Risk Of Skin Cancer Research Articles

Skin cancer and HIV

The risk of skin cancer in persons living with HIV (PLWH) is an evolving subject area shaped by the use of antiretroviral therapy. Keratinocyte carcinomas, including basal cell carcinoma and squamous cell carcinoma, have a high incidence in the general population as well as in PLWH. PLWH may have a higher risk of squamous cell carcinoma when compared to the general population. In addition, Merkel cell carcinoma and sebaceous carcinoma exhibit higher incidence rates in PLWH. Data on melanoma risk are varied. Risks of skin cancer may be influenced by vigilant surveillance, photosensitivity, and immune status. Screening for skin cancer is generally recommended, although national guidelines vary in specific recommendations. Treatments range from topical therapies to surgeries to immune checkpoint inhibitors, with Mohs micrographic surgery playing an important role. Data on immune checkpoint inhibitors suggest safe and efficacious use in PLWH, although larger trials are warranted. The dynamic interplay among HIV, antiretroviral use and immunosuppression, and the risk and treatment of skin cancer underscores the importance of rigorous research studies and screening and treatment guidelines specific to this population.

Abstract C102: Correlates of thorough skin self-examination intentions among individuals at risk for skin cancer

Abstract Background: Melanoma is a growing public health concern in the United States and has the highest fatality rate of all skin cancers. Early identification of melanoma can improve survival rates. A thorough skin self-examination (TSSE) means examining the skin on all areas of the body systematically and deliberately and is an effective way to detect melanoma early, which could decrease melanoma mortality by 63%. Therefore, early surveillance or detection of melanoma has great potential to improve survival and lower disease morbidity. This study examined potential socioeconomic factors and health beliefs associated with TSSE among individuals at risk for skin cancer. Methods: Participants were recruited via Amazon MTurk and screened for their eligibility (at risk for skin cancer; e.g., having more than 2 moles that are larger than 1/4 inch, reporting very fair or fair skin type) via a Qualtrics survey. Eligible participants were then guided online to view educational materials related to skin cancer and skin self-examination and completed an online questionnaire that assessed their TSSE intentions, beliefs about skin cancer and skin self-examination, and demographic information (N=321). Results: Participants ranged from 18 to 76 years old (M = 36.61, SD = 10.57); 56.7% (n=182) of the sample was female, 76.0% (n=244) had a college or higher degree, and over 80% (n=194) identified as non-Hispanic White. Linear regression analyses, controlling for age, gender, education, and melanoma risk, showed that perceived benefits of SSE (B=.163, SE=.097, p =.001), perceived barriers of SSE (B=-.344, SE=.075, p<.001), perceived risk of getting skin cancer (B=.349, SE=.077, p <.001), perceived efficacy of doing SSE (B=.118, SE=.090, p <.05), being scared of getting skin cancer (B=.139, SE=.066, p <.01), and social norms of performing SSE (B=.207, SE=.089, p =.001) were significantly associated with TSSE intention among individuals at risk for skin cancer. Participants who had great perceived benefits (e.g., identifying spots or growths on the skin that are cancerous or may become cancerous), fewer perceived barriers (e.g., taking too much time to do regular skin self-examination), greater perceived risk of getting skin cancer (e.g., chances of having melanoma in the future), great efficacy of conducting SSE (e.g., confident that I can tell the difference between a melanoma and normal skin growths), greater fear of the possibility of getting skin cancer, and stronger norms that family and friends expected them to conduct SSE reported greater TSSE intentions in the next 3 months. Conclusion: The findings of this study contribute to the preventive direction of skin cancer by identifying correlates of TSSE intentions among individuals at risk. By uncovering the factors significantly associated with TSSE intention, this study offers valuable insights into areas that can be targeted in future skin cancer prevention and intervention efforts. Citation Format: Zhaomeng Niu, Carolyn Heckman. Correlates of thorough skin self-examination intentions among individuals at risk for skin cancer [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C102.

