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Kandolf L, Peris K, Malvehy J, Mosterd K, Heppt MV, Fargnoli MC, Berking C, Arenberger P, Bylaite-Bučinskiene M, Del Marmol V, Dirschka T, Dreno B, Forsea AM, Harwood CA, Hauschild A, Heerfordt IM, Kauffman R, Kelleners-Smeets N, Lallas A, Lebbe C, Leiter U, Longo C, Mijušković Ž, Pellacani G, Puig S, Saiag P, Šitum M, Stockfleth E, Salavastru C, Stratigos A, Zalaudek I, Garbe C. European consensus-based interdisciplinary guideline for diagnosis, treatment and prevention of actinic keratoses, epithelial UV-induced dysplasia and field cancerization on behalf of European Association of Dermato-Oncology, European Dermatology Forum, European Academy of Dermatology and Venereology and Union of Medical Specialists (Union Européenne des Médecins Spécialistes). J Eur Acad Dermatol Venereol 2024; 38:1024-1047. [PMID: 38451047 DOI: 10.1111/jdv.19897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/23/2024] [Indexed: 03/08/2024]
Abstract
A collaboration of multidisciplinary experts from the European Association of Dermato-Oncology, the European Dermatology Forum, the European Academy of Dermatology and Venereology, and the European Union of Medical Specialists was formed to develop European recommendations on AK diagnosis and treatment, based on current literature and expert consensus. This guideline addresses the epidemiology, diagnostics, risk stratification and treatments in immunocompetent as well as immunosuppressed patients. Actinic keratoses (AK) are potential precursors of cutaneous squamous cell carcinoma (cSCC) and display typical histopathologic and immunohistochemical features of this malignancy in an early stage. They can develop into cSSC in situ and become invasive in a low percentage of cases. AK is the most frequent neoplasia in white populations, frequently occurring within a cancerous field induced by ultraviolet radiation. Since it cannot be predicted, which lesion will progress to cSCC and when treatment is usually recommended. The diagnosis of AK and field cancerization is made by clinical examination. Dermatoscopy, confocal microscopy, optical coherence tomography or line-field confocal-OCT can help in the differential diagnosis of AK and other skin neoplasms. A biopsy is indicated in clinically and/or dermatoscopically suspicious and/or treatment-refractory lesions. The choice of treatment depends on patients' and lesion characteristics. For single non-hyperkeratotic lesions, the treatment can be started upon patient's request with destructive treatments or topical treatments. For multiple lesions, field cancerization treatment is advised with topical treatments and photodynamic therapy. Preventive measures such as sun protection, self-examination and repeated field cancerization treatments of previously affected skin areas in high-risk patients are advised.
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Affiliation(s)
- Lidija Kandolf
- Department of Dermatology, Faculty of Medicine, University of Defence, Military Medical Academy, Belgrade, Serbia
| | - Ketty Peris
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Josep Malvehy
- Dermatology Department of Hospital Clinic of Barcelona, IDIBAPS, CIBER de Enfermedades Raras, Instituto Carlos III, University of Barcelona, Barcelona, Spain
| | - Klara Mosterd
- Department of Dermatology, Maastricht University Medical Centre+ Comprehensive Cancer Centre, Maastricht, The Netherlands
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Markus V Heppt
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CC ER-EMN), Erlangen, Germany
| | - Maria Concetta Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Carola Berking
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CC ER-EMN), Erlangen, Germany
| | - Petr Arenberger
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and University Hospital of Kralovske Vinohrady, Prague, Czech Republic
| | - Matilda Bylaite-Bučinskiene
- Clinic of Infectious Diseases and Dermatovenereology, Centre of Dermatovenereology, Vilnius University, Vilnius, Lithuania
| | - Veronique Del Marmol
- Department of Dermatology, University Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Thomas Dirschka
- Faculty of Health, University Witten-Herdecke, Witten, Germany
- CentroDerm Clinic, Wuppertal, Germany
| | - Brigitte Dreno
- Nantes Université, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302/EMR6001, Nantes, France
| | - Ana-Maria Forsea
- Department of Oncologic Dermatology, Elias University Hospital Bucharest, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Catherine A Harwood
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Axel Hauschild
- Department of Dermatology, University Hospital (UKSH), Kiel, Germany
| | - Ida Marie Heerfordt
- Department of Dermatology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Roland Kauffman
- Department of Dermatology, Venereology and Allergology, Frankfurt University Hospital, Frankfurt, Germany
