for promoting these behaviors among people with low per-capita income.
Collapse
Affiliation(s)
- Nasrin Roozbahani
- Department of Health Education & Promotion, School of Health, Arak University of Medical Science, Arak, Iran.
| | - Abdol-Hossain Kaviani
- Department of Health Education & Promotion, School of Health, Arak University of Medical Science, Arak, Iran
| | - Mahboobeh Khorsandi
- Department of Health Education & Promotion, School of Health, Arak University of Medical Science, Arak, Iran
| |
Collapse
|
23
|
Abstract
The worldwide incidence of melanoma has increased rapidly over the last 50 years. Melanoma is the most common cancer found in the young adult population, and its incidence is very high among geriatric populations. The incidence of melanoma varies by sex, and this factor is also associated with differences in the anatomical site melanoma. Adolescent and young adult women have a higher incidence than men. This may be, in part, due to the greater use of sunbeds, as well as intentional sun exposure among girls and, in general, risky behaviours in seeking to suntan, due to socially-determined aesthetic needs. Indeed, the World Health Organization declared that there is sufficient evidence to classify exposure to ultraviolet radiation (sunbed use and sun exposure) as carcinogenic to humans. Although pigmentation characteristics, such as skin colour, hair and eye colour, freckles and number of common and atypical naevi, do influence susceptibility to melanoma, recommendations regarding prevention should be directed to the entire population and should include avoiding sunbed, covering sun-exposed skin, wearing a hat and sunglasses. Sunscreen use should not be used to prolong intentional sun exposure. Primary prevention should be focused mainly on young adult women, while secondary prevention should be focused mainly on elderly men. In fact, after the age of 40 years, incidence rates reverse, and the incidence of melanoma among men is greater than among women. This is probably due to the fact that men are less likely than women to examine their own skin or present to a dermatologist for skin examination.
Collapse
|
24
|
Abstract
The incidence of cutaneous melanoma continues to increase in pale skinned peoples in Europe and elsewhere. Epidemiological studies identified genetically determined phenotypes such as pale skin, freckles and red hair, and sunburn as risk factors for this cancer. The development of many melanocytic naevi is also genetically determined and a strong melanoma risk phenotype. Not surprisingly then, genome wide association studies have identified pigmentation genes as common risk genes, and to a lesser extent, genes associated with melanocytic naevi. More unexpectedly, genes associated with telomere length have also been identified as risk genes. Higher risk susceptibility genes have been identified, particularly CDKN2A as the most common cause, and very rarely genes such as CDK4, POT1, TERT and other genes in coding for proteins in the shelterin complex are found to be mutated. Familial melanoma genes are associated with an increased number of melanocytic naevi but not invariably and the atypical naevus phenotype is therefore an imperfect marker of gene carrier status. At a somatic level, the most common driver mutation is BRAF, second most common NRAS, third NF1 and increasing numbers of additional rarer mutations are being identified such as in TP53. It is of note that the BRAF and NRAS mutations are not C>T accepted as characteristic of ultraviolet light induced mutations.
Collapse
|
25
|
Abstract
There is increasing evidence that the behaviour of naevi and melanoma is under significant genetic and/or epigenetic control. Melanoma tumours behaves similarly all over the world. Many genes have now been implicated in melanoma risk and naevi number. Embryogenesis has also been important in the discovery of links between several neurological diseases and melanoma susceptibility. Telomere biology, which regulates cell senescence, is increasingly relevant in melanoma. Melanoma is often found in the context of family cancer syndromes and the identification of these families is important as screening for cancer will save lives. Melanoma is also one of the most immunogenic cancer as the behaviour of naevi and melanoma differ in patients with vitiligo or eczema. The search for non-sun related melanoma risk factors should continue as it is likely to lead to important discoveries which will, in turn, have an impact on therapeutic targets for this tumour.
Collapse
Affiliation(s)
- Veronique BATAILLE
- Twin Research and Genetic Epidemiology Department, Kings College, London
- Dermatology Department, West Herts NHS Trust, Herts, UK. E-mail:
| |
Collapse
|
26
|
Abstract
Cutaneous melanoma arises from melanocytes following genetic, epigenetic and allogenetic (i.e. other than epi/genetic) modifications. An estimated 10% of cutaneous melanoma cases are due to inherited variants or de novo mutations in approximately 20 genes, found using linkage, next-generation sequencing and association studies. Based on these studies, 3 classes of predisposing melanoma genes have been defined based on the frequency of the variants in the general population and lifetime risk of developing a melanoma: (i) ultra-rare variants with a high risk, (ii) rare with a moderate risk, and (iii) frequent variants with a low risk. Most of the proteins encoded by these genes have been shown to be involved in melanoma initiation, including proliferation and senescence bypass. This paper reviews the role(s) of these genes in the transformation of melanocytes into melanoma. It also describes their function in the establishment and renewal of melanocytes and the biology of pigment cells, if known.
Collapse
Affiliation(s)
- Julie U Bertrand
- Curie Institute, PSL Research University, INSERM U1021, Normal and Pathological Development of Melanocytes, Orsay, France
| | | | | | | | | |
Collapse
|
27
|
Cust A, Drummond M, Bishop D, Azizi L, Schmid H, Jenkins M, Hopper J, Armstrong B, Aitken J, Kefford R, Giles G, Demenais F, Goldstein A, Barrett J, Kanetsky P, Elder D, Mann G, Newton‐Bishop J. Associations of pigmentary and naevus phenotype with melanoma risk in two populations with comparable ancestry but contrasting levels of ambient sun exposure. J Eur Acad Dermatol Venereol 2019; 33:1874-1885. [PMID: 31087403 PMCID: PMC6800761 DOI: 10.1111/jdv.15680] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 05/03/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND People at high risk of developing melanoma are usually identified by pigmentary and naevus phenotypes. OBJECTIVE We examined whether associations of these phenotypes with melanoma risk differed by ambient sun exposure or participant characteristics in two population-based, case-control studies with comparable ancestry but different ambient sun exposure. METHODS Data were analysed from 616 cases and 496 controls from the Australian Melanoma Family Study and 2012 cases and 504 controls from the Leeds (UK) case-control study. Questionnaire, interview and dermatological skin examination data were collected using the same measurement protocols. Relative risks were estimated as odds ratios using unconditional logistic regression, adjusted for potential confounders. RESULTS Hair and skin colour were the strongest pigmentary phenotype risk factors. All associations of pigmentary phenotype with melanoma risk were similar across countries. The median number of clinically assessed naevi was approximately three times higher in Australia than Leeds, but the relative risks for melanoma associated with each additional common or dysplastic naevus were higher for Leeds than Australia, especially for naevi on the upper and lower limbs. Higher naevus counts on the head and neck were associated with a stronger relative risk for melanoma for women than men. The two countries had similar relative risks for melanoma based on self-reported naevus density categories, but personal perceptions of naevus number differed by country. There was no consistent evidence of interactions between phenotypes on risk. CONCLUSIONS Classifying people at high risk of melanoma based on their number of naevi should ideally take into account their country of residence, type of counts (clinical or self-reported), body site on which the naevus counts are measured and sex. The presence of naevi may be a stronger indicator of a genetic predisposition in the UK than in Australia based on less opportunity for sun exposure to influence naevus development.