NTHL1 is a recessive cancer susceptibility gene

In search of novel breast cancer (BC) risk variants, we performed a whole-exome sequencing and variant analysis of 69 Finnish BC patients as well as analysed loss-of-function variants identified in DNA repair genes in the Finns from the Genome Aggregation Database. Additionally, we carried out a validation study of SERPINA3 c.918-1G>C, recently suggested for BC predisposition. We estimated the frequencies of 41 rare candidate variants in 38 genes by genotyping them in 2482–4101 BC patients and in 1273–3985 controls. We further evaluated all coding variants in the candidate genes in a dataset of 18,786 BC patients and 182,927 controls from FinnGen. None of the variants associated significantly with cancer risk in the primary BC series; however, in the FinnGen data, NTHL1 c.244C>T p.(Gln82Ter) associated with BC with a high risk for homozygous (OR = 44.7 [95% CI 6.90–290], P = 6.7 × 10–5) and a low risk for heterozygous women (OR = 1.39 [1.18–1.64], P = 7.8 × 10–5). Furthermore, the results suggested a high risk of colorectal, urinary tract, and basal-cell skin cancer for homozygous individuals, supporting NTHL1 as a recessive multi-tumour susceptibility gene. No significant association with BC risk was detected for SERPINA3 or any other evaluated gene.

Reducing Cancer Risk Through Primary Prevention Activities Among Children: A Demonstration Project.

Opportunities to reduce the risk of cancer, including cervical, liver, and skin cancer, start early in life. To encourage adoption of primary prevention activities in childhood to reduce cancer risk later in life, Centers for Disease Control and Prevention conducted a demonstration project with 3 National Comprehensive Cancer Control Program (NCCCP) recipients. Iowa, Northwest Portland Area Indian Health Board (NPAIHB), and Pennsylvania NCCCP recipients implemented evidence-based primary prevention activities for cervical, liver, and skin cancer among children using health care provider education, patient education, and policy development. Iowa implemented an announcement approach to improve provider education on human papillomavirus (HPV) vaccination. Pennsylvania focused on patient education for reducing skin cancer risk and both provider and patient education for liver cancer prevention. NPAIHB created a sun safety intervention for tribal organizations, including a policy guide, media materials, and patient education. In Iowa, health care providers taking the announcement approach reported significantly higher mean scores on a posttest compared with a pretest regarding perceptions about HPV vaccination, self-efficacy, and behavioral intentions related to vaccination. Pennsylvania integrated sun safety education and sunscreen dispenser programs as a health and wellness initiative in 8 state parks and the Pennsylvania Department of Conservation and Natural Resources incorporated the program in its Pennsylvania Outdoor Recreation Plan. Pennsylvania also implemented health care provider education on the primary prevention of liver cancer through hepatitis B and hepatitis C screening and hepatitis B vaccination. The NPAIHB skin cancer policy guide was created and distributed for use to all 43 federally recognized tribes of Oregon, Washington, and Idaho served by NPAIHB. The identification, dissemination, and implementation of these efforts can serve as best practices for future childhood primary prevention programs. NCCCP recipients and public health professionals can use health care provider education, patient education, and policy development to reduce future risk for cervical, liver, and skin cancer among children.

Revisiting the safety profile: Understanding the link between Methotrexate and skin cancer in psoriasis patients

Madam, Methotrexate (MTX) is an antimetabolite (formerly known as amethopterin) proven t effective in managing autoimmune diseases by suppressing the hyperactive immune response, reducing inflammation, and alleviating associated symptoms. In the case of psoriasis, a chronic autoimmune skin disorder characterized by red, scaly patches on the skin, MTX is among the available treatment options. It is proven beneficial for moderate to severe psoriasis that does not respond adequately to other treatments by reducing the severity and extent of the skin lesions, relieving itching, and improving the overall quality of life. A recent study by Ravi Bharadwaj et al. found that MTX exerts its therapeutic effect on psoriatic skin inflammation by inhibiting the activity of the muropeptide transporter SLC46A21. This mechanism interferes with two key inflammatory responses, namely the NOD1 and NOD2 pathways. It is administered orally, intramuscularly, intravenously, or subcutaneously. Doctors opt for a once-weekly oral dosage, which initiates at a low level to minimize adverse effects. Subsequently, the dosage is incrementally raised to attain the desired efficacy2. Although MTX can be an effective treatment choice, its usage has raised concerns regarding the potential elevation of skin cancer risk. In recently published studies, researchers have concluded that the use of this drug in psoriatic patients might be doing more harm than good. In a meta-analysis performed by Margaret et al., It was found that psoriasis patients receiving MTX therapy have a 2.8-fold greater likelihood of developing non-melanoma skin cancer (NMSC) in comparison to those who do not undergo MTX treatment3. Moreover, there is evidence that prolonged use of MTX may be associated with an increased probability of developing basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), following a dose-dependent trend4. Individuals with psoriasis who may require long-term systemic treatment could face a significantly elevated risk of developing skin cancer. Despite multiple studies confirming the link between MTX and different skin malignancies, its usage remains alarmingly high in treating psoriasis. In resource-limited settings such as Pakistan, this drug is a cost-effective and efficient therapeutic option for managing various forms of psoriasis, including extensive plaque-type psoriasis, acute pustular psoriasis, and erythrodermic psoriasis5. Nevertheless, healthcare workers in Pakistan must prioritize establishing an accurate drug administration plan, to reduce morbidity and mortality rates, as well as the heightened risk of non-melanoma skin cancer (NMSC) among psoriasis patients receiving this treatment.