| | - Nicole Kelleners-Smeets
- Department of Dermatology, Maastricht University Medical Centre+ Comprehensive Cancer Centre, Maastricht, The Netherlands
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Celeste Lebbe
- Université Paris Cite, AP-HP Dermato-oncology, Cancer institute APHP, Nord Paris cité, INSERM U976, Saint Louis Hospital, Paris, France
| | - Ulrike Leiter
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
| | - Caterina Longo
- Skin Cancer Center, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Željko Mijušković
- Department of Dermatology, Faculty of Medicine, University of Defence, Military Medical Academy, Belgrade, Serbia
| | - Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Susana Puig
- Dermatology Department of Hospital Clinic of Barcelona, IDIBAPS, CIBER de Enfermedades Raras, Instituto Carlos III, University of Barcelona, Barcelona, Spain
| | - Philippe Saiag
- Department of General and Oncologic Dermatology, Ambroise Paré Hospital, APHP, & EA 4340 "Biomarkers in Cancerology and Hemato-Oncology", UVSQ, Université Paris-Saclay, Boulogne-Billancourt, France
| | - Mirna Šitum
- Department of Dermatology and Venereology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Eggert Stockfleth
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - Carmen Salavastru
- Department of Pediatric Dermatology, Colentina Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Alexander Stratigos
- 1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
| | - Iris Zalaudek
- Dermatology Clinic, Maggiore Hospital, Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Claus Garbe
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
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Lashway SG, Worthen ADM, Abuasbeh JN, Harris RB, Farland LV, O'Rourke MK, Dennis LK. A meta-analysis of sunburn and basal cell carcinoma risk. Cancer Epidemiol 2023; 85:102379. [PMID: 37201363 DOI: 10.1016/j.canep.2023.102379] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/01/2023] [Accepted: 05/03/2023] [Indexed: 05/20/2023]
Abstract
Basal cell carcinoma (BCC) is the most common cancer in the United States. Sunburn is a modifiable risk factor for BCC. The objective of this project was to synthesize research on BCC and sunburn to quantify the impact and severity of sunburn at different life stages on BCC risk in the general population. A systematic literature search of four electronic databases was conducted and data were extracted by two independent reviewers using standardized forms. Data from 38 studies were pooled using both dichotomous and dose-response meta-analytic methods. BCC risk increased with ever experiencing a sunburn in childhood (OR=1.43, 95% CI: 1.19, 1.72) and with ever experiencing a sunburn in life (OR= 1.40, 95% CI: 1.02, 1.45). Every five sunburns experienced per decade in childhood increased BCC risk by 1.86 (95% CI: 1.73, 2.00) times. Every five sunburns experienced per decade in adulthood increased BCC risk by 2.12 (95% CI: 1.75, 2.57) times and every five sunburns per decade of life increased BCC risk by 1.91 (95% CI: 1.42, 2.58) times. The data on sunburn exposure and BCC show that an increase in number of sunburns at any age increased the risk of BCC. This may inform future prevention efforts.
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Affiliation(s)
- Stephanie G Lashway
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
| | - Aimee D M Worthen
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
| | - Jumanah N Abuasbeh
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
| | - Robin B Harris
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
| | - Leslie V Farland
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
| | - Mary Kay O'Rourke
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
| | - Leslie K Dennis
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
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Albornoz CA, Nichols SE, Wang JV, Saedi N, Munavalli GS. Optimizing skin tightening in aesthetics in men. Clin Dermatol 2021; 40:244-248. [PMID: 34838655 DOI: 10.1016/j.clindermatol.2021.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The field of cosmetic dermatology has recently witnessed unbridled growth in the past several years. Part of this has been due to the increasing popularity of aesthetic treatments in men, who represent a growing patient population. Men tend to have higher levels of collagen density and greater skin thickness, but these begin to decrease earlier on. They can also more frequently have severe photodamage. Their clinical presentations can affect the selection of treatments. Physicians should be familiar with the subtle differences between treating men and women. Early studies and literature are beginning to shed more light on these important distinctions. We review the notable differences in facial aging, pathophysiology, and patient selection and discuss available treatment options with these factors in mind.
