New Cases Of Skin Cancer Research Articles

Projection of the number of new cases of skin cancer in the world.

Projection of the number of new cases of skin cancer in the world.

SkiNet: A deep learning framework for skin lesion diagnosis with uncertainty estimation and explainability

Skin cancer is considered to be the most common human malignancy. Around 5 million new cases of skin cancer are recorded in the United States annually. Early identification and evaluation of skin lesions are of great clinical significance, but the disproportionate dermatologist-patient ratio poses a significant problem in most developing nations. Therefore a novel deep architecture, named as SkiNet, is proposed to provide faster screening solution and assistance to newly trained physicians in the process of clinical diagnosis of skin cancer. The main motive behind SkiNet's design and development is to provide a white box solution, addressing a critical problem of trust and interpretability which is crucial for the wider adoption of Computer-aided diagnosis systems by medical practitioners. The proposed SkiNet is a two-stage pipeline wherein the lesion segmentation is followed by the lesion classification. Monte Carlo dropout and test time augmentation techniques have been employed in the proposed method to estimate epistemic and aleatoric uncertainty. A novel segmentation model named Bayesian MultiResUNet is used to estimate the uncertainty on the predicted segmentation map. Saliency-based methods like XRAI, Grad-CAM and Guided Backprop are explored to provide post-hoc explanations of the deep learning models. The ISIC-2018 dataset is used to perform the experimentation and ablation studies. The results establish the robustness of the proposed model on the traditional benchmarks while addressing the black-box nature of such models to alleviate the skepticism of medical practitioners by incorporating transparency and confidence to the model's prediction.

Profile of Non-Melanoma Skin Cancer and Malignant Melanoma at Dr. Mohammad Hoesin General Hospital Palembang from 2017 - 2019: A Retrospective Study

Background: Currently, there is an increasing trend in skin cancer incidence, especially non-melanoma skin cancer (NMSC), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), also malignant melanoma (MM), causing an increase in morbidity and mortality rates. The high treatment cost causes an economic burden of disease in the country and negatively impacts public health issues. This study aimed to determine the profile of NMSC and MM regarding the sex, age, occupation, location of the lesion, clinicohistopathological diagnosis of skin cancer in Dr. Mohammad Hoesin General Hospital Palembang January 2017-December 2019.
 Methods: A retrospective analytical observational study obtained from medical records of NMSC and MM patients in Dr. Mohammad Hoesin General Hospital Palembang from January 2017-December 2019 as confirmed using histopathological results from the Pathology Department.
 Results: There were 324 new cases of NMSC and MM, including BCC 162 cases (50%) and SCC 130 cases (40.1%), whereas MM 32 cases (9.9%). Women had a higher probability of developing skin cancer with a ratio of 1.13:1. The average age of skin cancer was between 55-64 years old (33.6%), with a mean age of 57 years old. There was a statistically significant relationship between gender, age, occupation, and areas of skin cancer against skin cancer. Furthermore, overexposure to ultraviolet (UV) radiation is related to high-risk occupations, including farmers (50%), while the most frequent location of skin cancer was the face (67.3%).
 Conclusion: Our study implicated a 1.5-fold increase in new cases of skin cancer between 2017 to 2019. BCC cases were more prevalent than SCC and MM cases. There was also a significant association between skin cancer and occupation also the location of skin cancer as the risk factor for UV exposure. Nevertheless, further research involving larger samples or a multicenter approach is needed.

An Exploration of the Use and Impact of Preventive Measures on Skin Cancer.