Prevalence of Second Cancers in Patients with Polycythemia Vera (PV): A Retrospective Analysis of US Real-World Claims Data

Background:Polycythemia vera (PV) is a chronic myeloproliferative neoplasm (MPN) associated with risk of leukemic or fibrotic progression (Tefferi and Barbui. Am J Hematol. 2017;92;94-108). In addition to the known risk of disease transformation, patients with MPNs have a 60% higher risk of developing second non-hematologic cancers compared to matched controls. Skin cancers are among the most prevalent second cancers, with a reported 2.8-fold increase in risk of non-melanoma skin cancer (NMSC) (Landtblom et al., Leukemia. 2018;32:2203-10). The inherent risk associated with MPNs is exacerbated by cytoreductive treatments, as patients treated with hydroxyurea (HU) were found to have a two-fold higher risk of NMSC compared to patients who were not treated with HU (Barbui et al., Leukemia. 2019;33:1996-2005). Previous studies examined fewer than 2000 patients; the study populations may have included patients with other MPNs and PV. Our objective was to evaluate the frequency of second cancers in patients with a primary PV diagnosis who were treated with HU compared to phlebotomy only using a large US real-world claims database. Methods:This real-world, retrospective cohort study used Optum's deidentified Market Clarity Data consisting of electronic health records (EHR) on 105 million US patients and linked medical and prescription claims between 1/1/2007 to 12/31/2019. More than 82,000 patients with ≥1 PV diagnosis at any time were identified within the extracted dataset. For this analysis, eligible patients were ≥18 years old and required ≥2 PV diagnosis codes with ≥60 days between the first and last diagnosis code in the data period. Patients were indexed at the first diagnosis code of PV preceded by ≥1 year of EHR data (“index”) and required ≥1 year of post-index data or death prior to data period end. Patients with a pre-index diagnosis of secondary polycythemia, leukemia, myelodysplastic syndrome, myelofibrosis, or stem cell transplant were excluded. Second cancers were identified at first occurrence of a diagnosis code for a defined cancer in EHR during specified time periods. Analysis of post-treatment cancer rates used a subset of patients with pre-index medication data and excluded cancer types identified prior to treatment. Results:The total study cohort included 20,089 patients with PV (mean age, 63.0 years; 57.8% male; 88.6% Caucasian). Some patients (15.5%; n=3112) had evidence of a pre-index cancer. Median duration of follow-up was 4.3 years (IQR, 2.4-5.9). Among the total cohort, 35.7% (7181 patients) reported at least one second cancer in the post-index period (“post-index period prevalence”). The rate of second cancers in the post-index period was 109.7 events per 1000 patient years (PY). The most common non-hematologic malignancies were skin cancers (22.1/1000 PY) followed by prostate cancer (8.1/1000 PY) and breast cancer (6.7/1000 PY) (Figure 1). Within the total cohort, 9.1% (1830 patients) reported at least one skin cancer in the post-index period, with 8.3% (1659 patients) experiencing NMSC and 1.4% (286 patients) experiencing melanoma (Figure 1). The post-index period prevalence rate of NMSC was 6 times higher vs. the rate of melanoma (19.8 vs. 3.3/1000 PY). Among NMSCs, the rate of basal cell carcinoma was higher than the rate of squamous cell carcinoma (8.7 vs. 6.9/1000 PY). However, the highest rate was observed for non-specific or unspecified malignant neoplasms (8.9/1000 PY). Within a subset of 17,402 patients with pre-index medication data, 20.2% (n=3512) were exposed to at least 4 weeks of HU (without ruxolitinib) at any time; 19.0% (n=3314) were treated with phlebotomy (PHL) only. The rate of any second malignancy subsequent to treatment was >2.5-times higher in the HU vs. PHL group (140.4 vs. 55.3/1000 PY) (Table 1). Rates of skin cancers were nearly two times higher in the HU vs. PHL group for any skin cancer (31.6 vs. 17.7/1000 PY), NMSC (28.9 vs. 15.7/1000 PY), and melanoma (4.5 vs. 2.9/1000 PY). Conclusion:To our knowledge, this is the largest retrospective study evaluating the frequency of second cancers in a cohort of US patients with PV to-date. We found that patients with PV had high rates of malignancies associated with their primary PV diagnosis. The highest rates were observed for skin cancers, driven by the frequency of NMSC. Patients treated with HU had nearly twice the rate of skin cancers (including NMSC and melanoma) compared to PHL-only treated patients.

