Risk Of Skin Cancer Research Articles

Identification of novel small molecule-based strategies of COL7A1 upregulation and readthrough activity for the treatment of recessive dystrophic epidermolysis bullosa

Recessive dystrophic epidermolysis bullosa (RDEB) is a rare genetic disease caused by loss of function mutations in the gene coding for collagen VII (C7) due to deficient or absent C7 expression. This disrupts structural and functional skin architecture, leading to blistering, chronic wounds, inflammation, important systemic symptoms affecting the mouth, gastrointestinal tract, cornea, and kidney function, and an increased skin cancer risk. RDEB patients have an extremely poor quality of life and often die at an early age. A frequent class of mutations in RDEB is premature termination codons (PTC), which appear in homozygosity or compound heterozygosity with other mutations. RDEB has no cure and current therapies are mostly palliative. Using patient-derived keratinocytes and a library of 8273 small molecules and 20,160 microbial extracts evaluated in a phenotypic screening interrogating C7 levels, we identified three active chemical series. Two of these series had PTC readthrough activity, and one upregulated C7 mRNA, showing synergistic activity when combined with the reference readthrough molecule gentamicin. These compounds represent novel potential small molecule-based systemic strategies that could complement topical-based treatments for RDEB.

Does tattoo exposure increase the risk of skin cancer? A population-based case-control study

Does tattoo exposure increase the risk of skin cancer? A population-based case-control study

Geographical Differences in Hydrochlorothiazide Associated Risk of Skin Cancer Balanced Against Disability Related to Hypertensive Heart Disease.

Hypertension affects 25%-30% of the world population. Hydrochlorothiazide (HCTZ) is among the most used and cheapest medications but was in 2018 labeled with a warning stating the increased risk of nonmelanoma skin cancer (NMSC). This study describes geographical differences in the association between HCTZ and NMSC from the perspective of hypertensive heart disease (HHD). We conducted a systematic literature search (PubMed, Embase, Clinicaltrial.gov, and Clinicaltrial.eu) using PICO/PECO acronyms, including case-control, cohort, and randomized controlled trials. We constructed a rate ratio of disability-adjusted life years (DALY) for HHD/NMSC in the global burden of disease (GBD) regions. No increased risk of NMSC with the use of HCTZ was found in Taiwan, India, and Brazil. A small (hazard ratio (HR)/odds ratio (OR) ≤1.5) but significantly increased risk was seen in Canada, the United States, and Korea. An increased risk (1.5< HR/OR ≤2.5) in Iceland, Spain, and Japan and a highly increased risk (HR/OR >2.5) in the United Kingdom, Denmark, the Netherlands, and Australia. HHD is associated with a more than tenfold DALY rate compared with NMSC in 13 of 21 GBD regions, corresponding to 77.2% of the global population. In none of these 13 regions was there an increased risk of HCTZ-associated NMSC. Despite limited information from many countries, our data point to large geographical differences in the association between HCTZ and NMSC. In all GBD regions, except Australasia, HHD constitutes a more than fivefold DALY rate compared to NMSC. This disproportionate risk should be considered before avoiding HCTZ from the antihypertensive treatment.

Advanced progress of the relationship between renin-angiotensin-aldosterone system inhibitors and cancers.

Hypertension and cancers are the most common causes of death in humans, as well as common co-diseases among elderly population. Studies have shown that hypertension is associated with carcinogenesis. The renin-angiotensin-aldosterone system (RAAS) is a crucial regulatory system of blood pressure, fluid, and electrolyte homeostasis, which plays an essential role in the pathogenesis of hypertension, whose mechanism is relatively clear. Studies have indicated that RAAS also widely exists in cancer tissues of different systems, which can affect the risk of cancers by stimulating cancer angiogenesis, participating in cancer-related oxidative stress, and regulating cancer-related immunity. Therefore, inhibiting RAAS activity seems beneficial to decreasing the risk of cancers. As one of the most commonly used antihypertensive drugs, RAAS inhibitors have been widely used in clinical practice. However, the conclusions of clinical studies on the relationship between RAAS inhibitors and cancers are not entirely consistent, which has been widely concerned by clinicians. The latest findings suggest that while RAAS inhibitors may reduce the risk of digestive cancers, respiratory cancers, urological cancers, gynecological cancers, and skin cancers, ACEIs may increase the risk of lung cancer, endometrial cancer, basal cell carcinoma, and squamous cell carcinoma. This article comprehensively reviews animal experiments, clinical studies, and meta-analyses on the relationship between RAAS inhibitors and cancers, to provide references for related studies in the future.