Background: Skin cancer is the most common form of cancer, and both clinical and epidemiological data link cumulative solar dosages and the number of sunburns to skin cancer. Each year, more than 5.4 million new cases of skin cancer are diagnosed, incurring a significant health and financial burden. Recommended preventive measures for skin cancer include the use of sunscreen, sun avoidance, and protective clothing. This study used a national database to examine the association of preventive measures with the prevalence of skin cancer, specifically analyzing the preventive measures of sunscreen use, staying in the shade, and wearing long-sleeved shirts. The second aim was to determine which characteristics, if any, correlated with using prevention measures. Methods: This study analyzed data from the National Health and Nutritional Examination Survey 2015–2016 cycle to examine the association of three preventive measures (using sunscreen, staying in the shade, and wearing long-sleeved shirts) with skin cancer. Logistic regression and chi-square tests were utilized to examine the relationship between skin cancer and these prevention methods. Results: Sunscreen use (OR = 3.752; p < 0.05) was statistically associated with a lower prevalence of skin cancer, while wearing long-sleeved shirts (OR = 6.911; p = 0.064) and staying in the shade (OR = 0.646; p = 0.481) did not emerge as factors significantly associated with a lower prevalence after controlling for gender, race/ethnicity, marital status, income, health insurance, and general health. Additionally, men and individuals of color were less likely to use sunscreen. Conclusion: Sunscreen use was associated with a lower prevalence of skin cancer, while wearing long-sleeved shirts and staying in the shade was not significantly linked to lower rates of skin cancer, suggesting that these measures may not be as effective as sunscreen for preventing skin cancer. Men and individuals of color were significantly less likely to use sunscreen. These findings can help guide future education efforts and research regarding skin cancer prevention and suggest the need to develop male-oriented programs to mitigate the gender disparity in employing sun-protection measures.

Prevent Skin Cancer in the Society, An Integrated Personalised Care Approach

IntroductionIn the Netherlands, skin cancer is the most common type of cancer (KWF, 2016). More than 51.000 new cases of skin cancer are diagnosed every year and over 900 fatalities are reported (RIVM, 2017). Skin cancer incidence rates increase dramatically: since 1990 the number of new patients with skin cancer quadrupled (RIVM, 2017). This increase is much higher than in other types of cancer (IKNL, 2016). It is expected that incidence rates of skin cancer will increase even further, probably with a factor 2 to 5 (RIVM, 2017).Direct costs for medical treatment of skin cancer are estimated at 325 million each year (250-400 million) (RIVM, 2017). On top of that, sick leave and premature mortality are also important indirect costs in melanoma (Brochez et al., 1999). Increasing use of more costly treatment, such as Mohs surgery and photodynamic therapy, is contributing to rising treatment costs (Hollestein et al, 2017). In addition to the costs, this growing group of patients with skin cancer will represent an important burden on the limited specialized dermatological care in the Netherlands.Subsequent early assessment of skin cancer risk is necessary for timely preventive measures in the general population.Theory/Methods1) A systematic review of the literature on patient characteristics with a prognostic predictive value for future basal cell carcinoma, squamous cell carcinoma or melanoma (such as age, gender, presages, signs and risk behaviour).2) A Current practice analysis on care concerning risk behaviour, presages and signs of skin cancer.3) Prognostic modelling using existing data of over 5000 cases from the Netherlands Comprehensive Cancer Organisation (IKNL).4) Developing risk profiles and implement these through internet and social media.ResultsIt will provide insight in early risk behaviours in the general population. It also provide knowledge of serious presages or signs enabling these patients to be seen by their GP timely.ConclusionBasal cell carcinoma (BCC, approx. 70%), squamous cell carcinoma (SCC, approx. 20%) and melanoma (approx. 10%) are the three most common types of skin cancer. Melanoma is the most lethal type, accounting for 90% of all skin cancer fatalities. The incidence of melanoma in the Netherlands is among the highest in Europe (RIVM, 2017). Despite the fact that most non-melanoma skin cancers (BCC and SCC) can be cured, the treated lesions can be disfiguring or even lethal if not treated timely.Lessons learnedRisk profiles will enable healthcare professionals and citizens both with knowledge which persons are at high risk and should be screened and insight in risk behaviour.LimitationsRisk screening is costly, time consuming and it is to be expected that the adherence will be moderate.Suggestions for future researchBehaviour change intervention target groups in the society as implementation research.