The causal effects of atopic dermatitis on the risk of skin cancers: A two-sample Mendelian randomization study.

Observational and epidemiological studies show conflicting results on the relationship between atopic dermatitis and skin cancer. Additionally, observational studies are susceptible to the reverse causation and confounders, thus, may not interpret true causal relationships. The causal effects of atopic dermatitis on the risk of skin cancers remains unclear. To investigate the causal relationship between atopic dermatitis and skin cancer including cutaneous malignant melanoma, cutaneous squamous cell carcinoma, basal cell carcinoma and actinic keratosis. We performed a two-sample Mendelian randomization analysis based on summary datasets of public genome-wide association studies of European ancestry. The inverse variance-weighted approach was applied as the main analysis. MR-Egger and weighted median methods were used to complement the inverse variance-weighted results. A series of sensitivity analyses were used to ensure the robustness of the causality estimates. Inverse variance-weighted method showed that genetically predicted dermatitis patients were significantly associated with an increased incidence of basal cell carcinoma (OR, 1.20; 95% CI, 1.10-1.31; p = 4.07E-05) and cutaneous squamous cell carcinoma (OR, 1.14; 95% CI, 1.10-1.19; p = 1.05E-11). However, we did not find a significant causality for atopic dermatitis on melanoma neither did we find actinic keratosis. Subsequent sensitive analyses supported these results. Our study identified the causality between atopic dermatitis basal cell carcinoma and squamous cell carcinoma. Accordingly, regular skin cancer screening is recommended for patients with atopic dermatitis.

Assessment of oxygenated polycyclic aromatic hydrocarbon cytotoxicity using TiO2-MXene/MWCNTs/PDA/GCE electrochemical sensor

Oxygenated polycyclic aromatic hydrocarbons (OPAHs) present in the environment can enter the skin through direct contact and long-term exposure can increase the risk of skin inflammation, allergic reactions and skin cancer. In this study, a titanium dioxide-two-dimensional transition metal carbide/multi-walled carbon nanotubes/polydopamine/glassy carbon electrode (TiO2-MXene/MWCNTs/PDA/GCE) electrochemical biosensor was prepared to evaluate the cytotoxicity of OPAHs based on the changes in the content of xanthine/guanine (X/G) during cellular metabolism. The TiO2-MXene/MWCNTs/PDA/GCE exhibited excellent electrocatalytic activity and sensitivity. The surface morphology, structure and electrochemical properties of TiO2-MXene/MWCNTs/PDA composite material were characterized using scanning electron microscopy, X-ray diffraction and cyclic voltammetry. Human skin fibroblast cells (HFF-1) were used as model cells, and the cell viability was evaluated based on the electrochemical signal changes of X/G. When exposed to OPAHs for 30 h, the half-maximal inhibitory concentrations (IC50) of 1,4-benzoquinone (1,4-BQ), 1,2-naphthoquinone (1,2-NQ), and 9,10-phenanthrenequinone (9,10-PQ) on HFF-1 cells were 291.88, 67.72, and 4.44 µmol·L−1, respectively, which were lower than the IC50 values of 1075.51, 113.96, and 9.63 µmol·L−1 obtained using the traditional MTT assay, indicating higher sensitivity of the sensor. This study achieved sensitive detection of purines in HFF-1 cells, providing a technical method for evaluating the cytotoxicity of persistent organic pollutants OPAHs in the environment.