The Role of Health Literacy in Skin Cancer Preventative Behavior and Implications for Intervention: A Systematic Review.

Health literacy is essential for individuals to access, understand, and utilize information and services to inform health related decisions and actions. As one of the most diagnosed and preventable forms of cancer, skin cancer disease risk can be reduced through preventative behavior. Currently, there is no focused study looking specifically at health literacy and skin cancer. An understanding of how health literacy affects skin cancer-related preventive behaviors can improve current practices in skin cancer prevention. To systematically identify, synthesize, and summarize findings on the role of health literacy in skin cancers (including cutaneous squamous cell carcinoma, basal cell carcinoma, and melanoma), with a focus on preventive behaviors using studiesthat utilized quantifiablehealth literacy measurements. A literature search was performed by searching PubMed, Embase, PsycINFO, and CINAHL from inception until September 26, 2023 to identify cross-sectional, case-control, cohort, or randomized controlled studies that investigated the association between health literacy and skin cancer prevention and diagnosis. Health literacy levels varied across geographic regions, specific populations, and ethnicities. Most of the included studies found a positive association between higher health literacy and better skin cancer preventative behaviors. This included sun-protective behaviors such as: wearing sleeved shirts or shirts with collars, using gloves, covering head and face, limiting sun exposure, more sunscreen use, and less sunbathing or indoor tanning. Higher health literacy was associated with increased likelihood to engage in genetic testing and less family influence on health in one study which assessed determinants of interest in skin cancer genetic testing. Another study investigating family communication about skin cancer found that higher health literacy was associated with increased family communication regarding general cancer risk. One sun protection interventional education program was effective at increasing participants' knowledge, awareness of skin cancer risk, willingness to change sun protection, and use of sun protection, but results varied between ethnic groups. Skin cancer-related educational interventions can be effective in improving health literacy and potentially lessen the impact of skin cancer through positive behavior modification, early detection, and disease knowledge and awareness. Interventions need to be tailored to its target population to maximize effectiveness due to thevarying baseline of health literacy identified across different geographic and ethnic groups. Protocol Registration PROSPERO CRD42022340826.

The Causal Relationship Between Physical Activity and Skin Cancer Risk: An Univariable Mendelian Randomization Study.

The existing observational research on the relationship between physical activity (PA) and skin cancer (SC) is contentious, which points to the intricate nature of their association and underscores the imperative for more nuanced research to untangle the causal dynamics at play. The aim of this article is to delve deeper into this complex relationship, seeking to clarify whether PA serves as a protective factor against SC, or contributes to its risk. We utilized data from the genome-wide association study (GWAS) of PA from GWAS Catalog (include self-reported moderate to vigorous PA (MVPA), self-reported vigorous PA (VPA), and accelerometer-based average-accelerated PA). The data of SC is from FinnGen. All of the participants are of European ancestry. We used two-sample Mendelian Randomization (TSMR) to analyze the causal relationship between PA and SC.The research was conducted using inverse variance weighted (IVW) method as the primary approach, and MR Egger regression as supplementary analytical method. To ensure the robustness of the results, Cochran's Q-test and MR pleiotropy residual sum and outlier (MR-PRESSO) global tests were used to measure sensitivity. Our analysis indicated that average-accelerated PA was associated with an increased risk of SC (ORIVW = 0.94, 95% CI 0.93-0.96, P < 0.001). While neither MVPA (ORIVW = 0.99, 95% CI 0.67-1.47, P = 0.962) nor VPA (ORIVW = 0.80, 95% CI 0.29-2.18, P = 0.656) shows causal relationship on risk of SC. Our research suggests that PA is associated with a decrease in SC, provides a new perspective for future SC prevention. Our research findings bolster the hypothesis that increased levels of PA, characterized by average acceleration, are associated with a reduced risk of developing skin cancer. This has filled the gap of research on the causal relationship between PA and SC, and could pave the way for novel preventive strategies against skin cancer.

