Risk Factor For Skin Cancer Research Articles

Identification of Risk Factors for Multiple Non-Melanoma Skin Cancers in Italian Kidney Transplant Recipients.

Background and objectives: Non-melanoma skin cancers (NMSCs) represent the most frequently encountered malignancy in organ transplant recipients and their incidence increases proportionally to the duration of immunosuppression. Furthermore, patients of this group often develop multiple and more aggressive cancers and, to date, risk factors for the development of multiple NMSCs have not been yet established. The present study aimed to identify risk factors for multiple NMSCs in a cohort of Italian kidney transplant recipients (KTRs). Materials and Methods: We consecutively included all KTRs referring to two post-transplant outpatient clinics of North-Western Italy between 2001 and 2017. In this cohort, we evaluated different clinical (endogenous and exogenous) risk factors in order to establish their correlation with NMSCs. Results: 518 KTRs were included, of which 148 (28.6%) developed keratinocyte cancers, with a single tumor in 77 subjects, two skin cancers in 31 patients, 3 in 21 patients, whereas at least 4 NMSCs developed in 19 KTRs. We observed an increased risk of the development of cutaneous neoplasms for the male gender, old age at transplantation (>50 years), light phototype, solar lentigo, history of sunburns, or chronic actinic damage. Considering patients affected by multiple keratinocyte neoplasms, we observed a significant association of actinic damage and solar lentigo with an increased risk of NMSCs; their significance was confirmed even at the multivariable model. Conclusions: Our results confirm the role played by chronic cutaneous actinic damage in carcinogenesis on KTRs and highlight the significance of individualized periodic dermatological screening.

The high costs of cheap tanning: pricing and promotional practices of indoor tanning facilities in six cities in the United States.

Few studies have investigated pricing and promotional practices used by the indoor tanning industry, despite their potential to promote indoor UV tanning-a well-established risk factor for melanoma skin cancer. Posing as potential customers, we telephoned 94 indoor tanning businesses in six United States (U.S.) cities and requested pricing information. The price of a single tanning session ranged from $0 to $23, and was lower at facilities that offered indoor tanning as a secondary service (mean $4.82 and free in 35%) than at tanning salons (mean $16.45). Session prices in salons could be as low as $1.50 with daily use of an unlimited monthly plan. Free indoor tanning, monthly packages, and memberships encourage increased use. Policies that limit free indoor tanning or that restrict pricing and advertising for indoor tanning exist in several places in the U.S. and Europe. Future research should evaluate whether those policies are effective in reducing indoor tanning.

Public Health Messages Associated with Low UV Index Values Need Reconsideration.

Overexposure to ultraviolet (UV) radiation is the main modifiable risk factor for skin cancer. The Global Solar Ultraviolet Index (UVI) was introduced as a tool to visualize the intensity of UV radiation on a certain day, which should enable and encourage people to take appropriate protective measures. The ‘low’ exposure category of the UVI, defined by a rounded UVI value of 0, 1 or 2, was linked to the health message ‘No protection required’ by the World Health Organization and partner organizations. However, published evidence corroborating this advice is not available. To evaluate the erythemal risk of low UVI days, we analyzed 14,431 daily time series of ambient erythemal irradiance data measured at nine stations of the German solar UV monitoring network during the years 2007–2016. We analyzed the proportion of days in the sample for which ambient erythemal doses calculated for various time intervals exceed average minimal erythemal doses (MEDs) of the Fitzpatrick skin phototypes I–VI to assess the potential for erythema arising from sun exposure on days with low UVI values. Additionally, we calculated for each day the minimum exposure duration needed to receive one MED. Our results indicate that on days with a UVI value of 0, risk of erythema is indeed negligible. Conversely, the abovementioned health message appears misleading when melano-compromised individuals (skin type I and II) spend more than 1.5 hours outdoors on days with a UVI value of 2. Under rare circumstances of prolonged exposure, MEDs of the two most sensitive skin types can also be exceeded even on days with a UVI value of 1. Hence, current WHO guidance for sun protection on days with low UVI values needs reconsideration.