Sharing and seeking information about skin cancer risk and prevention among Hispanic people from Florida and Puerto Rico

ObjectiveTo explore factors associated with communication and information-seeking after receipt of skin cancer prevention information among Hispanic individuals. MethodsMultivariable logistic regression was used to analyze existing data on demographics, personal experience, salience, and beliefs variables collected from Hispanic individuals to determine independent associations with sharing and seeking information about skin cancer prevention. ResultsOf 578 participants, 53% reported any communication about skin cancer prevention behaviors or skin cancer genetic risk; and 31% and 21% sought additional information about preventive behaviors or genetic risk, respectively. Female sex, greater perceived severity, higher comparative chance of getting skin cancer, and lower health literacy were associated with greater communication, while having no idea of one's own skin cancer risk was related to less communication. Greater health numeracy and higher cancer worry were associated with information-seeking about prevention behaviors and genetic risk. ConclusionUp to half of participants reported communication or information-seeking, although factors associated with specific activities differed. Future studies should evaluate how to promote communication behaviors in the Hispanic community and how sharing and seeking information influence an individual's network prevention practices. InnovationSeveral factors related to communication behaviors among Hispanic people after obtaining skin cancer prevention information were identified.Trial registration: This trial was registered on clinicaltrials.gov (NCT03509467).

Childhood sunburn and risk of melanoma and non-melanoma skin cancer: a Mendelian randomization study

Previous evidence has suggested that childhood sunburn could be a risk factor for cutaneous malignant melanoma (MM) and non-melanoma skin cancer (NMSC). However, existing observational studies could not reveal the causal associations genetically. This study aimed to investigate whether there was a genetic causal relationship between childhood sunburn and skin cancers. Univariable Mendelian randomization (MR) and Causal Analysis Using Summary Effect analysis was carried out for causal estimates and evaluation for the horizontal pleiotropy. Multivariable MR and the mediation effects analysis were used to test whether the causal associations were mediated by potential confounders. A suggestively significant causal association between childhood sunburn and MM was indicated (OR = 4.74; 95% CI: 1.31–17.19; p = 1.79E-02). Genetically predicted childhood sunburn was significantly associated with increased risk of overall melanoma in situ (MIS) (OR = 4.02; 95% CI: 2.00–8.08; p = 9.40E-05), MIS of face (OR = 18.28; 95% CI: 5.28–63.35; p = 4.59E-06), and MIS of trunk (OR = 7.05; 95% CI: 2.06–24.13; p = 1.88E-03). Similar trends were found for childhood sunburn and NMSC (OR = 8.16; 95% CI: 6.07–10.99; p = 1.53E-20), including both basal cell carcinoma (BCC) (OR = 3.76; 95% CI:2.96–4.77; p = 2.19E-08) and squamous cell carcinoma (SCC) (OR = 7.44; 95% CI: 5.09–10.87; p = 2.19E-08). After adjustment for hair and skin color, facial ageing, vitamin D levels, body mass index, alcohol consumption, and smoking status, childhood sunburn showed an independent association with MIS, MIS of face, MIS of trunk, as well as NMSC, including both BCC and SCC. Mediation analysis showed no significant mediation effect. This study demonstrated a causal relationship between childhood sunburn and the risk of both MM and NMSC, which suggested that enhanced screening and prevention for childhood sunburn could contribute to the early detection and decreased risk of MM and NMSC.

#1 Dermatologist Recommended: A Clinician’s Guide to Self-Tanning

Skin tanning is an evolving area of focus for dermatologists. For hundreds of years, fair skin was socially preferred. That is until Coco Chanel returned from the French Riviera in 1923 sporting a sun-tan. Since then, tanned skin has become a booming industry. As the perception of tanning evolved, so did the methods to attain it. Today, skin tanning is achieved by: outdoor UV tanning, indoor UV tanning, spray-tanning, or cosmetic self-tanning products. Dermatologists counsel against UV tanning, as UV exposure is correlated with increased risks of both melanoma and non-melanoma skin cancers. The question that remains to be investigated is the skin safety of self-tanning products. In this review, 20 products were chosen from five major U.S. retailers (Walmart, CVS, Sephora, Ulta, and Amazon). The product ingredients were then analyzed for skin safety. The resulting data suggests that there is no major difference in the number of ingredients that have been deemed safe by the major U.S. cosmetic regulatory bodies among the products, and that cosmetic products are likely getting safer every year. Therefore, clinicians should focus on application counseling and reiterate FDA guidelines by discouraging spray- tanning and tanning pills.