Skin cancer risk in patients with BRCA mutations

Skin cancer risk in patients with BRCA mutations

Sun protection vs. the “sunscreen paradox”

The role sun filters in cosmetics that protect the skin from ultraviolet radiation is to reduce the risk of skin cancer. Nevertheless, recent studies indicate a paradoxical increase in sunlight-induced skin cancer, which is referred to as the “sunscreen paradox.” The study aimed to provide an answer to the question regarding the factors that contribute to this phenomenon and whether the legitimacy of sunscreen use will be doubtful in light of such results. An analysis of the current literature was conducted. The obtained results were surprisingly unexpected, which prompted the author to undertake further research and an indepth analysis of the results based on available sources. This is due to the possibility that the need for sunscreen could be questioned.

Associations of Social Factors and Self-Efficacy with Skin-Self Examination Intentions Among Hispanics at Risk for Skin Cancer and Their Preferences for Digital Interventions.

Skin cancer ranks as the most prevalent cancer in the United States. Over the past two decades, the incidence of melanoma, the deadliest form of skin cancer, among Hispanics has risen by 20%. Melanoma mortality rates are higher in Hispanics than in non-Hispanic Whites (NHW). Early detection of melanoma via skin self-examination may lead to diagnosis of melanoma at an earlier stage, when they are thinner, less invasive, and more easily treatable, resulting in improved survival rates. Given the gap in research addressing culturally relevant factors related to skin cancer prevention and detection among Hispanics and informed by the Preventive Health Model, this study tested the associations between social and normative factors and self-efficacy with thorough skin self-examination (TSSE) intentions and queried participants about their preferences for skin cancer-related interventions. Among respondents (n = 79), 55.7% were female (n = 44), and 89.9% held a college or higher degree (n = 71). Self-efficacy fully mediated the effects of descriptive norms, injunctive norms, and provider-patient communication on TSSE intentions among Hispanics. On average, respondents demonstrated considerable interest in participating in a skin cancer-related behavioral intervention using a mobile application (75.6%) and/or using WhatsApp (71.8%). These preliminary findings provide new insights for development of future digital skin cancer intervention programs among Hispanics targeting social factors, including social norms and provider-patient communication, and utilizing preferred digital tools.

Engineering a durable BDDE cross-linked collagen filler for skin rejuvenation

Skin aging, characterized by reduced regeneration, chronic inflammation, and heightened skin cancer risk, poses a significant challenge. Collagen fillers have emerged as a potential solution for skin rejuvenation by stimulating collagen regeneration. However, their clinical efficacy is limited by inherent instability and vulnerability toin vivodegradation by collagenase. Chemical cross-linking presents a promising approach to enhance stability, but it carries risks such as cytotoxicity, calcification, and discoloration. Here, we introduce a highly durable 1,4-butanediol diglycidyl ether (BDDE) cross-linked collagen filler for skin rejuvenation. BDDE effectively cross-links collagen, resulting in fillers with exceptional mechanical strength and injectability. These fillers demonstrate favorable stability and durability, promoting proliferation, adhesion, and spreading of human foreskin fibroblast-1 cellsin vitro. In vivostudies confirm enhanced collagen regeneration without inducing calcification. BDDE cross-linked collagen fillers offer promising prospects for medical cosmetology and tissue regeneration.