Use of antiepileptic drugs and risk of skin cancer: A nationwide case-control study

Several antiepileptic drugs are photosensitizing; however, it is not known whether this confers an increased risk of skin cancer. To examine the association between common antiepileptic drugs and basal cell carcinoma, squamous cell carcinoma (SCC), and malignant melanoma. We conducted a nested case-control study identifying skin cancer patients in Denmark from 2004 through 2015 matched 1:10 with disease-free controls. We estimated odds ratios (ORs) for skin cancer associated with high cumulative use of antiepileptic drugs (≥500 defined daily doses) compared with nonuse. Most antiepileptic drugs were not associated with skin cancer. SCC was associated with use of carbamazepine (OR, 1.88; 95% confidence interval, 1.42-2.49) and lamotrigine (OR, 1.57; 95% confidence interval, 1.12-2.22) with evidence of a dose-response relationship for carbamazepine. The estimated absolute risks were low; for example, 6335 person-years of high cumulative exposure to carbamazepine were required for 1 additional SCC to occur. Data on important risk factors for skin cancer, such as sun exposure, were not available. Most antiepileptic drugs were not associated with skin cancer; however, carbamazepine and lamotrigine were associated with SCC. These findings need to be replicated and characterized further in other settings and have no direct clinical implications.

Skin Cancer Knowledge and Prevention Practices Among Young Adult Athletes

ABSTRACT The Skin Cancer Foundation defines skin cancer as uncontrolled growth of abnormal skin cells (The Skin Cancer Foundation, 2016b). Skin cancer risk factors include ultraviolet radiation and sun exposure (American Cancer Society, 2016b). Young adult outdoor athletes are frequently exposed to the sun and are at an increased risk of developing skin cancer. Research found young adult athletes average 1,000 hours in the sun annually for their sport (Wysong et al., 2012). This article examines current literature and studies that have researched young adult athletes on their knowledge of being at an increased skin cancer risk as well as their attitudes and sun protective behaviors in regard to skin cancer and prevention. The purpose is to evaluate as a whole whether frequent sun exposure influences young adult athletes’ use of preventative measures such as sunscreen or protective clothing. Results found that most athletes were knowledgeable of sunscreen use being a preventative measure for sun protection and skin cancer; however, sunscreen was not always applied (Lawler et al., 2012; Walker et al., 2014; Wysong et al., 2012). Results indicate that skin cancer and preventative practices among young adult athletes continue to be a concern, and therefore research should focus on addressing ways to promote skin cancer prevention practices as well as screening, management, and treatment strategies (U.S. Department of Health and Human Services, 2014).

180 Skin health practices and skin risk behaviors of youth sexual minorities

Previous studies have found a high prevalence of skin cancer in sexual minority males, and have reported an association with increased indoor tanning among sexual minority men. The existing literature is limited in its examination of skin health practices of youth sexual minorities, and no prior analysis has been performed for sunburn as a skin cancer risk factor in this cohort. Given the established association between skin cancer and sexual minority status, there is a need to better understand high-risk behaviors in this population. The aim of this study is to examine sunburn prevalence, indoor tanning, and sunscreen use among sexual minority youth. Data was obtained from the 1991-2017 CDC Youth Risk Behavior Surveillance System (YRBSS), a national survey of students in grades 9-12. We applied a linear regression model to assess association between sexual minority status in male and female youth and separate outcome variables of sunburn prevalence, indoor tanning, and sunscreen use. We found no significant correlation between sexual minority status and number of self-reported sunburns over a 12-month time period (β = -0.036, p=0.52, n=177,252) or appropriate use of sunscreen (β = 0.0078, p=0.79, n=16,085). There was, however, a significant association between sexual minority status and use of an indoor tanning device (sunlamp, sunbed, or tanning booth) over a 12-month time period (β = 0.148, p<0.001, n= 14,724). We report no association between sunburn prevalence, sunscreen use and youth sexual minority status in a male and female sexual minority youth population. These findings add to the body of literature that suggests the existence of unique skin risk behaviors among sexual minorities, and suggests future targets for health behavior instruction and public health interventions.