Glucagon like peptide-1 receptor agonists and the risk of skin cancer among patients with type 2 diabetes: Population-based cohort study.

The objective of this study was to determine whether the use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) is associated with an increased risk of melanoma and nonmelanoma skin cancer, separately, compared with the use of sulfonylureas among patients with type 2 diabetes. Using the United Kingdom Clinical Practice Research Datalink (2007-2019), we assembled two new-user active comparator cohorts. In the first cohort assessing melanoma as the outcome, 11,786 new users of GLP-1 RAs were compared with 208,519 new users of sulfonylureas. In the second cohort assessing nonmelanoma skin cancer as the outcome, 11,774 new users of GLP-1 RAs were compared with 207,788 new users of sulfonylureas. Cox proportional hazards models weighted using propensity score fine stratification were fit to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of melanoma and nonmelanoma skin cancer, respectively. Compared with sulfonylureas, GLP-1 RAs were not associated with an increased risk of either melanoma (42.6 vs. 43.9 per 100,000 person-years, respectively; HR 0.96, 95% CI 0.53-1.75) or nonmelanoma skin cancer (243.9 vs. 229.9 per 100,000 person-years, respectively; HR 1.03, 95% CI 0.80-1.33). There was no evidence of an association between cumulative duration of use with either melanoma or nonmelanoma skin cancer. Consistent results were observed in secondary and sensitivity analyses. In this population-based cohort study, GLP-1 RAs were not associated with an increased risk of melanoma or nonmelanoma skin cancer, compared with sulfonylureas.

Association of hydrochlorothiazide treatment compared to alternative diuretics with overall and skin cancer risk: a propensity-matched cohort study

Abstract Introduction Hydrochlorothiazide (HCT) has been suggested to induce photosensitivity, thereby increasing the incidence of skin cancers. After a pharmacovigilance alert, HCT was frequently withdrawn or substituted by other diuretics. The aim of this study was to compare the association of exposure to HCT with cancer risk versus alternative diuretics. Methods A retrospective cohort study was conducted based on data from the AOK PLUS, a large German statutory health insurance fund. Patients with HCT treatment were propensity score matched (PSM) to patients using non-HCT diuretics. Incidence of cancer of any kind and, specifically, skin cancer was assessed in both groups. Time to incident cancer diagnosis was evaluated and compared between the groups. Results A total of 199,708 patients were included in the final analysis (n=76,855 in the HCT-group; n=122,853 in the non-HCT-diuretics group). After PSM, 122,554 patients remained in the sample (n=61,277 for both groups, of which >96% had hypertension, mean age 73 years, 61% female). HCT treatment was associated with a lower incidence of cancer of any kind, compared with non-HCT diuretics (Incidence rate ratio (IRR) per 100 patient years 0.84 95% Confidence interval (CI): 0.82-0.87). HCT treatment was associated with a small albeit significantly higher IRR of skin cancer (1.14 95% CI: 1.06-1.24) with significant variances over time. Although numerically higher, the difference accounts to only 0.05 more skin cancer diagnoses in 100 patient years. Conclusions HCT treatment compared to alternative diuretics was associated with a lower all-cancer risk and was not associated with a meaningful increase in skin cancer risk in a large German population. Nevertheless, advice for skin protection is warranted in all patients taking thiazide or thiazide-like diuretics.HR of overall and skin cancerTime to cancer diagnosis - time to event