A sequence of SVA retrotransposon insertions in ASIP shaped human pigmentation

Retrotransposons comprise about 45% of the human genome1, but their contributions to human trait variation and evolution are only beginning to be explored2,3. Here, we find that a sequence of SVA retrotransposon insertions in an early intron of the ASIP (agouti signaling protein) gene has probably shaped human pigmentation several times. In the UK Biobank (n = 169,641), a recent 3.3-kb SVA insertion polymorphism associated strongly with lighter skin pigmentation (0.22 [0.21–0.23] s.d.; P = 2.8 × 10−351) and increased skin cancer risk (odds ratio = 1.23 [1.18–1.27]; P = 1.3 × 10−28), appearing to underlie one of the strongest common genetic influences on these phenotypes within European populations4–6. ASIP expression in skin displayed the same association pattern, with the SVA insertion allele exhibiting 2.2-fold (1.9–2.6) increased expression. This effect had an unusual apparent mechanism: an earlier, nonpolymorphic, human-specific SVA retrotransposon 3.9 kb upstream appeared to have caused ASIP hypofunction by nonproductive splicing, which the new (polymorphic) SVA insertion largely eliminated. Extended haplotype homozygosity indicated that the insertion allele has risen to allele frequencies up to 11% in European populations over the past several thousand years. These results indicate that a sequence of retrotransposon insertions contributed to a species-wide increase, then a local decrease, of human pigmentation.

Know Your Sunscreen

Ultraviolet(UV) radiation from the sun has significant adverse effects on the skin, including sunburns, premature aging (photoaging), tanning, and many skin cancers. Sunscreens protect from harmful UV radiation. This article delves into the fundamentals of solar radiation, focusing on the UV spectrum, its effect on the skin, various types of sunscreens, and their mechanism of action to offer protection from harmful rays. UV exposure depends on factors like geographic location, altitude, time of day, season, and surface reflectivity. Sunscreen efficacy is measured by the Sun Protection Factor (SPF), which indicates how well a sunscreen can protect against UVB-induced sunburn. SPF ratings of 15, 30, and 50+ correspond to 93%, 96%, and 98% UVB blockage, respectively. In contrast, UVA protection lacks a standardized measure, with various in vitro and in vivo indices used globally. Sunscreens are categorized as organic (chemical) or inorganic (physical), each with distinct mechanisms and properties. Proper application of sunscreen, involving adequate coverage and reapplication, maximizes its protective benefits, significantly reducing the risk of UV-induced skin damage and cancers. Despite minor side effects like potential allergies, the advantages of sunscreen use, including prevention of sunburn, tanning, premature aging, and skin cancers, far outweigh the drawbacks. UV radiation from the sun poses significant risks to skin health. Understanding the nature and effects of UV radiation is crucial in appreciating the importance of protective measures such as sunscreen. The role of sunscreens in providing comprehensive protection cannot be overstated.

Skin cancer risk after hematopoietic stem cell transplantation: a systematic review and meta-analysis.

Hematopoietic stem cell transplantation (HSCT) has improved outcomes for severe hematologic, malignant, and immune disorders, yet poses an increased risk of subsequent malignancies. This study aimed to examine the risk of skin cancer following HSCT and identify potential risk factors. The search was conducted in MEDLINE, EMBASE, and CINAHL databases until December 2023. Cohort studies reporting standardized incidence ratios (SIRs) for post-HSCT skin cancer or investigating risk factors were included. SIRs, or hazard ratios (HRs) with 95% confidence interval (CI), were calculated using random-effects inverse-variance models. Outcome endpoints were SIRs of skin cancer post-HSCT and risk factors, including gender, chronic graft-versus-host disease (cGVHD), voriconazole exposure, and total body irradiation (TBI). Twenty-six studies involving 164,944 HSCT recipients (allogeneic HSCT, n = 68,637; autologous HSCT, n = 95,435; mean age: 38.5 ± 13.8 years; 71,354 females [43.3%]) were analyzed. Overall, SIR for skin cancer post-HSCT was 7.21 (95% CI 3.98-13.08), with SIRs of 2.25 (95% CI: 1.37-3.68) for autologous HSCT, and 10.18 (95% CI 5.07-20.43) for allogeneic HSCT. Risk factors for skin cancer risk included cGVHD (HR = 2.86 [95% CI: 2.01-4.07]), specifically for basal cell and squamous cell carcinoma (SCC) (HR = 1.80 [95% CI: 1.31-2.46] and HR = 3.68 [95% CI: 2.39-5.68], respectively), male gender (HR = 1.56 [95% CI: 1.15-2.13]), especially for SCC (HR = 1.70 [95% CI: 1.03-2.80]), and voriconazole exposure (HR = 2.01 [95% CI: 1.12-3.61]). TBI showed no statistically significant association with subsequent skin cancer (HR = 1.12 [95% CI: 0.73-1.71]). These findings highlight the importance of rigorous skin cancer surveillance and preventive strategies in HSCT recipients, particularly in male individuals undergoing allogeneic transplants and those with identifiable risk factors, to enable early detection and intervention.