254 Does funding source influence the outcome of indoor tanning studies? a systematic review

Indoor tanning is a known risk factor for non-melanoma skin cancers and malignant melanoma. Yet scientific publications challenging its harms and promoting the benefits continue to emerge. We performed a systematic review to learn if funding source is associated with the conclusions of studies on indoor tanning. We followed PRISMA guidelines and used Covidence software. PubMed, Embase, and Web of Science were searched and two investigators (LA, RC) assessed eligibility using the article’s title and abstract. We included published papers addressing artificial ultraviolet tanning use with a definitive exposure and health outcome (e.g. skin cancer, vitamin D production). We excluded studies on animals, cell lines, without full text (e.g. abstracts) and non-English articles. Author affiliations and funding information were independently extracted by a third investigator (LM) and removed from PDFs for blinding. Full-text review was performed by two reviewers (LA, RC) blinded to funding source and affiliations. Each study was coded using a Likert scale ranging from 1-5, where 1=only mentions benefits, never mentions harms, 2=mostly mentions benefits and at least one harm, 3=neutral, 4=mostly mentions harms and at least one benefit, 5=only mentions harms, never mentions benefits. Out of 460 articles, the majority of articles highlighted harms of indoor tanning (N=365, 79% score 4 or 5), 66 articles highlighted benefits of indoor tanning (14% score of 1 or 2), while 29 (6.5%) were neutral. N=415 (90.2%) articles had no financial affiliations with industry. N=41 or 8.9% of articles disclosed links to industry via affiliation or funding. 85.4% of articles with financial links to industry highlighted benefits of tanning, while 86.7% of articles not affiliated with industry highlighted harms of tanning. Our findings suggest that articles with financial links to the indoor tanning industry are much more likely than those without links to mention benefits rather than harms of indoor tanning.

Skin cancer in organ transplant recipients: dynamics in the incidence and clinical predictors for the first and subsequent post-transplant non-melanoma skin cancer.

Risk factors for primary non-melanoma skin cancer (NMSC) in organ transplant recipients (OTR) have been well described. Data for subsequent NMSC and dynamics in their occurrence in OTR are limited. To study long-term risks of primary and subsequent NMSC and associated risk factors in OTR. A retrospective single-centre cohort study analysing medical records from a dermato-oncological specialty clinic. Of 464 OTR 110 (23.7%) developed at least one, 73 (15.7%) two and 51 (11%) three NMSC during a median follow-up of 9.6 years. Cumulative incidences at 5, 10 and 15 years were 14.7%, 23.5% and 34.5% for the first and 75.8%, 86.5% and 93.3% for the second. Median time-to-diagnosis declined from 22 years (95% CI 19-25) to 2 years (1-3) and about 1 year (0-2) for the first, second and third NMSC. Risk for subsequent NMSC only partially related to risk factors for the primary NMSC. Histologic type of the first NMSC predicted subtype and time-to-diagnosis of the subsequent NMSC. A first post-transplant NMSC, particularly a SCC, confers a high risk for subsequent NMSC arising with accelerated dynamics. Risk-adapted dermato-oncologic surveillance is advisable for all OTR.

Ingenol mebutate-mediated reduction in p53-positive keratinocytes in skin cancerization field directly correlates with clinical response in patients with multiple actinic keratoses.

UV radiation represents the main risk factor for non-melanoma skin cancers. Chronic UV exposure induces 'p53 patches', i.e. clonal outgrowths of keratinocytes with high nuclear expression of mutated p53, which might progress to actinic keratosis (AK) and ultimately squamous cell carcinomas (SCCs). Analysis of ingenol mebutate gel (150 and 500mcg/g) effects in the reduction in 'p53 patches' inside skin cancerization field (CF) in patients with multiple AKs of face/scalp or trunk/extremities, in order to investigate whether the expected reduction in p53+ keratinocytes might have a direct role in the long-term AK reduction in treated areas. We enrolled n=10 patients, treated with ingenol mebutate and evaluated at 2 and 6months after treatment. We observed clinical responses in the majority of patients (n=7), with AK reduction or complete clearance (n=6 and n=1, respectively). Notably, two patients did not respond to the treatment, and in one patient, after initial partial response, new lesion was recorded. In untreated skin CF samples (n=3), we observed numerous p53+ keratinocytes, similar to those observed in invasive SCC samples (53.56±8.79 and 74.34±22.05, respectively; P=0.2). After treatment, we observed a variable p53+ keratinocyte reduction in CF samples at 2months (24.67±31.19; P=0.19). Importantly, the amount of p53+ keratinocytes strongly and directly correlated with AK number (R2 =0.81). Untreated skin CF expresses high level of p53+ keratinocytes as invasive SCC. Ingenol mebutate is able to reduce p53+ keratinocytes with variable efficacy, this reduction degree directly correlating with clinical efficacy.