Image segmentation of skin cancer using MobileNet as an encoder and linknet as a decoder

Cancer causes many deaths in the world. One of the most dangerous types of cancer is skin cancer caused by cancer cells that grow and spread uncontrollably in the skin layers. There are an estimated that 100,000 new cases of skin cancer will occur in the United States, which will cause around 6000 deaths by 2020. The survival rate of people with skin cancer can increase if successfully treated at an early stage. Examination of the lesion or dermoscopy images takes a long time and is prone to errors due to differences of opinion by doctors. A computer program for image processing was developed to improve accuracy and efficiency that helps doctors diagnose and evaluate. The most crucial stage in the diagnosis process is the segmentation of skin lesions. Wrong segmentation results will affect accuracy at the classification stage. This study developed a segmentation model for a skin cancer image that uses the MobileNet model as an encoder block and Linknet model for a decoder block by selecting the best hyper-parameter value from several training scenarios. MobileNet encoder and Linknet as a decoder are known to have the same ability, which is to overcome the problem of computational efficiency without compromising accuracy. Four hyper-parameters used are learning rate, the number of epochs, image size, and using pre-trained or not. Besides, there is a performance comparison scenario between the MobileNetV1 and MobileNetV2 encoder blocks. The model trained using the 2017 ISIC Challenge dataset consisting of 2000 training data, 150 validation data, and 600 test data. The Intersection over Union score obtained was 71.5% from models trained with a hyper-parameter learning rate of 0.001, 50 epochs, with an image size of 256 × 256 × 3, using a pre-trained model, and using a MobileNetV1 encoder block. The mask image that is the result of the segmentation of skin cancer images using the MobileNet encoder model and Linknet decoder is accurate enough to be used in the process at a later stage.

Microscopic melanoma detection and classification: A framework of pixel-based fusion and multilevel features reduction.

The numbers of diagnosed patients by melanoma are drastic and contribute more deaths annually among young peoples. An approximately 192,310 new cases of skin cancer are diagnosed in 2019, which shows the importance of automated systems for the diagnosis process. Accordingly, this article presents an automated method for skin lesions detection and recognition using pixel-based seed segmented images fusion and multilevel features reduction. The proposed method involves four key steps: (a) mean-based function is implemented and fed input to top-hat and bottom-hat filters which later fused for contrast stretching, (b) seed region growing and graph-cut method-based lesion segmentation and fused both segmented lesions through pixel-based fusion, (c) multilevel features such as histogram oriented gradient (HOG), speeded up robust features (SURF), and color are extracted and simple concatenation is performed, and (d) finally variance precise entropy-based features reduction and classification through SVM via cubic kernel function. Two different experiments are performed for the evaluation of this method. The segmentation performance is evaluated on PH2, ISBI2016, and ISIC2017 with an accuracy of 95.86, 94.79, and 94.92%, respectively. The classification performance is evaluated on PH2 and ISBI2016 dataset with an accuracy of 98.20 and 95.42%, respectively. The results of the proposed automated systems are outstanding as compared to the current techniques reported in state of art, which demonstrate the validity of the proposed method.

Analysis of a decade of skin cancer prevention using a mobile unit in Brazil.

For the past 10 years, skin cancer has been the most frequent malignant neoplasm in Brazil and worldwide. Each year, there are more new cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung and colon. There were an estimated 188 000 new cases of skin cancer in Brazil in 2016. The prevention department of Barretos Cancer Hospital (BCH) runs some prevention programs for cancer such as breast, prostate, cervical, oral, colon and skin cancers. The skin cancer prevention program comprises educational activities and medical assistance conducted at the hospital and at a mobile unit (MU). The objective of this study is to evaluate the use of the MU as part of a skin cancer prevention program, 10 years after the implementation of this prevention program, using an MU in remote areas of Brazil. The database of the BCH was used. These data refer to data collected by the BCH Prevention MU. A total of 45 872 patients with suspected skin cancer were evaluated at the MU from 2004 to 2013. Of these, 8954 surgical procedures (excisions and/or biopsy) were performed. This study demonstrated a significant number of skin cancer cases diagnosed and treated by the MU. This study showed that the MU positively contributes to the early diagnosis and treatment of skin cancer among populations residing in remote areas of Brazil.