Collapse
Affiliation(s)
- A.E. Cust
- Cancer Epidemiology and Prevention ResearchSydney School of Public HealthThe University of SydneySydneyAustralia
- Melanoma Institute AustraliaThe University of SydneySydneyAustralia
| | - M. Drummond
- Cancer Epidemiology and Prevention ResearchSydney School of Public HealthThe University of SydneySydneyAustralia
- Melanoma Institute AustraliaThe University of SydneySydneyAustralia
| | - D.T. Bishop
- Section of Epidemiology and BiostatisticsLeeds Institute of Cancer and PathologyUniversity of LeedsLeedsUK
| | - L. Azizi
- School of Mathematics and StatisticsThe University of SydneySydneyAustralia
| | - H. Schmid
- Centre for Cancer ResearchWestmead Institute for Medical ResearchThe University of SydneySydneyAustralia
| | - M.A. Jenkins
- Centre for Epidemiology and BiostatisticsMelbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia
| | - J.L. Hopper
- Centre for Epidemiology and BiostatisticsMelbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia
| | - B.K. Armstrong
- Cancer Epidemiology and Prevention ResearchSydney School of Public HealthThe University of SydneySydneyAustralia
| | - J.F. Aitken
- Viertel Centre for Research in Cancer ControlCancer Council QueenslandBrisbaneAustralia
| | - R.F. Kefford
- Melanoma Institute AustraliaThe University of SydneySydneyAustralia
- Macquarie University Health Sciences CentreMacquarie UniversitySydneyAustralia
| | - G.G. Giles
- Centre for Epidemiology and BiostatisticsMelbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia
- Cancer Epidemiology CentreCancer Council VictoriaMelbourneAustralia
| | - F. Demenais
- Genetic Variation and Human Diseases UnitUMR‐946INSERMUniversité Paris DiderotUniversité Sorbonne Paris CitéParisFrance
| | - A.M. Goldstein
- Human Genetics ProgramDivision of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaMDUSA
| | - J.H. Barrett
- Section of Epidemiology and BiostatisticsLeeds Institute of Cancer and PathologyUniversity of LeedsLeedsUK
| | - P.A. Kanetsky
- Cancer Epidemiology ProgramMoffitt Cancer CenterTampaFLUSA
| | - D.E. Elder
- Department of Pathology and Laboratory MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - G.J. Mann
- Melanoma Institute AustraliaThe University of SydneySydneyAustralia
- Centre for Cancer ResearchWestmead Institute for Medical ResearchThe University of SydneySydneyAustralia
| | - J.A. Newton‐Bishop
- Section of Epidemiology and BiostatisticsLeeds Institute of Cancer and PathologyUniversity of LeedsLeedsUK
| |
Collapse
|
28
|
Wright CY, Kapwata T, Singh E, Green AC, Baade P, Kellett P, Norval M. Trends in Melanoma Mortality in the Population Groups of South Africa. Dermatology 2019; 235:396-399. [PMID: 31269484 DOI: 10.1159/000500663] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 04/29/2019] [Indexed: 11/19/2022] Open
Abstract
The incidence of cutaneous melanoma (CM) is increasing in countries around the world. However, little is known about melanoma trends in African countries by population group. We studied CM mortality in South Africa from 1997 to 2014 to partly address this knowledge gap. Unit record mortality data for all South Africans who died from CM (n = 8,537) were obtained from Statistics South Africa. Join-point regression models were used to assess whether there was a statistically significant change in the direction and/or magnitude of the annual trends in CM mortality. A significant increasing trend of 11% per year was observed in age-adjusted mortality rates in men between 2000 and 2005 (p < 0.01), rising from 2 to 3 per 100,000. There was also a statistically significant increase of 180% per year among White South Africans from 1997 to 1999 (p < 0.05) and of 3% from 1999 to 2014 (p < 0.01). These results may be used to inform CM awareness campaigns and will motivate efforts to improve the collection and analysis of relevant statistics regarding the present burden of CM in South Africa.
Collapse
Affiliation(s)
- Caradee Yael Wright
- Environment and Health Research Unit, South African Medical Research Council, Pretoria, South Africa,
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa,
| | - Thandi Kapwata
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg, South Africa
| | - Elvira Singh
- National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Adele C Green
- QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Brisbane, Queensland, Australia
- Cancer Research UK, Manchester Institute and Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Peter Baade
- Cancer Council Queensland, Brisbane, Queensland, Australia
| | - Patricia Kellett
- National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa
| | - Mary Norval
- Biomedical Sciences, University of Edinburgh Medical School, Edinburgh, United Kingdom
| |
Collapse
|
29
|
Yamazaki N, Kiyohara Y, Uhara H, Uehara J, Fujisawa Y, Takenouchi T, Otsuka M, Uchi H, Ihn H, Hatsumichi M, Minami H. Long-term follow up of nivolumab in previously untreated Japanese patients with advanced or recurrent malignant melanoma. Cancer Sci 2019; 110:1995-2003. [PMID: 30959557 PMCID: PMC6549931 DOI: 10.1111/cas.14015] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/01/2019] [Accepted: 04/01/2019] [Indexed: 12/22/2022] Open
Abstract
The immune checkpoint inhibitor nivolumab inhibits the programmed death 1 receptor and suppresses the immune resistance of cancer cells. This is a long-term follow up of a single-arm, open-label, multicenter, phase II study of nivolumab in untreated Japanese patients with stage III/IV or recurrent melanoma. In addition, a post-hoc subgroup analysis stratified by melanoma types was performed. Nivolumab was administered intravenously at a dose of 3 mg/kg every 2 weeks. The primary endpoint was the overall response rate (ORR), and secondary endpoints included overall survival (OS), progression-free survival (PFS), best overall response, the disease control rate and change in tumor diameter. Safety was assessed by recording treatment-related adverse events (TRAE), including select immune-related adverse events. Of the 24 patients initially included in the primary phase II study, 10 survived for over 3 years (41.7%). The ORR was 34.8% (90% confidence interval [CI]: 20.8, 51.9) for all patients. When analyzing by melanoma type, the ORR was 66.7% (90% CI: 34.7, 88.3) for superficial spreading, 33.3% (90% CI: 11.7, 65.3) for mucosal, and 28.6% (90% CI: 10.0, 59.1) for acral lentiginous tumors. The median OS was 32.9 months, the 3-year OS rate was 43.5%, and the 3-year PFS rate was 17.2%. A long-term response was observed in all the tumor types. The most common TRAE included skin toxicity (45.8%) and endocrine disorders (29.2%). This study demonstrated the long-term efficacy and tolerability of nivolumab in patients with advanced or recurrent melanoma, irrespective of melanoma type.