Potential benefits of phytochemicals for treatment of hyperpigmentation

UV radiation (UV) is considered as a complete carcinogen as it is both a mutagen and a non-specific damaging agent. It is the most important risk factor for skin cancer and many other skin disorders like Hyperpigmentation. There is a need of long-term topical skin care treatments (both cosmetic and cosmeceutical) to address problems associated with hyperpigmentation. Synthetic depigmenting agents, such as hydroquinone, mequinol, although highly effective, can raise several safety concerns (for example, ochronosis, cataract, impaired wound healing, desquamation, and other local or systemic side effects) with long-term exposure. The benefits of phytochemicals and natural extracts offer opportunities to develop new formulations to treat pigmentation problems. Cosmeceuticals are topical cosmetic-pharmaceutical preparations containing active ingredients which improve the appearance of skin. Among cosmeceuticals, the phytochemicals have been known to have a multitude of cellular actions for various dermatological diseases. Plant-derived compounds and their effectiveness in the treatment of hyperpigmentation disorders (Melasma) are discussed.&#x0D; Keywords: UV radiation, Hyperpigmentation, Phytochemicals, Cosmeceuticals

Risk of Skin Cancers with Long-Term Itraconazole in Lung Transplant Recipients

Purpose The objective of this study was to determine if long term itraconazole use, as antifungal prophylaxis, in lung transplant recipients is an independent risk factor for skin cancer. Methods We retrospectively reviewed patients who received a lung transplant at Mayo Clinic Rochester from 2002 to 2010. The antifungal prophylaxis protocol at our institution is triazole therapy, itraconazole or voriconazole, for a minimum of 3 years. Patients who died within 6 months of initial transplant were excluded. Characteristics to help assess independent risk for the development of cutaneous cancers and type of antifungal prophylaxis were noted. Patients who were exposed to both voriconazole and more than 6 months of itraconazole were analyzed separately. Results We identified 102 patients who underwent lung transplant at Mayo Clinic from 2002 to 2010; 11 patients died within 6 months of transplant and were excluded. Of the remaining 91 patients, 44 received only itraconazole prophylaxis, 10 received only voriconazole prophylaxis, and 37 received both itraconazole and voriconazole. No statistically significant difference between the baseline characteristics of the 3 groups was observed with the exception of race. There was a lower proportion of Caucasians in the voriconazole only group compared with the itraconazole only and combined itraconazole/voriconazole groups (p=0.02). Out of the 91 patients included in the study, 40 (44.0%) were diagnosed with skin cancer post-transplant, and 5 (12.5%) developed aggressive, metastatic cutaneous squamous cell carcinoma. Follow-up time was similar between patients who developed skin cancer (93.0 ± 45.0 months) and those who did not (62.0 ± 49.0 months, p=0.23). No significant difference was found in incidence of skin cancer or rate of metastatic squamous cell carcinoma between patients in the three groups (p=0.65) Duration of itraconazole was greater in patients who developed skin cancer [median 62.5 months (22.7, 87.5) vs 32.0 (18.0, 64.8), p=0.07] despite similar follow-up time. Absolute exposure (i.e. exposed to itraconazole or not) did not appear to correlate with the development of skin cancer post-transplant. Conclusion Prolonged itraconazole exposure when used as a prophylactic agent in lung transplant recipients appears to correlate with the development of skin cancers but further studies are warranted.

Nonmelanoma Skin Cancer in Childhood and Young Adult Cancer Survivors Previously Treated With Radiotherapy.