[Translated article] Risk of Skin Cancer Associated with Disease-Modifying Therapies in Multiple Sclerosis: A Comprehensive Evidence Review

The use of disease-modifying therapies (DMT) has led to a paradigm shift in the management of multiple sclerosis. A comprehensive narrative review was conducted through an extensive literature search including Medline and Google Scholar to elucidate the link between DMT and the propensity of cutaneous malignancies. Sphingosine-1-phosphate receptor modulators, such as fingolimod and siponimod are associated with a higher risk of basal cell carcinoma (BCC), but not squamous cell carcinoma, or melanoma. The associated physiopathological mechanisms are not fully understood. Alemtuzumab and cladribine show isolated associations with skin cancer. Regarding other DMT, no increased risk has ever been found. Given the evidence currently available, it is of paramount importance to advocate for necessary dermatological assessments that should be individualized to the risk profile of each patient. Nonetheless, additional prospective studies are still needed to establish efficient dermatological follow-up protocols.

Adolescent Cardiorespiratory Fitness and Risk of Cancer in Late Adulthood: Nationwide Sibling-Controlled Cohort Study.

To investigate whether the higher risks of certain cancers associated with high cardiorespiratory fitness can be explained by increased detection and unobserved confounders. Nationwide sibling-controlled cohort study of adolescents. Sweden. 1 124 049 men of which 477 453 were full siblings, who underwent mandatory military conscription examinations between 1972 and 1995 at a mean age of 18.3 years. Hazard ratios (HR) and 95% confidence intervals (CI) of overall cancer diagnosis and cancer mortality, and 14 site-specific cancers (diagnosis or death), as recorded in the Swedish National Patient Register or Cause of Death Register until 31 December 2023, modelled using flexible parametric regressions. Participants were followed until a median (maximum) age of 55.9 (73.5) years, during which 98 410 were diagnosed with cancer and 16 789 had a cancer-related death (41 293 and 6908 among full siblings respectively). The most common cancers were non-melanoma skin (27 105 diagnoses & 227 deaths) and prostate cancer (24 211 diagnoses & 869 deaths). In cohort analysis, those in the highest quartile of cardiorespiratory fitness had a higher risk of prostate (adjusted HR 1.10; 95% CI: 1.05 to 1.16) and skin cancer (e.g., non-melanoma HR 1.44; 1.37 to 1.50) compared to those in the lowest quartile, which led to a higher risk of any type of cancer diagnosis (HR 1.08; 1.06 to 1.11). However, those in the highest quartile had a lower risk of cancer mortality (HR 0.71; 0.67 to 0.76). When comparing full siblings, and thereby controlling for all behavioural, environmental, and genetic factors they share, the excess risk of prostate (HR 1.01; 0.90 to 1.13) and skin cancer (e.g., non-melanoma HR 1.09; 0.99 to 1.20) attenuated to the null. In contrast, the lower risk of overall cancer mortality was still statistically significant after control for such shared confounders (HR 0.78; 0.68 to 0.89). For other site-specific cancers, the influence of such confounding tended to vary, but none showed the same excess risk as prostate and non-melanoma skin cancer. The association between high levels of adolescent cardiorespiratory fitness and excess risk of some cancers, such as prostate and non-melanoma skin cancer, appears to be fully explained by unobserved confounders shared between full siblings. However, the protective association with cancer mortality persists even after control for such confounding.

Patients poorly recognize lesions of concern that are malignant melanomas: is self-screening the correct advice?