Collapse
Affiliation(s)
- Naoya Yamazaki
- Department of Dermatologic OncologyNational Cancer Center HospitalTokyoJapan
| | - Yoshio Kiyohara
- Dermatology DivisionShizuoka Cancer Center HospitalShizuokaJapan
| | - Hisashi Uhara
- Department of DermatologyShinshu University School of MedicineNaganoJapan
- Present address:
Department of DermatologySapporo Medical UniversityHokkaidoJapan
| | - Jiro Uehara
- Department of DermatologyAsahikawa Medical UniversityHokkaidoJapan
| | | | | | - Masaki Otsuka
- Department of DermatologyOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
- Present address:
Dermatology DivisionShizuoka Cancer Center HospitalShizuokaJapan
| | - Hiroshi Uchi
- Department of DermatologyGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Hironobu Ihn
- Department of Dermatology and Plastic SurgeryFaculty of Life SciencesKumamoto UniversityKumamotoJapan
| | | | - Hironobu Minami
- Department of Medical Oncology/HematologyKobe University Graduate School of MedicineHyogoJapan
| |
Collapse
|
30
|
Wong K, Robles-Espinoza CD, Rodriguez D, Rudat SS, Puig S, Potrony M, Wong CC, Hewinson J, Aguilera P, Puig-Butille JA, Bressac-de Paillerets B, Zattara H, van der Weyden L, Fletcher CDM, Brenn T, Arends MJ, Quesada V, Newton-Bishop JA, Lopez-Otin C, Bishop DT, Harms PW, Johnson TM, Durham AB, Lombard DB, Adams DJ. Association of the POT1 Germline Missense Variant p.I78T With Familial Melanoma. JAMA Dermatol 2019; 155:604-609. [PMID: 30586141 PMCID: PMC6506889 DOI: 10.1001/jamadermatol.2018.3662] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 08/23/2018] [Indexed: 12/31/2022]
Abstract
Importance The protection of telomeres 1 protein (POT1) is a critical component of the shelterin complex, a multiple-protein machine that regulates telomere length and protects telomere ends. Germline variants in POT1 have been linked to familial melanoma, and somatic mutations are associated with a range of cancers including cutaneous T-cell lymphoma (CTCL). Objective To characterize pathogenic variation in POT1 in families with melanoma to inform clinical management. Design, Setting, and Participants In this case study and pedigree evaluation, analysis of the pedigree of 1 patient with melanoma revealed a novel germline POT1 variant (p.I78T, c.233T>C, chromosome 7, g.124870933A>G, GRCh38) that was subsequently found in 2 other pedigrees obtained from the GenoMEL Consortium. Main Outcomes and Measures (1) Identification of the POT1 p.I78T variant; (2) evaluation of the clinical features and characteristics of patients with this variant; (3) analysis of 3 pedigrees; (4) genomewide single-nucleotide polymorphism genotyping of germline DNA; and (5) a somatic genetic analysis of available nevi and 1 melanoma lesion. Results The POT1 p.I78T variant was found in 3 melanoma pedigrees, all of persons who self-reported as being of Jewish descent, and was shown to disrupt POT1-telomere binding. A UV mutation signature was associated with nevus and melanoma formation in POT1 variant carriers, and somatic mutations in driver genes such as BRAF, NRAS, and KIT were associated with lesion development in these patients. Conclusions and Relevance POT1 p.I78T is a newly identified, likely pathogenic, variant meriting screening for in families with melanoma after more common predisposition genes such as CDKN2A have been excluded. It could also be included as part of gene panel testing.
Collapse
Affiliation(s)
- Kim Wong
- Experimental Cancer Genetics, The Wellcome Trust Sanger Institute, Hinxton, England
| | - Carla Daniela Robles-Espinoza
- Experimental Cancer Genetics, The Wellcome Trust Sanger Institute, Hinxton, England
- Laboratorio Internacional de Investigación sobre el Genoma Humano, Universidad Nacional Autónoma de México, Campus Juriquilla, Santiago de Querétaro, Qro, Mexico
| | - David Rodriguez
- Departamento de Bioquímica y Biología Molecular, Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, Oviedo, Spain
- Centro de Investigación en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Saskia S. Rudat
- Experimental Cancer Genetics, The Wellcome Trust Sanger Institute, Hinxton, England
| | - Susana Puig
- Melanoma Unit, Department of Dermatology, Hospital Clínic de Barcelona, IDIBAPS, Barcelona University, Barcelona, Spain
- Centre of Biomedical Research on Rare Diseases (CIBERER), ISCIII, Barcelona, Spain
| | - Miriam Potrony
- Melanoma Unit, Department of Dermatology, Hospital Clínic de Barcelona, IDIBAPS, Barcelona University, Barcelona, Spain
- Centre of Biomedical Research on Rare Diseases (CIBERER), ISCIII, Barcelona, Spain
| | - Chi C. Wong
- Experimental Cancer Genetics, The Wellcome Trust Sanger Institute, Hinxton, England
| | - James Hewinson
- Experimental Cancer Genetics, The Wellcome Trust Sanger Institute, Hinxton, England
| | - Paula Aguilera
- Melanoma Unit, Department of Dermatology, Hospital Clínic de Barcelona, IDIBAPS, Barcelona University, Barcelona, Spain
- Centre of Biomedical Research on Rare Diseases (CIBERER), ISCIII, Barcelona, Spain
| | - Joan Anton Puig-Butille
- Centre of Biomedical Research on Rare Diseases (CIBERER), ISCIII, Barcelona, Spain
- Biochemistry and Molecular Genetics Department, Melanoma Unit, Hospital Clínic de Barcelona, IDIBAPS, Barcelona University, Barcelona, Spain
| | - Brigitte Bressac-de Paillerets
- Gustave Roussy, Université Paris-Saclay, Département de Biologie et Pathologie Médicales, Villejuif, France
- INSERM U1186, Université Paris-Saclay, Villejuif, France
| | - Hélène Zattara
- Département de Génétique, APHM, CHU Timone-Enfants, Marseille, France
| | | | | | - Thomas Brenn
- Pathology Department, Western General Hospital, Edinburgh, Scotland
| | - Mark J. Arends
- Pathology Department, Western General Hospital, Edinburgh, Scotland
| | - Víctor Quesada
- Departamento de Bioquímica y Biología Molecular, Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, Oviedo, Spain
- Centro de Investigación en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Julia A. Newton-Bishop
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, England
| | - Carlos Lopez-Otin
- Departamento de Bioquímica y Biología Molecular, Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, Oviedo, Spain
- Centro de Investigación en Red de Cáncer (CIBERONC), Madrid, Spain
| | - D. Timothy Bishop
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, England
| | - Paul W. Harms
- Department of Pathology, University of Michigan, Ann Arbor
| | | | | | | | - David J. Adams
- Experimental Cancer Genetics, The Wellcome Trust Sanger Institute, Hinxton, England
| |
Collapse
|
31
|
Maarouf M, Zullo SW, DeCapite T, Shi VY. Skin Cancer Epidemiology and Sun Protection Behaviors Among Native Americans. J Drugs Dermatol 2019; 18:420-423. [PMID: 31141849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Introduction: Sun protection behaviors in Native American populations are historically under-reported, though the greatest proportion lives in Western states that have the greatest UV-index burden within the United States. Materials/Methods: We deployed an anonymous questionnaire online, in-clinic, and in the community to Native Americans belonging to federally recognized tribe and have resided on a reservation. The questionnaire explored demographics, sunscreen use and preference, skin cancer screening, and personal and family history. Results: One-hundred fifty-nine respondents fit the inclusion criteria. Greater than 80% reported experiencing at least one sunburn, though only 10.7% and 36.4% reported regular sunscreen use on their body and face, respectively. The participants reported a myriad of reasons for which they do not utilize sunscreen, with 9% believing that Native Americans, or other skin of color persons, do not develop skin cancer. This was additionally observed in the low reports of ever receiving a skin exam (7.5%). Discussion: Sunscreen use among Native Americans (36.4%) appears to be greater than other skin of color users, but less than that of non-Hispanic Whites (40.4%). We postulate that this may be due to the respondents living in states with high UV burden, or an intrinsically greater propensity to burn. Native American populations tend to lack skin cancer screenings by dermatologists and understanding of skin cancer etiology. Efforts are needed to encourage education and dermatologic services to Native American reservations. J Drugs Dermatol. 2019;18(5):420-423.