Association of Lower Extremity Lymphedema and Nonmelanoma Skin Cancers

ObjectiveTo determine whether patients with lymphedema of a lower extremity (LE) had a greater risk of skin cancer than those without lymphedema. Patients and MethodsThis retrospective cohort study included patients with LE lymphedema examined at Mayo Clinic in Rochester, MN, USA, from January 1, 2000, through December 31, 2020. All patients with the phrase “lower extremity lymphedema” and a diagnostic code for lymphedema present in their electronic health record, as well as their age-, race-, and sex-matched controls without lymphedema, were included in the study. A Kaplan-Meier curve was constructed to examine the time to development of the first skin cancer for the lymphedema cohort and the controls. A Cox proportional hazards regression model was used to calculate hazard ratios. ResultsIn total, 4437 patients had lymphedema within the study period. Compared with the matched control group, the lymphedema group had a significantly increased risk of skin cancer. For the subset of patients with unilateral lymphedema, the lymphedematous extremity was 2.65 times as likely as the nonlymphedematous LE to have skin cancer, particularly basal cell carcinoma. ConclusionLower extremity lymphedema appears to be a risk factor for squamous cell carcinoma, basal call carcinoma, and as expected, angiosarcoma. Clinicians caring for patients with LE lymphedema should be aware of this increased risk and monitor at-risk patients accordingly.

Dipeptidyl peptidase-4 inhibitors and the risk of skin cancer among patients with type 2 diabetes: a UK population-based cohort study

IntroductionThe dipeptidyl peptidase-4 (DPP-4) enzyme significantly influences carcinogenic pathways in the skin. The objective of this study was to determine whether DPP-4 inhibitors are associated with the incidence of melanoma...

Global, regional and national burdens of non-melanoma skin cancer attributable to occupational exposure to solar ultraviolet radiation for 183 countries, 2000–2019: A systematic analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury

BackgroundA World Health Organization (WHO) and International Labour Organization (ILO) systematic review reported sufficient evidence for higher risk of non-melanoma skin cancer (NMSC) amongst people occupationally exposed to solar ultraviolet radiation (UVR). This article presents WHO/ILO Joint Estimates of global, regional, national and subnational occupational exposures to UVR for 195 countries/areas and the global, regional and national attributable burdens of NMSC for 183 countries, by sex and age group, for the years 2000, 2010 and 2019. MethodsWe calculated population-attributable fractions (PAFs) from estimates of the population occupationally exposed to UVR and the risk ratio for NMSC from the WHO/ILO systematic review. Occupational exposure to UVR was modelled via proxy of occupation with outdoor work, using 166 million observations from 763 cross-sectional surveys for 96 countries/areas. Attributable NMSC burden was estimated by applying the PAFs to WHO’s estimates of the total NMSC burden. Measures of inequality were calculated. ResultsGlobally in 2019, 1.6 billion workers (95 % uncertainty range [UR] 1.6–1.6) were occupationally exposed to UVR, or 28.4 % (UR 27.9–28.8) of the working-age population. The PAFs were 29.0 % (UR 24.7–35.0) for NMSC deaths and 30.4 % (UR 29.0–31.7) for disability-adjusted life years (DALYs). Attributable NMSC burdens were 18,960 deaths (UR 18,180–19,740) and 0.5 million DALYs (UR 0.4–0.5). Men and older age groups carried larger burden. Over 2000–2019, attributable deaths and DALYs almost doubled. ConclusionsWHO and the ILO estimate that occupational exposure to UVR is common and causes substantial, inequitable and growing attributable burden of NMSC. Governments must protect outdoor workers from hazardous exposure to UVR and attributable NMSC burden and inequalities.

Predictors of Sun-Protective Behaviors and Sunburn in the United States Population

ABSTRACT Skin cancer is the most diagnosed cancer in the United States. Despite years of education about prevention, incidence is increasing. There are mixed findings about sun protection factors' relationship to preventing sunburn. This study aimed to identify the factors associated with the performance of sun-protective behaviors and understand sunburn risk factors, which relate to skin cancer risk, controlling for demographic factors. This is a secondary analysis of cross-sectional data from the National Health and Nutrition Examination Survey from 2017 to 2018. Data were subset to U.S. participants ages 20 years and older who answered the dermatology questions, which included 3,404 people. A hierarchical logistic regression analysis was conducted in SPSS to investigate the contribution of several factors predicting sun-protective behaviors while controlling for demographic variables. In addition, multiple logistic regression analyses were used to examine potential factors related to getting a sunburn. Statistical significance was p < .05. Race, education, birth country, gender, and sun sensitivity were significant predictors of sun protection behaviors. Those who used sunscreen with a higher frequency and those with severe sun sensitivity had the highest odds of reporting a sunburn. Younger age and severe sun sensitivity were associated with multiple sunburns. The discrepancy between the perceived level of sun sensitivity and the incidence of sunburn suggests that people need to be adequately informed about the risks of sunburn. This finding supports the need for additional research to understand the attitudes and health beliefs toward sunburn and skin cancer prevention.