Radiotherapy (RT) is a risk factor for nonmelanoma skin cancer (NMSC), specifically basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), but whether features, histology, or recurrence of NMSC after RT resemble those observed in the general population is unknown. A retrospective review (1994-2017) was performed within the Adult Long-Term Follow-Up Program and Dermatology Service at Memorial Sloan Kettering Cancer Center. Demographics, clinical features, histology, treatment, and recurrence were collected for this patient cohort that was under close medical surveillance. Pathology images were reviewed when available. A total of 946 survivors (mean age, 40 years [SD, 13]) were assessed for NMSC. The mean age at first cancer diagnosis was 16 years (range, 0-40 years [11]), and the most common diagnosis was Hodgkin lymphoma (34%; n=318). In 63 survivors, 281 primary in-field lesions occurred, of which 273 (97%) were BCC and 8 (3%) were SCC. Mean intervals from time of RT to BCC and SCC diagnosis were 24 years (range, 2-44 years) and 32 years (range, 14-46 years), respectively. The most common clinical presentation of BCC was macule (47%; n=67), and the most common histologic subtypes were superficial for BCC (48%; n=131) and in situ for SCC (55%; n=5). Mohs surgery predominated therapeutically (42%; n=117), the mean duration of follow-up after treatment was 6 years (range, 12 days-23 years), and the 5-year recurrence rate was 1% (n=1). Most NMSCs arising in sites of prior RT were of low-risk subtypes. Recurrence was similar to that observed in the general population. Current guidelines recommend surgical intervention for tumors arising in sites of prior RT because they are considered to be at high risk for recurrence. These findings suggest that an expanded role for less aggressive therapy may be appropriate, but further research is needed.

Who, why, where: an overview of determinants of sunbed use in Europe

Although exposure to indoor tanning has been established as a clear risk factor for skin cancer, sunbeds are still commonly used in Europe. Understanding the determinants of sunbed use in Europe is key to plan educational interventions, behavioural strategies and legislative measures, which should be tailored to subgroups with different risk profiles. Evidences show that the typical sunbed users in Europe are young-adult women, with intermediate skin type, a current employment and a medium/high socio-economic status. Typical users display sun-seeking behaviours and other risky behaviours such as smoking. Indoor tanning seems more common in northern than southern Europe. However, sunbed use remains common in fair-skinned individuals and among adolescents/pre-adolescents. Commonly reported reasons for sunbed use in Europe include aesthetic motives (i.e. looking attractive), the pursue of a prevacation tan, the influence of peers/parents engaging in the same habit, and the treatment of health conditions. The most commonly reported places to get an artificial tan in Europe are tanning studios and beauty salons. However, sunbeds are also available in sport venues, such as swimming pools and gyms, hotels and private houses. All these factors should be taken into account when planning educational, behavioural and legislative interventions to reduce the popularity of artificial tanning in Europe.

Association of sunbed use with skin cancer risk factors in Europe: an investigation within the Euromelanoma skin cancer prevention campaign.

Sunbed use has been significantly associated with increased risk of melanoma and non-melanoma skin cancer (NMSC), but its relationship with melanoma's risk factors such as high nevus count, atypical nevi and lentigines is poorly studied. Euromelanoma is a skin cancer prevention campaign conducted all over Europe. It offers a once-a-year screening during which participants' data, including sunbed use and phenotype, are collected via questionnaires. To investigate the association of sunbed use with nevus count, atypical nevi, lentigines and suspicion of skin cancer. To ensure reliability of the data, we defined inclusion and exclusion criteria for countries' eligibility for the risk analysis. Multivariate logistic regression models (including age, gender, education, skin type, family history of melanoma, personal history of skin cancer, any sun exposure and any sunscreen use) were used to calculate summary odds ratios (SORs) of each clinical endpoint for ever sunbed use. Overall, 227888 individuals from 30 countries completed the Euromelanoma questionnaire. After the data quality check, 16 countries were eligible for the multivariate analysis, for a total of 145980 participants (64.8% females; median age 43years; 62.3% highly educated; 28.5% skin type I-II; 11.0% ever sunbed use). Ever sunbed use was independently associated with nevus count >50 [SOR=1.05 (1.01-1.10)], atypical nevi [SOR=1.04 (1.00-1.09)], lentigines [SOR=1.16 (1.04-1.29)] and suspicion of melanoma [SOR=1.13 (1.00-1.27)]. Conversely, no significant association was found between ever sunbed use and suspicion of NMSC [SOR=1.00 (0.91-1.10)]. Indoor tanning is significantly associated with well-recognized risk factors for melanoma (including high nevus count, presence of atypical nevi and lentigines) as well as suspicion of melanoma within the Euromelanoma screenees. In order to reduce the prevalence of melanoma risk factors, avoidance/discontinuation of sunbed use should always be encouraged, especially but not exclusively for individuals with high-risk phenotypes.