Collapse
|
32
|
Tan A, Stein JA. Dermoscopic patterns of acral melanocytic lesions in skin of color. Cutis 2019; 103:274-276. [PMID: 31233579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Acral lentiginous melanoma (ALM) is a rare but aggressive subtype of melanoma often associated with poor prognosis. Although overall incidence is rare, ALM accounts for a larger proportion of melanomas among black, Asian, and Hispanic individuals than among white individuals. Similarly, the proportion of acral melanocytic nevi tends to be greater in ethnic skin despite a lower overall nevi count. Dermoscopy can help differentiate between benign and malignant acral melanocytic lesions. Herein, we discuss the population trends of acral melanocytic lesions in patients with skin of color. We also examine the diagnostic challenges of acral lesions and review the dermoscopic patterns unique to acral volar skin.
Collapse
Affiliation(s)
- Andrea Tan
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, USA
| | - Jennifer A Stein
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, USA
| |
Collapse
|
33
|
Loescher LJ, Rawdin S, Machain T, Emrick G, Pasvogel A, Spartonos D, Johnson RE, Campas D. Implementation of Project Students Are Sun Safe (SASS) in Rural High Schools Along the Arizona-Mexico Border. J Cancer Educ 2019; 34:259-268. [PMID: 29103193 DOI: 10.1007/s13187-017-1296-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The incidence of skin cancer is raising in Hispanics/Latinos, which is a concern for Hispanics/Latinos living in Arizona, a state with a high amount of ultraviolet radiation exposure. There is a dearth of research on skin cancer prevention education for Hispanic/Latino adolescents in high school. Using a community-based participatory research (CBPR) framework, academic and community partners conducted a project to adapt an existing efficacious skin cancer prevention program, Project Students are Sun Safe (SASS) and the current SASS online training model, for dissemination to predominantly Hispanic/Latino students attending high schools in rural southeastern Arizona, located along the Arizona-Mexico border. We assessed the feasibility of training some of these students as peer educators (n = 16) to implement the "Border SASS" lesson to their peers in high school classrooms (n = 198). Border SASS training and the classroom lesson were feasible for, and highly acceptable to, peer educators and classroom students. These students significantly improved skin cancer prevention knowledge scores and self-reported skin cancer prevention behaviors over a 3- to 4-month period post training and the intervention implementation. Here we report on the following: (1) academic-community partnership and adaptation of the SASS training model for rural Hispanic high school students, (2) training of the high school peer educators, (3) administration of the SASS lesson by the trained peer educators to high school students, and (4) further evaluation of peer educator training and classroom student outcomes.
Collapse
Affiliation(s)
- Lois J Loescher
- Colleges of Nursing and Public Health, The University of Arizona, 1305 N. Martin Street, Tucson, AZ, 85721, USA.
| | - Sarah Rawdin
- College of Nursing, The University of Arizona, 1305 N. Martin Street, Tucson, AZ, 85721, USA
| | - Tashina Machain
- Southeast Arizona Area Health Education Center, 1171 W Target Range Road, Nogales, AZ, 85621, USA
| | - Gail Emrick
- Southeast Arizona Area Health Education Center, 1171 W Target Range Road, Nogales, AZ, 85621, USA
| | - Alice Pasvogel
- College of Nursing, The University of Arizona, 1305 N. Martin Street, Tucson, AZ, 85721, USA
| | - Denise Spartonos
- Cancer Center, The University of Arizona, 1515 N. Campbell Ave, PO Box 245024, Tucson, USA
| | - Riley E Johnson
- Cancer Center, The University of Arizona, 1515 N. Campbell Ave, PO Box 245024, Tucson, USA
| | - David Campas
- Cancer Center, The University of Arizona, 1515 N. Campbell Ave, PO Box 245024, Tucson, USA
| |
Collapse
|
34
|
Asdigian NL, Barón AE, Morelli JG, Mokrohisky ST, Aalborg J, Dellavalle RP, Daley MF, Berwick M, Muller KE, Box NF, Crane LA. Trajectories of Nevus Development From Age 3 to 16 Years in the Colorado Kids Sun Care Program Cohort. JAMA Dermatol 2018; 154:1272-1280. [PMID: 30208471 PMCID: PMC6248123 DOI: 10.1001/jamadermatol.2018.3027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 07/13/2018] [Indexed: 11/14/2022]
Abstract
Importance Nevi are a risk factor for melanoma and other forms of skin cancer, and many of the same factors confer risk for both. Understanding childhood nevus development may provide clues to possible causes and prevention of melanoma. Objectives To describe nevus acquisition from the ages of 3 to 16 years among white youths and evaluate variation by sex, Hispanic ethnicity, and body sites that are chronically vs intermittently exposed to the sun. Design, Setting, and Participants This annual longitudinal observational cohort study of nevus development was conducted between June 1, 2001, and October 31, 2014, among 1085 Colorado youths. Data analysis was conducted between February 1, 2015, and August 31, 2017. Main Outcomes and Measures Total nevus counts on all body sites and on sites chronically and intermittently exposed to the sun separately. Results A total of 557 girls and 528 boys (150 [13.8%] Hispanic participants) born in 1998 were included in this study. Median total body nevus counts increased linearly among non-Hispanic white boys and girls between the age of 3 years (boys, 6.31; 95% CI, 5.66-7.03; and girls, 6.61; 95% CI, 5.96-7.33) and the age of 16 years (boys, 81.30; 95% CI, 75.95-87.03; and girls, 77.58; 95% CI, 72.68-82.81). Median total body nevus counts were lower among Hispanic white children (boys aged 16 years, 51.45; 95% CI, 44.01-60.15; and girls aged 16 years, 53.75; 95% CI, 45.40-63.62) compared with non-Hispanic white children, but they followed a largely linear trend that varied by sex. Nevus counts on body sites chronically exposed to the sun increased over time but leveled off by the age of 16 years. Nevus counts on sites intermittently exposed to the sun followed a strong linear pattern through the age of 16 years. Hispanic white boys and girls had similar nevus counts on sites intermittently exposed to the sun through the age of 10 years, but increases thereafter were steeper for girls, with nevus counts surpassing those of boys aged 11 to 16 years. Conclusions and Relevance Youths are at risk for nevus development beginning in early childhood and continuing through midadolescence. Patterns of nevus acquisition differ between boys and girls, Hispanic and non-Hispanic white youths, and body sites that are chronically exposed to the sun and body sites that are intermittently exposed to the sun. Exposure to UV light during this period should be reduced, particularly on body sites intermittently exposed to the sun, where nevi accumulate through midadolescence in all children. Increased attention to sun protection appears to be merited for boys, in general, because they accumulated more nevi overall, and for girls, specifically, during the adolescent years.