Australia is known for its outdoor culture, with a large percentage of its population engaging in outdoor recreational activities, aquatic, non-aquatic and outdoor occupational activities. However, these outdoor enthusiasts face increased exposure to ultraviolet radiation (UVR), leading to a higher risk of skin cancer, including malignant melanoma (MM). Over the past 40 years, there has been a significant rise in skin cancer rates in Australia, with two out of three Australians expected to develop some form of skin cancer by age 70. Currently, skin cancer examinations are not endorsed in asymptomatic or low-risk individuals in Australia, with only high-risk individuals recommended to undergo regular skin examinations. Notably, the Melanoma Institute Australia suggests that one-half of patients identify MMs themselves, although this claim appears to be based on limited Australian data which may not reflect contemporary practice. Therefore this study sought to determine the percentage of patients who were able to self-identify MMs as lesions of concern when presenting for a skin cancer examination. Multi-site, cross-sectional study design incorporating a descriptive survey and total body skin cancer screening, including artificial intelligence by a skin cancer doctor. A total of 260 participants with suspect MM lesions were biopsied, with 83 (31.9%) found to be melanomas. Of the true positive MMs only a small percentage of participants (21.7% specificity) correctly had concerns about the suspect lesion being a MM. These MMs were located primarily on the back (44.4%), shoulder (11.1%) and upper leg (11.1%). There was no significant difference in the size between those participants aware of a MM versus those who were not (P=0.824, 24.6 vs 23.4 mm2). Significantly more males identified lesions of concern that were MMs as compared to females (P=0.008, 61.1% vs 38.9%, respectively). With regard to true negatives males and females were similar (52.1% vs 47.9%, respectively). With regard to false negatives (n=65), a greater percentage of males than females did not recognize the MM as a lesion of concern (66.2% vs 33.8%, respectively). Participants were more likely to correctly identify an invasive MM as opposed to an in situ MM (27.3% versus 21.3%). Only a small percentage of participants in this study were able to self-identify either in situ or invasive MM as a lesion of concern with a tendency to identify the more advanced, thicker MMs. Given that MM is associated with a high mortality and cost of treatment, particularly when invasive, the inability of lay persons to identify these cancerous lesions will likely lead to delayed treatment and a possible adverse outcome. We believe the current melanoma screening practices in Australian general practice should be revisited to improve patient outcomes with regard to MM. Additionally, prevention campaigns should include images and primary risk factors for MM.

Digital Interventions to Modify Skin Cancer Risk Behaviors in a National Sample of Young Adults: Randomized Controlled Trial.

Young adults engage in behaviors that place them at risk for skin cancer. Dissemination of digital health promotion interventions via social media is a potentially promising strategy to modify skin cancer risk behaviors by increasing UV radiation (UVR) protection and skin cancer examinations. This study aimed to compare 3 digital interventions designed to modify UVR exposure, sun protection, and skin cancer detection behaviors among young adults at moderate to high risk of skin cancer. This study was a hybrid type II effectiveness-implementation randomized controlled trial of 2 active interventions, a digital skin cancer risk reduction intervention (UV4.me [basic]) compared with an enhanced version (UV4.me2 [enhanced]), and an electronic pamphlet (e-pamphlet). Intervention effects were assessed over the course of a year among 1369 US young adults recruited primarily via Facebook and Instagram. Enhancements to encourage intervention engagement and behavior change included more comprehensive goal-setting activities, ongoing proactive messaging related to previously established mediators (eg, self-efficacy) of UVR exposure and protection, embedded incentives for module completion, and ongoing news and video updates. Primary outcome effects assessed via linear regression were UVR exposure and sun protection and protection habits. Secondary outcome effects assessed via logistic regression were skin self-exams, physician skin exams, sunscreen use, indoor tanning, and sunburn. The active interventions increased sun protection (basic: P=.02; enhanced: P<.001) and habitual sun protection (basic: P=.04; enhanced P=.01) compared with the e-pamphlet. The enhanced intervention increased sun protection more than the basic one. Each active intervention increased sunscreen use at the 3-month follow-up (basic: P=.03; enhanced: P=.01) and skin self-exam at 1 year (basic: P=.04; enhanced: P=.004), compared with the e-pamphlet. Other intervention effects and differences between the Basic and Enhanced Intervention effects were nonsignificant. The active interventions were effective in improving several skin cancer risk and skin cancer prevention behaviors. Compared with the basic intervention, the enhanced intervention added to the improvement in sun protection but not other behaviors. Future analyses will explore intervention engagement (eg, proportion of content reviewed). ClinicalTrials.gov NCT03313492; http://clinicaltrials.gov/ct2/show/NCT03313492.