UJI AKTIVITAS ANTIBAKTERI EKSTRAK DAUN JELANTIR (Conyza sumatrensis (Retz.) E. Walker) DALAM SEDIAAN DEODORAN SPRAY TERHADAP BAKTERI Staphylococcus epidermidis

The bacteria Staphylococcus epidermidis is known to cause body odour in the human body. A common method to kill bacteria that cause body odour is deodorant. Commercial deodorants contain aluminium chlorohydrate and the compound is known to increase the risk of skin cancer and alzheimer's disease. A candidate for a safer deodorant is one made from natural ingredients. One of the natural ingredients that has potential as a deodorant is jelantir leaves. The purpose of this study was to extract and characterise phytochemical compounds and test their antibacterial activity in deodorant spray preparations on Staphylococcus epidermidis. The extraction method used was maceration using ethanol solvent, extract characterisation using UV-Vis spectrophotometry and antibacterial test of deodorant spray preparation of jelantir leaf extract using disc diffusion. The results showed that jelantir leaf extract contained flavonoids 5.5727 ±0.1336 (%w/w QE), saponins 8.6472 ±0.0353 (% w/w SE), tannins 2.1448 ±0.0506 (%w/w TAE), steroids 1.0231 ±0.0083 (%w/w BSE), triterpenoids 0.9090 ±0.0030 (%w/w UAE) and the antibacterial test results had the highest inhibition zone diameter of 13.50 ±0.50 (mm) in formula 30 (%w/v).

Natural hair color and skin cancers: A two-sample Mendelian randomization study

Previous observational studies have indicated an association between hair color and the risk of melanoma and keratinocyte skin cancer (KSC); however, different hair colors show inconsistent effects on skin cancers. Here, we conducted a two-sample Mendelian randomization (MR) study to evaluate the causal relationship between natural hair color and skin cancers by using 211 single nucleotide polymorphisms as genetic instruments from a genome-wide meta-analysis of 360,270 individuals of European ancestry. Light hair colors (red, blonde, and light brown) were associated with high levels of cutaneous melanoma (CM) and KSC (CM-inverse variance weighted [IVW] odds ratio [OR]-red: 1.034, 95% confidence interval [CI]: 1.025–1.044, P < 0.001; OR-blonde: 1.008, 95% CI: 1.003–1.014, P = 0.003; OR-light brown: 1.006, 95% CI: 1.002–1.011, P = 0.009; KSC-IVW OR-red: 1.078, 95% CI: 1.053–1.103, P < 0.001; OR-blonde: 1.024, 95% CI: 1.009–1.040, P = 0.002; OR-light brown: 1.018, 95% CI: 1.004–1.033, P = 0.01). However, dark brown hair showed an inverse causal relationship with skin cancers (CM IVW OR: 0.987, 95% CI: 0.984–0.990, P < 0.001; KSC IVW OR: 0.979, 95% CI: 0.970–0.988, P < 0.001). Black hair was associated with a decreased risk of KSC (IVW OR: 0.954, 95% CI: 0.913–0.997, P = 0.036) but showed no causal relationship with CM. The present study provides strong MR evidence of a causal association between hair color and skin cancer. Secondary MR analyses enhances result robustness by replicating findings, exploring gender-specific effects, and providing a more comprehensive understanding of the complex relationship between hair color and skin cancers. More large-scale MR studies or randomized controlled trials are required to further investigate the mechanisms of the association between hair color and skin cancers.

Zebrafish as an Animal Model for Albinism Disorders

Zebrafish (Danio rerio) is a relevant model for studying many diseases, including the melanocyte-related disorders. In this review of melanocyte literature, we discuss current knowledge about different forms of albinism and the potential of the zebrafish model to find new mechanisms and treatments. Melanin is produced in a process called melanogenesis. This, if altered, leads to diseases such as albinism. Albinism causes an increased risk of skin cancer. Zebrafish are used to study pigment disorders, due to their high fecundity, visible development of melanin in melanophores (melanocytes in mammals) from 24 h post-fertilization, and preserved melanogenesis pathways. In this case, we looked for developmental pathways in zebrafish melanophores and mammalian melanocytes. In addition, we summarized advances in understanding pigment cell disease and evidence supporting the potent potential of using zebrafish to better understand the management of albinism