Convolutional Neural Network for Diagnosing Skin Cancer

Diagnosis of melanoma (skin cancer disease) is a challenging task in medical science field due to the amount and nature of the data. Skin cancer datasets are usually comes in different format and shapes including medical images, hence, data require tremendous efforts for preprocessing before the auto-diagnostic task itself. In this work, deep learning (convolutional neural network) is used to build a computer model for predicting new cases of skin cancer. The first phase in this work is to prepare images data, this include images segmentation to find useful parts that are easier for analysis and to detect region of interest in digital images, reduce the amount of noise and image illumination, and to easily detect sharp edges (boundaries) of objects. Then, the proposed approach built a convolutional neural network model which consists of three convolution layers, three max pooling layers, and four fully connected layers. Testing the model produced promising results with accuracy of 0.74. The result encourages and motivates for future improvement and research on online diagnosing of melanoma in early stages. Therefore, a web application was built to utilize the model and provide online diagnosis of melanoma.

Prevent Skin Cancer in the Society, an Evidence Based Integrated Care Approach

Introduction: In the Netherlands, skin cancer is the most common type of cancer KWF, 2016. More than 51.000 new cases of skin cancer are diagnosed every year and over 900 fatalities are reported RIVM, 2017. Skin cancer incidence rates increase dramatically: since 1990 the number of new patients with skin cancer quadrupled RIVM, 2017. This increase is much higher than in other types of cancer IKNL, 2016. It is expected that incidence rates of skin cancer will increase even further, probably with a factor 2 to 5 RIVM, 2017. Direct costs for medical treatment of skin cancer are estimated at 325 million each year 250-400 million RIVM, 2017. On top of that, sick leave and premature mortality are also important indirect costs in melanoma Brochez et al., 1999. Increasing use of more costly treatment, such as Mohs surgery and photodynamic therapy, is contributing to rising treatment costs Hollestein et al, 2017. In addition to the costs, this growing group of patients with skin cancer will represent an important burden on the limited specialized dermatological care in the Netherlands. Subsequent early assessment of skin cancer risk is necessary for timely preventive measures in the general population. Methods: 1- A systematic review of the literature on patient characteristics with a prognostic predictive value for future basal cell carcinoma, squamous cell carcinoma or melanoma such as age, gender, presages, signs and risk behaviour. 2- A Current practice analysis on care concerning risk behaviour, presages and signs of skin cancer. 3- Prognostic modelling using existing data of over 5000 cases from the Netherlands Comprehensive Cancer Organisation IKNL. 4- Developing risk profiles and implement these through internet and social media. Results: It will provide insight in early risk behaviours in the general population. It also provide knowledge of serious presages or signs enabling these patients to be seen by their GP timely. Conclusion: Basal cell carcinoma BCC, approx. 70%, squamous cell carcinoma SCC, approx. 20% and melanoma approx. 10% are the three most common types of skin cancer. Melanoma is the most lethal type, accounting for 90% of all skin cancer fatalities. The incidence of melanoma in the Netherlands is among the highest in Europe RIVM, 2017. Despite the fact that most non-melanoma skin cancers BCC and SCC can be cured, the treated lesions can be disfiguring or even lethal if not treated timely. Lessons learned: Risk profiles will enable healthcare professionals and citizens both with knowledge which persons are at high risk and should be screened and insight in risk behaviour. Limitations: Risk screening is costly, time consuming and it is to be expected that the adherence will be moderate. Suggestions for future research: Behaviour change intervention target groups in the society as implementation research

Prevención 365 (Prevention 365)