Collapse
Affiliation(s)
- Nancy L. Asdigian
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
| | - Anna E. Barón
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
| | - Joseph G. Morelli
- Department of Dermatology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
| | | | - Jenny Aalborg
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
| | - Robert P. Dellavalle
- Department of Dermatology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
- Dermatology Service, US Department of Veterans Affairs Rocky Mountain Regional Medical Center, Aurora, Colorado
| | - Matthew F. Daley
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
- Institute for Health Research, Kaiser Permanente Colorado, Aurora
| | - Marianne Berwick
- Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque
- Department of Dermatology, School of Medicine, University of New Mexico, Albuquerque
| | - Keith E. Muller
- Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville
| | - Neil F. Box
- Department of Dermatology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
| | - Lori A. Crane
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
| |
Collapse
|
35
|
Gaulding JV, Gutierrez D, Bhatia BK, Han X, Krajenta R, Neslund-Dudas C, Lim HW, Pritchett EN. Epidemiology of Skin Diseases in a Diverse Patient Population. J Drugs Dermatol 2018; 17:1032-1036. [PMID: 30365582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Epidemiologic studies of patients who present to dermatology clinics are necessary to identify the needs of patients. OBJECTIVE To quantify and compare diagnoses according to race, ethnicity, and socioeconomic status (SES) at 6 general dermatology clinics from January 2013 to December 2016. METHODS A retrospective cohort of new patients was established using an electronic medical record database. Primary diagnoses and diagnostic codes were recorded. Geocoding was utilized to obtain SES. RESULTS There were 65969 new patient visits. Racial and ethnic demographics were obtained with the overall top 3 conditions being eczema or dermatitis, benign skin neoplasm, and adnexal disease. In blacks, however, follicular disorders were the third most common condition seen. The most frequently encountered diagnoses at the clinics with the highest and lowest SES were benign skin neoplasm and eczema or dermatitis, respectively. LIMITATIONS Only primary diagnoses were included in analysis. Determining one's race is increasingly difficult. CONCLUSION Follicular disorders occurred with an increased frequency in blacks. When examining SES, eczema or dermatitis was the most frequently encountered primary diagnosis at the clinic with the lowest SES, with benign skin neoplasm seen with the highest frequency at the clinic with the highest SES. J Drugs Dermatol. 2018;17(10):1032-1036.
Collapse
|
36
|
Gironi LC, Colombo E, Pasini B, Giorgione R, Farinelli P, Zottarelli F, Esposto E, Zavattaro E, Allara E, Ogliara P, Betti M, Dianzani I, Savoia P. Melanoma-prone families: new evidence of distinctive clinical and histological features of melanomas in CDKN2A mutation carriers. Arch Dermatol Res 2018; 310:769-784. [PMID: 30218143 DOI: 10.1007/s00403-018-1866-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 08/30/2018] [Accepted: 09/08/2018] [Indexed: 11/26/2022]
Abstract
Germline mutations on the CDKN2A gene, the most important known genetic factors associated with cutaneous melanomas (CMs), predispose carriers to multiple primary CMs (MPMs) with higher frequency and younger onset compared to non-carriers. Most of the largest published studies concerning clinical and histological characteristics of CMs with CDKN2A mutation carriers did not specify if the described CMs are first or subsequent to the first, and they used sporadic CMs from non-genotyped patients as controls. We conducted a single-centre observational study to compare clinical and histological CM features of 32 unrelated carriers (MUT) of 5 germline CDKN2A mutations (one of which was never previously described) compared to 100 genotyped wild-type (WT) patients. We stratified the data based on time of diagnosis, anatomical site and histological subtype of CMs, demonstrating several significant unreported differences between the two groups. MUT developed a higher number of dysplastic nevi and MPMs. We proved for the first time that anatomical distribution of CMs in MUT was independent of gender, unlike WTs. MUTs developed in situ and superficial spreading melanomas (SSMs) more frequently, with significantly higher number of SSMs on the head/neck. In MUTs, Breslow thickness was significantly lower for all invasive CMs. When CMs were stratified on the basis of the time of occurrence, statistical significance was maintained only for SSMs subsequent to the first. In WTs, Clark level was significantly higher, and ulceration was more prevalent than in MUTs. Significant differences in ulceration were observed only in SSMs. In nodular CMs, we did not find differences in terms of Breslow thickness or ulceration between WTs and MUTs. In situ CMs developed 10 years earlier in MUTs with respect to WTs, whereas no significant differences were observed in invasive CMs. In contrast to those reported previously by other authors, we did not find a difference in skin phototype.