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Affiliation(s)
- Christian A Albornoz
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Sarah E Nichols
- Dermatology, Laser & Vein Specialists of the Carolinas, Charlotte, North Carolina, USA
| | - Jordan V Wang
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA; Laser & Skin Surgery Center of New York, New York, NY, USA.
| | - Nazanin Saedi
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Girish S Munavalli
- Dermatology, Laser & Vein Specialists of the Carolinas, Charlotte, North Carolina, USA
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Rollison DE, Messina JL, Cherpelis BS, Fenske NA, Schell MJ, Adeegbe DO, Zhao Y, Amorrortu RP, Akuffo AA, Hesterberg RS, Epling-Burnette PK. Circulating Immunosuppressive Regulatory T Cells Predict Risk of Incident Cutaneous Squamous Cell Carcinoma. Front Med (Lausanne) 2021; 8:735585. [PMID: 34796183 PMCID: PMC8593034 DOI: 10.3389/fmed.2021.735585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/04/2021] [Indexed: 11/13/2022] Open
Abstract
Ultraviolet radiation exposure (UVR) is a risk factor for cutaneous squamous cell carcinoma (cuSCC) and has been shown to be positively associated with circulating immunosuppressive regulatory T cells ("Tregs"). However, the risk of cuSCC in association with circulating Tregs has not been studied. The aim of this study was to determine whether circulating Treg levels are associated with cuSCC development, particularly in the context of high UVR. Blood and spectrophotometer-based UVR measurements were obtained on 327 immunocompetent individuals undergoing routine skin cancer screenings at baseline and followed for up to 4 years for incident cuSCC development within a prospective cohort study. Proportions of phenotypically distinct Tregs, especially CCR4hi and CLA+ cells which are associated with activation and homing, respectively, were measured by flow cytometry. Tregs in cuSCC tumors were assessed using immunohistochemistry and graded for solar elastosis, a measure of cumulative UVR damage. Of several Treg phenotypes examined, higher levels of circulating CCR4hi Tregs at baseline were significantly associated with increased risk of subsequent cuSCC; those with higher levels of both CCR4hi and UVR were four times more likely to develop cuSCC compared to those with lower levels of both (Hazard Ratio = 4.11, 95% CI = 1.22-13.90). Within cuSCC tumors, CCR4hi Tregs were positively associated with solar elastosis. Results show that a higher proportion of CCR4hi peripheral Tregs predicts incident cuSCC up to 4 years, especially among highly UV-exposed individuals. Research of the underpinning biology of Tregs in UVR-associated skin damage may possibly reveal novel opportunities for screening, prevention, and treatment.