In Peru every year there are 1200 new cases of skin cancer, of which 80% is caused by overexposure to unprotected ultraviolet rays. In Peru, there was no culture of ultraviolet prevention. The population believed that they should only be protected from solar radiation in the summer season. Therefore, in 2017 the League Against Cancer - Peru, two major objectives were set: breaking the paradigm about protection only in summer and/or in aggressive solar exposure, and generate annual preventive check-ups. To achieve this, we created “Prevention 365”, a campaign designed to sensitize the population about the importance of protecting from the ultraviolet rays 365 days a year and not only in summer (Fig 1). Aim: Promote a change in the culture of skin cancer prevention in Peru, breaking the paradigm that you only have to protect yourself from ultraviolet rays in summer, and generate annual preventive check-ups. Strategy/Tactics: We identified the regions with the highest index of ultraviolet radiation at national level and the group of people who work under solar radiation who are more vulnerable for developing the disease, such as policemen, serene, cleaning staff, workers, journalists, taxi drivers, fishermen, among others, to carry out awareness actions. To achieve a greater impact, we convinced various characters from theater, television and sports to become spokespersons and image of the campaign, and to influence Peruvians to prevent skin cancer. We implemented a powerful digital plan that included communication on various platforms - our own and those of third parties. In this way we are able to exponentially expand the scope of our message. The mobile unit of the institution - outpatient clinic - visited municipalities, buildings, police stations, among others, where they conducted screening, educational talks and delivery of information material. Outcomes: More than 900 publications in media, which obtained 389,425,940 views and an advertising investment savings of more than US $5,660,452.00 dollars. More than 200 celebrities who shared each of our messages. More than 10 thousand people who were sensitized through outdoor advertising and media. More than 100 thousand Peruvians from areas more exposed to ultraviolet rays sensitized by materials and informative talks. More than 2 million people who received our message through our official fan page. Thanks to the campaign “Prevention 365” more than 130 thousand people made for the first time a preventive skin check. That is, more than 300% of what was projected. We have understood that a well-structured communication campaign can achieve great results. Thanks to this, the League Against Cancer has helped to reduce the incidence of skin cancer thanks to the fact that more than 130,000 Peruvians were screened for skin cancer for the first time. [Figure: see text]

Automatic histologically-closer classification of skin lesions

According to the American Cancer Society, melanoma is one of the most common types of cancer in the world. In 2017, approximately 87,110 new cases of skin cancer were diagnosed in the United States alone. A dermatoscope is a tool that captures lesion images with high resolution and is one of the main clinical tools to diagnose, evaluate and monitor this disease. This paper presents a new approach to classify melanoma automatically using structural co-occurrence matrix (SCM) of main frequencies extracted from dermoscopy images. The main advantage of this approach consists in transform the SCM in an adaptive feature extractor improving his power of discrimination using only the image as parameter. The images were collected from the International Skin Imaging Collaboration (ISIC) 2016, 2017 and Pedro Hispano Hospital (PH2) datasets. Specificity (Spe), sensitivity (Sen), positive predictive value, F Score, Harmonic Mean, accuracy (Acc) and area under the curve (AUC) were used to verify the efficiency of the SCM. The results show that the SCM in the frequency domain work automatically, where it obtained better results in comparison with local binary patterns, gray-level co-occurrence matrix and invariant moments of Hu as well as compared with recent works with the same datasets. The results of the proposed approach were: Spe 95.23%, 92.15% and 99.4%, Sen 94.57%, 89.9% and 99.2%, Acc 94.5%, 89.93% and 99%, and AUC 92%, 90% and 99% in ISIC 2016, 2017 and PH2 datasets, respectively.

Fast Diagnostics of BRAF Mutations in Biopsies from Malignant Melanoma.

According to the American skin cancer foundation, there are more new cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung, and colon each year, and malignant melanoma represents its deadliest form. About 50% of all cases are characterized by a particular mutation BRAF(V600E) in the BRAF (Rapid Acceleration of Fibrosarcoma gene B) gene. Recently developed highly specific drugs are able to fight BRAF(V600E) mutated tumors but require diagnostic tools for fast and reliable mutation detection to warrant treatment efficiency. We completed a preliminary clinical trial applying cantilever array sensors to demonstrate identification of a BRAF(V600E) single-point mutation using total RNA obtained from biopsies of metastatic melanoma of diverse sources (surgical material either frozen or fixated with formalin and embedded in paraffin). The method is faster than the standard Sanger or pyrosequencing methods and comparably sensitive as next-generation sequencing. Processing time from biopsy to diagnosis is below 1 day and does not require PCR amplification, sequencing, and labels.