Collapse
Affiliation(s)
- Laura Cristina Gironi
- Department of Health Sciences, A. Avogadro University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy.
| | - Enrico Colombo
- Department of Translational Medicine, A. Avogadro University of Eastern Piedmont, Novara, Italy
| | - Barbara Pasini
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Roberto Giorgione
- Department of Health Sciences, A. Avogadro University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy
| | - Pamela Farinelli
- Department of Health Sciences, A. Avogadro University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy
| | - Francesca Zottarelli
- Department of Health Sciences, A. Avogadro University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy
| | - Elia Esposto
- Department of Health Sciences, A. Avogadro University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy
| | - Elisa Zavattaro
- Department of Health Sciences, A. Avogadro University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy
| | - Elias Allara
- NIHR Blood and Transplant Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Paola Ogliara
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Marta Betti
- Department of Health Sciences, A. Avogadro University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy
| | - Irma Dianzani
- Department of Health Sciences, A. Avogadro University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy
| | - Paola Savoia
- Department of Health Sciences, A. Avogadro University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy
| |
Collapse
|
37
|
Yen H, Li WQ, Dhana A, Li T, Qureshi A, Cho E. Red meat and processed meat intake and risk for cutaneous melanoma in white women and men: Two prospective cohort studies. J Am Acad Dermatol 2018; 79:252-257.e6. [PMID: 29698709 PMCID: PMC6089375 DOI: 10.1016/j.jaad.2018.04.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 04/09/2018] [Accepted: 04/12/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Red and processed meat consumption has been associated with increased risk for several cancers, but the association with cutaneous melanoma risk has been inconclusive. OBJECTIVE To investigate the association between red and processed meat intake and melanoma risk. METHODS Dietary information was assessed by using food frequency questionnaires in 2 prospective cohorts: 75,263 women from the Nurses' Health Study (1984-2010) and 48,523 men from the Health Professionals Follow-up Study (1986-2010). Melanoma cases were confirmed by reviewing pathology records. Pooled multivariable hazard ratios and 95% confidence intervals were estimated by using Cox proportional hazards models. RESULTS A total of 679 female and 639 male melanoma cases were documented during follow-up. Red and processed meat intake was inversely associated with melanoma risk (P = .002 for trend); the pooled hazard ratios (95% confidence intervals) of the 2 cohorts were 1.00 (reference), 1.00 (0.87-1.14), 0.98 (0.86-1.13), 0.89 (0.77-1.02), and 0.81 (0.70-0.95) for increasing quintiles of intake. LIMITATIONS Findings might have limited generalizability, considering that the cohorts were limited to white health professionals. CONCLUSION Red and processed meat intake was inversely associated with melanoma risk in these 2 cohorts.
Collapse
Affiliation(s)
- Hsi Yen
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Dermatology, Chang Gung Memorial Hospital Linkou and Taipei Branch, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Qing Li
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island; Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island
| | - Ashar Dhana
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Division of Dermatology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Tricia Li
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Abrar Qureshi
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island; Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Eunyoung Cho
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island; Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
| |
Collapse
|
38
|
Padovese V, Franco G, Valenzano M, Pecoraro L, Cammilli M, Petrelli A. Skin cancer risk assessment in dark skinned immigrants: the role of social determinants and ethnicity. Ethn Health 2018; 23:649-658. [PMID: 28277022 DOI: 10.1080/13557858.2017.1294657] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVES Dark-skinned people have a lower incidence rate of skin cancer, in particular melanoma, which is detected at more advanced stages leading to poorer prognoses and long-term outcomes compared to whites. The gap in survival is due to some difficulty in melanoma detection, lack of attention from doctors and awareness by patients. This study aims to assess skin cancer risk awareness in dark-skinned immigrants and to determine the influence of socioeconomic factors and ethnic origin on behaviors. DESIGN This is a cross-sectional health facility based study carried out in a 12-month period. A semi-structured questionnaire to assess skin cancer risk awareness and a dermatological examination was offered to dark-skinned immigrants consecutively attending the dermatology department of the National Institute for Health, Migration and Poverty in Rome. RESULTS 147 dark-skinned immigrants were enrolled, of which 54.4% were males, coming from Africa (53.1%). They were mainly young, aged 18-34 (56.5%). The level of education and length of stay in Italy was significantly related to the awareness about skin cancer: people with a high educational level (OR: 8.1 95% CI: 3.2-23.4) or immigrated more than 4 years before the interview (OR: 2.1 95% CI: 1.0-4.4) have a greater knowledge about skin cancer. CONCLUSIONS Education level is the strongest predictive factor of skin cancer awareness, whereas cultural behaviours and personal experience of sunburns are the main factors determining sunlight avoidance. Health promotion programs targeting immigrants must consider cultural differences related to ethnicity and country of origin, and adopt a transcultural approach.
Collapse
Affiliation(s)
- Valeska Padovese
- a Department of Dermatology , National Institute for Health, Migration and Poverty (INMP) , Rome , Italy
| | - Gennaro Franco
- a Department of Dermatology , National Institute for Health, Migration and Poverty (INMP) , Rome , Italy
| | - Mariacarla Valenzano
- a Department of Dermatology , National Institute for Health, Migration and Poverty (INMP) , Rome , Italy
| | - Laura Pecoraro
- a Department of Dermatology , National Institute for Health, Migration and Poverty (INMP) , Rome , Italy
| | - Marina Cammilli
- a Department of Dermatology , National Institute for Health, Migration and Poverty (INMP) , Rome , Italy
| | - Alessio Petrelli
- a Department of Dermatology , National Institute for Health, Migration and Poverty (INMP) , Rome , Italy
| |
Collapse
|
39
|
Koga M, Yoshida Y, Imafuku S. Clinical Characteristics of the Halo Phenomenon in Infants with Neurofibromatosis 1: A Case Series. Acta Derm Venereol 2018; 98:153-154. [PMID: 28902947 DOI: 10.2340/00015555-2796] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Monji Koga
- Department of Dermatology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, 814-0180 Fukuoka, Japan.
| | | | | |
Collapse
|
40
|
Desai A, Ugorji R, Khachemoune A. Acral melanoma foot lesions. Part 1: epidemiology, aetiology, and molecular pathology. Clin Exp Dermatol 2017; 42:845-848. [PMID: 28940724 DOI: 10.1111/ced.13243] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2017] [Indexed: 01/16/2023]
Abstract
Acral melanoma (AM) is a rare subtype of cutaneous malignant melanoma (MM) found on acral skin, primarily on the soles of the feet. Although rare, it is the most common subtype of MM found in patients of African or East Asian ethnicity and has a poor prognosis, often because of the more advanced stage of presentation at diagnosis. The pathogenesis of AM is unclear, but genetic alterations, including mutations in BRAF, NRAS, and KIT have been implicated. Early diagnosis of AM is important for a better prognosis, but its identification is often challenging, leading to easy misdiagnosis. In the first of this two-part review, we review the history, epidemiology, aetiology and molecular pathology of AM; in part 2 we will review diagnosis and management.