An Insight on Skin Cancer About Different Targets With Update on Clinical Trials and Investigational Drugs.

Cancer is a diverse disease caused by transcriptional changes involving genetic and epigenetic features that influence a huge variety of genes and proteins. Skin cancer is a potentially fatal disease that affects equally men and women globally and is characterized by many molecular changes. Despite the availability of various improved approaches for detecting and treating skin cancer, it continues to be the leading cause of death throughout society. This review highlights a general overview of skin cancer, with an emphasis on epidemiology, types, risk factors, pathological and targeted facets, biomarkers and molecular markers, immunotherapy, and clinical updates of investigational drugs associated with skin cancer. The skin cancer challenges are acknowledged throughout this study, and the potential application of novel biomarkers of skin cancer formation, progression, metastasis, and prognosis is explored. Although the mechanism of skin carcinogenesis is currently poorly understood, multiple articles have shown that genetic and molecular changes are involved. Furthermore, several skin cancer risk factors are now recognized, allowing for efficient skin cancer prevention. There have been considerable improvements in the field of targeted treatment, and future research into additional targets will expand patients' therapeutic choices. In comparison to earlier articles on the same issue, this review focused on molecular and genetic factors and examined various skin cancer-related factors in depth.

P065 Attitudes and practices of patients with inflammatory bowel disease towards skin cancer risk and sun protection

P065 Attitudes and practices of patients with inflammatory bowel disease towards skin cancer risk and sun protection

Are Welsh primary schools Sunproofed? Results of a national survey Part 2: sun protection practices in primary schools in Wales

Abstract Background Skin cancer rates are on the rise globally. School sun safety programmes are recommended by the World Health Organisation to reduce the risk of future skin cancer at population level; however, these are encouraged but not mandated in Wales. Objectives To explore current sun protection practices and sun safety education in primary schools in Wales and whether these are linked to the existence of a formal sun safety policy. Methods An online survey to all 1241 Welsh primary schools asking about sun safety practices, education and formal policies. Results 471 (38.0%) schools responded with the profile of responding schools generally matching the profile of schools in Wales. A minority (22,4.7%) of responding schools reported they had sufficient shade for most activities. In the spring and summer terms almost two thirds of schools encourage hat wearing (304, 64.8%) and sunscreen (296, 63.2%). While nearly all schools reported that parents were encouraged to apply sunscreen to students before school (449, 95.7%), there was wide variation in other sunscreen application practices. Less than one third of schools (129, 29.0%) reported that they include sun protection education in the curriculum in every year group, with 11.7% (52) including this in certain years only. Schools with a formal policy were more likely to report more comprehensive sun protection practices including having sufficient shade [OR 1.51, 95% CI 1.04-2.19; p = 0.032], having spare hats for pupils to wear [OR 1.59, 95% CI 1.07-2.37; p = 0.023], providing guidance for staff [OR 5.87, 95% CI 3.05-11.28; p &amp;lt; 0.001], encouraging them to model sun safe behaviours [OR 1.82, 95% CI 1.18-2.80; p = 0.007] and teaching sun protection education as part of the curriculum in every year group [OR 2.56, 95% CI 1.76-3.71; p &amp;lt; 0.001]. With respect to sunscreen, the existence of a formal policy did not seem to affect a school’s practice. Conclusions While in most cases, the existence of a formal policy suggests more comprehensive sun protection practices and education in schools, sun protection measures and education need improvement across the primary school sector in Wales to reverse rising skin cancer rates.