Vivascope© For Diagnosing Melanoma: A Systematic Review

Melanoma is the fifth most common cancer in the UK, accounting for 4% of all new cases of skin cancer. In 2011, 13,300 cases of malignant melanoma were diagnosed in the UK, out of which 2,200 people died from the disease. This systematic review evaluates the clinical effectiveness of VivaScope (MAVIG GmbH, Munich), a non-invasive reflectance confocal microscope (RCM), used following dermoscopy for the diagnosis of melanoma. This research was conducted as part of a National Institute for Health and Care Excellence (NICE) Diagnostic Assessment Report on VivaScope. Electronic databases (MEDLINE, EMBASE and the Cochrane Library) were searched in October 2014 and updated in February 2015 to identify studies evaluating RCM following dermoscopy with histopathology as the reference standard in detecting malignant melanoma. Researchers were contacted for additional information on studies identified. Clinical experts were contacted for details on any unpublished studies. Of the 7,446 studies identified in the literature search, 10 were considered relevant to this review. However, none were conducted in the UK (1 Spain, 1 China, 1 Australia, 2 Brazil/USA, 2 Australia/Italy, 3 Italy) and the studies were considered too heterogeneous (e.g. differences in study design, patient/lesion level data, with/without comparator) for their results to be combined in a meta-analysis. Overall results indicate that RCM subsequent to dermoscopy may improve diagnostic accuracy of malignant melanomas compared to dermoscopy alone. One study (Alarcon et al. 2014) was deemed to be most representative of UK clinical practice and reported statistically significant differences in sensitivity (97.8% vs 94.6%, p=0.043) and specificity (92.4% vs 26.74%, p<0.000001), for VivaScope 1500 following dermoscopy compared with dermoscopy alone. VivaScope following dermoscopy may increase the accuracy of a diagnosis of malignant melanoma compared to dermoscopy alone. However, the absence of UK studies makes the generalisability of the results to UK clinical practice unclear.

Skin Cancer (Basal Cell Carcinoma, Squamous Cell Carcinoma, and Malignant Melanoma): New Cases, Treatment Practice, and Health Care Costs in New Brunswick, Canada, 2002–2010

In Canada, there is no formal process for registering nonmelanoma skin cancer (NMSC); thus, the epidemiology, treatment practices, and associated health costs are not well known. To investigate trends in new cases of skin cancer, treatment practices, and health care costs in New Brunswick, Canada. Data were extracted from the Provincial Cancer Registry and New Brunswick administrative health databases for 2002-2010. New cases: Basal Cell Carcinoma (BCC) was the most common skin cancer diagnosed, and incidence rates significantly increased between 1992 and 2010.Treatment practice: Dermatologists managed the majority (45%) of the overall skin cancer treatments.Health care costs: NMSC accounted for ∼80% of the health care costs for skin cancer and was dominated by BCC. Development of best practice treatment guidelines for NMSC in New Brunswick would improve future health care efficiencies, and standard protocols for registering new cases of NMSC in Canada would strengthen surveillance and reporting capacity.

Sun-protective behaviors in populations at high risk for skin cancer

Over 3 million new cases of skin cancer are diagnosed in the US annually. Melanoma, a subtype of skin cancer that can be fatal if the disease is not detected and treated at an early stage, is the most common cancer for those aged 25–29 years and the second most common cancer in adolescents and young adults aged 15–29 years. The primary carcinogen for the genesis of skin cancers is ultraviolet light from solar radiation and tanning beds. In spite of massive health campaigns to raise public awareness on ultraviolet radiation, sun-protective practices still fall behind. A plausible explanation is the lack of behavioral change in the populations at risk; in this review article, we examine sun-protective behavior in the four high-risk skin cancer groups: skin cancer survivors, individuals with a family history of melanoma, individuals with physical characteristics associated with skin cancer risk, and organ transplantation patients. Findings in the literature demonstrate that increased knowledge and awareness does not consequently translate into behavioral changes in practice. Behavior can differ as a result of different attitudes and beliefs, depending on the population at risk. Thus, intervention should be tailored to the population targeted. A multidisciplinary health team providing consultation and education is required to influence these much needed changes.

Skin cancer prevention

There are two main types of skin cancer: malignant melanoma and non-melanoma skin cancers (NMSC). More than 100 000 new cases of skin cancer are diagnosed every year. The major cause of skin cancers is overexposure to ultraviolet radiation. Prevention strategies are important in reducing the occurrence of skin cancers. They include environmental measures as well as public education campaigns about sun safety and early detection.