Collapse
Affiliation(s)
- A Desai
- Department of Dermatology, State University of New York Downstate Medical Center, Department of Dermatology, Brooklyn, NY, USA
| | - R Ugorji
- Department of Dermatology, State University of New York Downstate Medical Center, Department of Dermatology, Brooklyn, NY, USA
| | - A Khachemoune
- Department of Dermatology, State University of New York Downstate Medical Center, Department of Dermatology, Brooklyn, NY, USA
- Department of Dermatology, Veterans Health Administration, Department of Dermatology, Brooklyn, NY, USA
| |
Collapse
|
41
|
Kailas A, Botwin AL, Pritchett EN, Jackson-Richards D, Lewis S, Sadhwani D, Desai SR, Taylor SC. Assessing the effectiveness of knowledge-based interventions in increasing skin cancer awareness, knowledge, and protective behaviors in skin of color populations. Cutis 2017; 100:235-240. [PMID: 29136057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Skin of color (SOC) populations (ie, blacks, Hispanics, Asians) are at a notably higher risk for mortality from skin cancers such as melanoma than white individuals. In this article, we seek to answer the following question: Do knowledge-based interventions increase skin cancer awareness among SOC patients? Following an extensive literature search, a total of 4 articles were analyzed and discussed in this review.
Collapse
Affiliation(s)
- Ajay Kailas
- University of Central Florida College of Medicine, Orlando, USA
| | - Ariel L Botwin
- University of Central Florida College of Medicine, Orlando, USA
| | - Ellen N Pritchett
- Multicultural Dermatology Center, Henry Ford Medical Center, Detroit, Michigan, USA
| | | | - Suzanna Lewis
- Department of Dermatology, University of South Florida, Tampa, USA
| | - Divya Sadhwani
- Department of Dermatology, University of South Florida, Tampa, USA
| | - Seemal R Desai
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, USA
| | - Susan C Taylor
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| |
Collapse
|
42
|
Kunene Z, Albers PN, Lucas RM, Banwell C, Mathee A, Wright CY. 'My child did not like using sun protection': practices and perceptions of child sun protection among rural black African mothers. BMC Public Health 2017; 17:677. [PMID: 28841823 PMCID: PMC5574151 DOI: 10.1186/s12889-017-4688-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 08/20/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Photodamage is partially mitigated by darker skin pigmentation, but immune suppression, photoaging and cataracts occur among individuals with all skin types. METHODS To assess practices and acceptability to Black African mothers of sun protection equipment for their children living in a rural area, participants were recruited at the time of their child's 18-month vaccinations. Mothers completed a baseline questionnaire on usual sun behaviours and sun protection practices. They were then provided with sun protection equipment and advice. A follow-up questionnaire was administered two weeks later. RESULTS Mothers reported that during the week prior to the baseline questionnaire, children spent on average less than 1 hour of time outdoors (most often spent in the shade). Most mothers (97%) liked the sun protection equipment. However, many (78 of 86) reported that their child did not like any of the sun protection equipment and two-thirds stated that the sun protection equipment was not easy to use. CONCLUSIONS Among Black Africans in rural northern South Africa, we found a mismatch between parental preferences and child acceptance for using sun protection when outdoors. A better understanding of the health risks of incidental excess sun exposure and potential benefits of sun protection is required among Black Africans.
Collapse
Affiliation(s)
- Zamantimande Kunene
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg, South Africa
| | - Patricia N. Albers
- Environment and Health Research Unit, South African Medical Research Council, 1 Soutpansberg Road, Private Bag x385, Pretoria, 0001 South Africa
| | - Robyn M. Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia
- Centre for Ophthalmology and Visual Sciences, University of Western Australia, Perth, Australia
| | - Cathy Banwell
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia
| | - Angela Mathee
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg, South Africa
- Department of Community Medicine, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Caradee Y. Wright
- Environment and Health Research Unit, South African Medical Research Council, 1 Soutpansberg Road, Private Bag x385, Pretoria, 0001 South Africa
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa
| |
Collapse
|
43
|
Bryant J, Zucca A, Brozek I, Rock V, Bonevski B. Sun protection attitudes and behaviours among first generation Australians with darker skin types: results from focus groups. J Immigr Minor Health 2016; 17:248-54. [PMID: 23963873 DOI: 10.1007/s10903-013-9900-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Despite residing in a country that has the highest rates of skin cancer in the world, little is known about the knowledge, attitudes and sun protection practices of first generation Australian-born individuals with olive and darker skin types. Six focus groups with first generation Australian-born individuals of Asian, Mediterranean, Middle Eastern and Indian background were conducted. Participants had good knowledge of the dangers of skin cancer. Most correctly perceived darker skin types as protective and believed they were at low risk of skin cancer. Most participants could recall high profile mass media sun protection campaigns. Several participants suggested that greater representation of ethnic minorities and/or individuals with darker skin types would increase the personal relevance of campaigns. Beliefs that sun protection is not necessary on the basis of skin type highlights the need for further studies to explore fundamental differences in attitudes and practices between those with olive and darker skin and the general Australian population.
Collapse
Affiliation(s)
- Jamie Bryant
- Priority Research Centre for Health Behaviour, Health Behaviour Research Group, University of Newcastle and Hunter Medical Research Institute, Public Health/HBRG, HMRI Building, Callaghan, NSW, 2308, Australia,
| | | | | | | | | |
Collapse
|
44
|
Number of New Cases per 100,000 Persons by Race/Ethnicity & Sex: Melanoma of the Skin. J Natl Cancer Inst 2016; 108:djw289. [PMID: 27920056 DOI: 10.1093/jnci/djw289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
45
|
Dawes SM, Tsai S, Gittleman H, Barnholtz-Sloan JS, Bordeaux JS. Racial disparities in melanoma survival. J Am Acad Dermatol 2016; 75:983-991. [PMID: 27476974 DOI: 10.1016/j.jaad.2016.06.006] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 05/30/2016] [Accepted: 06/03/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Melanoma is a cutaneous malignancy common in the white population but can also occur in other racial groups. OBJECTIVE We sought to evaluate survival across racial groups in patients given a diagnosis of malignant melanoma. METHODS The Surveillance, Epidemiology, and End Results database was used to populate a cohort of 96,953 patients given a diagnosis of cutaneous melanoma as their primary cancer, from 1992 to 2009. RESULTS White patients had the longest survival time (P < .05), followed by Hispanic (P < .05), Asian American/Native American/Pacific Islander (P < .05), and black (P < .05) patients, respectively. Survival stratified by race and stage showed that for stages I and III, blacks had a significantly lower survival (P < .05), and increased hazard ratios (stage I hazard ratio, 3.037 [95% confidence interval, 2.335-3.951]; stage III hazard ratio, 1.864 [95% confidence interval, 1.211-2.87]). The proportion of later stage cutaneous melanoma (stages II-IV) was greater in blacks compared with whites. CONCLUSION Despite higher incidence of cutaneous melanoma in whites, overall survival for cutaneous melanoma in non-whites was significantly lower. Our results suggest that more emphasis is needed for melanoma screening and awareness in non-white populations to improve survival outcomes.