Long-Term Risk of Skin Cancer Among Childhood Cancer Survivors: A DCOG-LATER Cohort Study.

Skin cancer is common after radiotherapy among childhood cancer survivors (CCSs). We studied risks and risk factors for subsequent skin cancers, with emphasis on radiation dose, exposed skin surface area, and chemotherapeutic agents. The DCOG-LATER cohort study includes 5-year Dutch CCSs diagnosed 1963-2001. Subsequent skin cancers were identified from record linkages with the Netherlands Cancer Registry and Dutch Pathology Registry. Incidence rates were compared with general population rates. Multivariable Cox regression models were used, applying a novel method of case-control sampling enabling use of tumor location in cohort analyses. All statistical tests were two-sided. Among 5843 CCSs, 259 developed 1061 basal cell carcinomas (BCCs) (standardized incidence ratio [SIR] = 29.8, 95% confidence interval [CI] = 26.3 to 33.6; excess absolute risk per 10 000 person-years (EAR) = 24.6), 20 had melanoma (SIR = 2.3, 95% CI = 1.4 to 3.5; EAR = 1.1), and 10 had squamous cell carcinoma (SIR = 7.5, 95% CI = 3.6 to 13.8; EAR = 0.8). Cumulative incidence of BCC 40 years after childhood cancer was 19.1% (95% CI = 16.6 to 21.8%) after radiotherapy vs 0.6% expected based on general population rates. After a first BCC, 46.7% had more BCCs later. BCC risk was associated with any radiotherapy to the skin compartment of interest (hazard ratio [HR] = 14.32, 95% CI = 10.10 to 20.29) and with estimated percentage in-field skin surface area (26-75%: HR = 1.99, 95% CI = 1.24 to 3.20; 76-100%: HR = 2.16, 95% CI = 1.33 to 3.53, vs 1-25% exposed; Ptrend among exposed = .002), but not with prescribed radiation dose and likelihood of sun-exposed skin-area. Of all chemotherapy groups examined, only vinca alkaloids increased BCC risk (HR = 1.54, 95% CI = 1.04 to 2.27). CCSs have a strongly, 30-fold increased BCC risk. BCC risk appears to increase with increasing skin surface area exposed. This knowledge underscores the need for awareness by survivors and their health care providers.

Who Needs a Skin Exam? Skin Cancers in Allogeneic Hematopoietic Stem Cell Transplant Recipients in the Contemporary Era

Allogeneic hematopoietic stem cell transplantation provides a graft-versus-malignancy effect and long-term remissions in high-risk hematological malignancies. Reduced-intensity conditioning regimens have been developed, transplantation has become safer, and the number of long-term transplantation survivors is expected to rise. Wu etal. (2018) report the increased incidence and risk factors of skin cancer in 1994 transplant recipients followed in the last 25 years.