Skin cancer prevention

Prevention signifies the avoidance of diseases. It also includes the early detection of diseases and taking measures to avoid worsening of an existing disease. Prevention is divided into primary, secondary and tertiary prevention. The prevention of skin cancer is particularly important due to the rising incidence of skin cancer in recent years. In Germany, 195.000 new cases of skin cancer, including non melanoma skin cancer and melanoma are occurring. Therefore, skin cancer is among the most common cancer diseases. Primary prevention comprises the reduction of skin cancer risk behavior, including education about the danger of UV exposure and the right way of dealing with natural and artificial UV radiation. The implementation of a systematic skin cancer screening in Germany contributes to secondary prevention. First data from the initial project in Schleswig-Holstein, Germany's most northern state, indicate for the first time that the incidence and mortality of melanoma can be reduced by secondary prevention. For tertiary prevention, the national associations recommend a risk-adapted, evidence-based follow-up for all types of skin cancer. From the perspectives of the payers and from the patients, prevention is assessed positively. Prevention can contribute to a reduction of disease burden.

Sunlight and skin cancer: Lessons from the immune system

The ultraviolet (UV) radiation in sunlight induces skin cancer development. Skin cancer is the most common form of human neoplasia. Estimates suggest that in excess of 1.5 million new cases of skin cancer (www.cancer.org/statistics) will be diagnosed in the United States this year. Fortunately, because of their highly visible location, skin cancers are more rapidly diagnosed and more easily treated than other types of cancer. Be that as it may, approximately 10,000 Americans a year die from skin cancer, and the cost of treating skin cancer in the United States (both melanoma and non-melanoma skin cancer) is estimated to be in excess of $2.9 billion a year. In addition to causing skin cancer, UV radiation is also immune suppressive. In fact, data from studies with both experimental animals and biopsy proven skin cancer patients suggest that there is an association between the immune suppressive effects of UV radiation and its carcinogenic potential. Recent studies in my laboratory have focused on understanding the initial molecular events that induce immune suppression. We made two novel observations: first UV-induced keratinocyte-derived platelet activating factor plays a role in the induction of immune suppression. Second, cis-urocanic acid, a skin-derived immunosuppressive compound mediates immune suppression by binding to serotonin receptors on target cells. Recent findings suggest that blocking the binding of these compounds to their receptors not only inhibits UV-induced immune suppression but it also interferes with skin cancer induction.

Use of UV-protective windows and window films to aid in the prevention of skin cancer.

People are exposed to ambient solar ultraviolet (UV) radiation throughout their daily routine, intentionally and unintentionally. Cumulative and excessive exposure to UV radiation is the behavioral cause to skin cancers, skin damage, premature skin aging, and sun-related eye disorders. More than one million new cases of skin cancer were diagnosed in the United States this year. UV radiates directly and diffusely scattered by the various environmental and atmospheric conditions and has access to the skin from all directions. Because of this diffuse UV radiation, a person situated under a covering, such as the roof of a car or house, is not completely protected from the sun's rays. Because shade structures do not protect effectively against UV radiation, there have been major advances in photoprotection of glass by the development of specially designed photoprotective windows and films. It is the purpose of this collective review to highlight the photoprotective windows and films that should be incorporated into residential, commercial, and school glass windows to reduce sun exposure. Low-emittence (low-E) coatings are microscopically thin, virtually invisible, metal or metallic oxide layers deposited on a window or skylight glazing surface to reduce the U-factor by suppressing radiative heat flow as well as to limit UV radiation. The exclusive Thermaflect coating uses the most advanced, double-layer soft coat technology to continue to deliver top performance for UV protection as well as prevent heat loss in the home. This product blocks 87% of UV radiation and has an Energy Star certification in all climate zones. Tints and films have been another important advance in glass photoprotection, especially in automobiles. Quality widow film products are high-tech laminates of polyester and metallized coatings bonded by distortion-free adhesives. The International Window Film Association provides members with accreditation in solar control films, safety films, and automotive films in an effort to increase consumer awareness and demand for all professionally installed film window products. The Skin Cancer Foundation has also played a leadership role in certifying window films that limit UV transmission. The Panorama Designer and Safety Films are currently recommended for UV photoprotection by The Skin Cancer Foundation. On the basis of these innovative scientific and industrial advances in window and film photoprotective products, we recommend that they be used in all residential, commercial, and school facilities to provide photoprotection in an effort to reduce skin cancer.