Collapse
Affiliation(s)
- Sean M Dawes
- Michigan State University College of Osteopathic Medicine, East Lansing, Michigan
| | - Sheena Tsai
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Haley Gittleman
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio
| | - Jill S Barnholtz-Sloan
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio; Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Jeremy S Bordeaux
- Department of Dermatology, University Hospitals Case Medical Center, Cleveland, Ohio.
| |
Collapse
|
46
|
Abstract
BACKGROUND Melanoma accounts for the majority of skin cancer deaths. It has over thirty different subtypes. Different races have been observed to differ in multiple aspects of melanoma. METHODS SEER (Surveillance, Epidemiology, and End Results) data on six major subtypes, namely melanoma in situ (MIS), superficial spreading melanoma (SSM), nodular melanoma (NM), lentigo maligna melanoma (LMM), acral lentiginous melanoma malignant (ALM), and malignant melanoma NOS (NOS), were analyzed. The racial groups studied included NHW (non-Hispanic white), HW (Hispanic white), Black, and Asian/PI (Pacific Islanders). Univariate and multivariate analysis was conducted to quantify racial differences in patients' characteristics, incidence, treatment, and survival. RESULTS Significant racial differences are observed in patients' characteristics. For all subtypes except for ALM, NHWs have the highest incidence rates, followed by HWs, while Blacks have the lowest. For ALM, HWs have the highest rate, followed by NHWs. In stratified analysis, interaction between gender and race is observed. For the first five subtypes and localized and regional NOS, the dominating majority of patients had surgery, while for distant NOS, the distribution of treatment is more scattered. Significant racial differences are observed for distant ALM and NOS. For MIS, SSM, NM, LMM, and ALM, there is no significant racial difference in survival. For NOS, significant racial differences in survival are observed for the localized and regional stages, with NHWs having the best and Blacks having the worst five-year survival rates. CONCLUSIONS Racial differences exist for the six major melanoma subtypes in the U.S. More data collection and analysis are needed to fully describe and interpret the differences across racial groups and across subtypes.
Collapse
Affiliation(s)
- Yu Wang
- School of Statistics and The center for Applied Statistics, Renmin University of China, 59 Zhongguancun Ave., Beijing, 100872 China
| | - Yinjun Zhao
- School of Public Health, Yale University, 60 College ST, LEPH 206, New Haven, CT 06520 USA
| | - Shuangge Ma
- School of Statistics and The center for Applied Statistics, Renmin University of China, 59 Zhongguancun Ave., Beijing, 100872 China
- School of Public Health, Yale University, 60 College ST, LEPH 206, New Haven, CT 06520 USA
- VA Cooperative Studies Program Coordinating Center, West Haven, CT USA
| |
Collapse
|
47
|
Ward-Peterson M, Acuña JM, Alkhalifah MK, Nasiri AM, Al-Akeel ES, Alkhaldi TM, Dawari SA, Aldaham SA. Association Between Race/Ethnicity and Survival of Melanoma Patients in the United States Over 3 Decades: A Secondary Analysis of SEER Data. Medicine (Baltimore) 2016; 95:e3315. [PMID: 27124020 PMCID: PMC4998683 DOI: 10.1097/md.0000000000003315] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 03/14/2016] [Accepted: 03/16/2016] [Indexed: 11/26/2022] Open
Abstract
UNLABELLED Melanoma is a treatable and preventable skin cancer. It is responsible for 75% of deaths among all skin cancers. Previous studies have found that race/ethnicity may play a role in survival among melanoma patients. However, there are no studies that cover 30 years and take race into account for the U.S. POPULATION This study is a secondary analysis of the National Cancer Institute's Surveillance, Epidemiology, and End Result (SEER) Program. Adults with primary cutaneous melanoma from 1982 to 2011 were included; the final sample size was 185,219. The outcome was survival; both cause-specific and all-cause mortality were examined. The main exposure was race/ethnicity. Kaplan-Meier survival analysis was used to estimate overall survival. Cox proportional hazards regression was used to estimate unadjusted and adjusted hazard ratios (HRs). A P-value less than 0.05 was considered statistically significant.More than 50% of patients in all races/ethnicities were diagnosed at the in situ or localized stage. Non-Hispanic White patients were more frequently diagnosed at the in situ stage. Overall, more men were diagnosed than women. The majority of cases among all races were men. Non-Hispanic Black females represented the smallest percentage of melanoma cases among all races. The smallest number of diagnoses across all races/ethnicities was made from 1982 to 1991. Median follow-up was 81 months and no collinearity was observed in the adjusted models. When examining cause-specific mortality and controlling for site and stage at diagnosis, gender, age and decade of diagnosis, the HR for non-Hispanic Black patients was lower than that for non-Hispanic White patients (HR 0.7; 95% confidence interval (CI): 0.6-0.8). However, when examining all-cause mortality, this difference disappeared (HR 1.1; 95% CI: 1.0-1.2). Stage at diagnosis impacted HR; patients diagnosed with distant metastases had significantly worse survival.When taking cause-specific mortality into consideration and after controlling for stage and site at diagnosis, gender, and age and decade of diagnosis, non-Hispanic Black patients had a lower HR compared to non-Hispanic White patients. However, this difference disappeared when examining all-cause mortality. Further research is needed to explore this finding and to determine what factors may be associated with late-stage melanoma diagnosis.
Collapse
Affiliation(s)
- Melissa Ward-Peterson
- From the Department of Medical and Population Health Sciences Research (MW-P, JMA), Department of Human and Molecular Genetics, Herbert Wertheim College of Medicine (JMA), Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL (MW-P), and College of Medicine, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia (MKA, AMN, ESA-A, TMA, SAD, SAA)
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Perez M. Current Trends in Skin of Color. J Drugs Dermatol 2016; 15:381-382. [PMID: 27050691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
|
49
|
Hammoud SM, Kruis RWJ, Sigurdsson V. Prediction of the Occurrence of Melanoma and Non-melanoma Skin Cancer in Patients with Vitiligo. Acta Derm Venereol 2016; 96:106-7. [PMID: 26084211 DOI: 10.2340/00015555-2179] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Shedia M Hammoud
- Department of Internal Medicine, Tergooi Ziekenhuis, 1201DA Hilversum, The Netherlands.
| | | | | |
Collapse
|
50
|
Zhang W, Lu B, Cui R, Lu H. Number, Distribution and Dermoscopic Pattern of Melanocytic Naevi in a Chinese Population. Acta Derm Venereol 2016; 96:134-5. [PMID: 26073162 DOI: 10.2340/00015555-2172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Wei Zhang
- Department of Dermatology, Affiliated Hospital of Guiyang Medical College, 550001 Guiyang, China
| | | | | | | |
Collapse
|