Skin cancer risk factors and screening among sexual minority and heterosexual women

Skin cancer risk factors and screening among sexual minority and heterosexual women

Postmenopausal hormone use and cutaneous melanoma risk: A French prospective cohort study

Cutaneous melanoma has been suspected to be influenced by female hormones. Several studies reported a positive association between menopausal hormone therapy (MHT) use and melanoma risk; however, previous findings were conflicting. We sought to explore the associations between MHT use and melanoma risk in a prospective cohort of women in France, where a particularly wide variety of MHT formulations are available. E3N is a prospective cohort of 98,995 French women aged 40-65 years in 1990. MHT use was assessed through biennial self-administered questionnaires. We used Cox proportional hazards regression models adjusted for age and skin cancer risk factors. Over 1990-2008, 444 melanoma cases were ascertained among 75,523 postmenopausal women. Ever use of MHT was associated with a higher melanoma risk (hazard ratio (HR) = 1.35, 95% confidence intervals (CI) = 1.07-1.71). The association was strongest among past users (HR = 1.55, CI = 1.17-2.07, homogeneity for past vs. recent use: p = 0.11), and users of MHT containing norpregnane derivatives (HR = 1.59, CI = 1.11-2.27), although with no heterogeneity across types of MHT (p = 0.13). Among MHT users, the association was similar across durations of use. However, a higher risk was observed when treatment onset occurred shortly after menopause (<6 months: HR = 1.55, CI = 1.16-2.07 vs. ≥2 years). Associations between MHT use and melanoma risk were similar after adjustment for UV exposure, although MHT users were more likely to report sunscreen use than nonusers. Our data do not support a strong association between MHT use and melanoma risk. Further investigation is needed to explore potential effect modification by UV exposure on this relationship.

Risk factors for keratinocyte carcinoma skin cancer in nonwhite individuals: A retrospective analysis

Because most of the US population will consist of nonwhite individuals by the year 2043, it is essential that both physicians and patients are educated about skin cancer in nonwhite persons. To update the epidemiology, investigate specific risk factors, and facilitate earlier diagnosis and intervention of keratinocyte carcinoma in nonwhite individuals. Institutional review board-approved retrospective chart review of all nonwhite patients who had received a biopsy-proven diagnosis of skin cancer at Drexel Dermatology during June 2008-June 2015. Squamous cell carcinoma (SCC) was the most commonly diagnosed skin cancer in black and Asian populations, and basal cell carcinoma was the most common skin cancer in Hispanics. Black persons exhibited the majority of their SCC lesions in sun-protected areas, particularly the anogenital area. On average, current smokers received skin cancer diagnoses 12.27years earlier than former smokers and 9.36years earlier than nonsmokers. Single-center design and interpractitioner variability of skin examination. The importance of lesions in photoprotected areas in nonwhite individuals should not go overlooked. However, emphasis should also be placed on active examination of sun-protected areas in nonwhite persons and recognition of the relationship between human papillomavirus and genitalSCClesions. Smoking cessation should be integrated in dermatologic counseling of all patients.Interventions tailored to each of these ethnic groups are needed.

Knowledge, attitude, and practices toward sun exposure and use of sun protection among non-medical, female, university students in Saudi Arabia: A cross-sectional study.

Excessive unprotected sun exposure is a significant risk factor for skin damage and skin cancers. In recent decades, the incidence of skin cancer has increased dramatically worldwide, reaching epidemic proportions. Skin cancer is the most common type of cancer worldwide, and the ninth most common malignancy in Saudi Arabia. Sun protection is a key primary preventive strategy against skin cancer and skin damage induced by sun exposure.Herein, a cross-sectional study was made to evaluate the knowledge, attitude, and practices toward sun exposure, and the use of sun protection among non-medical female students on the Sulaymaniyah campus of the King Abdul-Aziz University. Also, we identified the reasons that prevented the students from using sun protection measures. A special-designed, self-administered questionnaire was applied on a sample size of 501 students. We found that most students were aware of the risks of unprotected sun exposure. Nevertheless, a view of sunscreen as harmful was reported (34.1%). Seeking shade and wearing protective clothing were the most used sun protection methods (58.1% and 43.1%, respectively). Sunscreen users made up only one third of our sample (23.6%). However, the majority of students (64.9%) did not know about the sun protection factor of sunscreen products. Discomfort felt on the skin was the most commonly reported reason for avoiding the use of sunscreen (40.7%). When comparing our study with Western studies, we found a high level of awareness among our sample of students. Significant differences in the attitude toward the application of suntan and sun protection products might be due to differences in cultural background. Our results spotted the need for future health education programs for our society that focus on the significant importance of sunscreen, as well as the correct methods of application.