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Affiliation(s)
- Dana E Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, United States
| | - Jane L Messina
- Departments of Pathology and Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, United States
| | - Basil S Cherpelis
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, FL, United States
| | - Neil A Fenske
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, FL, United States
| | - Michael J Schell
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, United States
| | - Dennis O Adeegbe
- Department of Immunology, Moffitt Cancer Center, Tampa, FL, United States
| | - Yayi Zhao
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, United States
| | | | - Afua A Akuffo
- Department of Immunology, Moffitt Cancer Center, Tampa, FL, United States
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Zhang L, Zhao Z, Wang P, Zhang G, Wang B, Shi L, Liu X, Zhou Z, Wang X. Long-term improvement on photoaging after ALA photodynamic therapy for actinic keratosis: A retrospective study. Photodiagnosis Photodyn Ther 2021; 33:102181. [PMID: 33429100 DOI: 10.1016/j.pdpdt.2021.102181] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 01/02/2021] [Accepted: 01/04/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND 5-aminolevulinic acid photodynamic therapy (ALA-PDT) is not only the first-line treatment for actinic keratosis (AK), but also demonstrated to improve photoaging during AK field treatment. However, its long-term effect on photoaging remains elusive. OBJECTIVE To evaluate the long-term improvement effect of ALA-PDT on photoaging. METHODS The data of 10 patients with AK who received field-directed ALA-PDT on one side of the face and lesion-directed ALA-PDT on the other side were retrospectively reviewed. Their clinical photographs were evaluated with Global scores of photoaging (GSP) assessment independently by two dermatologists at baseline and 1 month, 6 months and 24 months after ALA-PDT. RESULTS GSP evaluation was performed after 24 months of follow-up. Improvements in the fine line and mottled pigmentation were observed (p < 0.05). All the 10 patients achieved complete response of AK lesions and had no relapse during the 24-month follow-up period. LIMITATION A small sample size. CONCLUSION Photoaging can be effectively alleviated in the long-term follow-up after ALA-PDT treatment for AK. The present study may inspire new treatment strategies for photoaging.
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Affiliation(s)
- Linglin Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zijun Zhao
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Peiru Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Guolong Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Bo Wang
- Lincoln Medical Center, Department of Internal Medicine, Bronx, NY, United States
| | - Lei Shi
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaojing Liu
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zhongxia Zhou
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.
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Triebner K, Bifulco E, Barrera-Gómez J, Basagaña X, Benediktsdóttir B, Forsberg B, Franklin KA, Garcia-Larsen V, Leynaert B, Lindberg E, Martínez-Moratalla J, Muniozguren-Agirre N, Pin I, Raherison C, Pereira-Vega A, Schlünssen V, Valentin A, Hustad S, Real FG, Dadvand P. Ultraviolet radiation as a predictor of sex hormone levels in postmenopausal women: A European multi-center study (ECRHS). Maturitas 2021; 145:49-55. [PMID: 33541562 DOI: 10.1016/j.maturitas.2020.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 11/02/2020] [Accepted: 12/26/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Solar ultraviolet radiation (UVR) affects the body through pathways that exhibit positive as well as negative health effects such as immunoregulation and vitamin D production. Different vitamin D metabolites are associated with higher or lower concentrations of estrogens and may thus alter the female sex hormone balance. OBJECTIVE To study whether exposure to UVR, as a modifiable lifestyle factor, is associated with levels of sex hormones (17β-estradiol, estrone, estrone 3-sulfate, testosterone, dehydroepiandrosterone sulfate), gonadotropins (follicle stimulating hormone, luteinizing hormone) as well as sex hormone binding globulin in postmenopausal women, and thus investigate whether managing UVR exposure can influence the hormone balance, with potential benefits for the biological aging process. METHODS The study included 580 postmenopausal women from six European countries, participating in the European Community Respiratory Health Survey (2010-2014). Average UVR exposure during the month before blood sampling was estimated based on personal sun behavior and ambient levels. Hormone concentrations were measured in serum using state-of-the-art methods. Subsequently we applied linear mixed-effects models, including center as random intercept, hormone concentrations (one at a time) as outcome and UVR, age, skin type, body mass index, vitamin D from dietary sources, smoking, age at completed full-time education and season of blood sampling as fixed-effect predictors. RESULTS One interquartile range increase in UVR exposure was associated with decreased levels of 17β-estradiol (-15.6 pmol/L, 95 % Confidence Interval (CI): -27.69, -3.51) and estrone (-13.36 pmol/L, 95 % CI: -26.04, -0.68) and increased levels of follicle stimulating hormone (9.34IU/L, 95 % CI: 2.91, 15.77) and luteinizing hormone (13.86 IU/daL, 95 % CI: 2.48, 25.25). CONCLUSIONS Exposure to UVR is associated with decreased estrogens and increased gonadotropins in postmenopausal women, a status associated with osteoporosis, lung function decline and other adverse health effects. This study indicates that managing UVR exposure has potential to influence the hormone balance and counteract adverse health conditions after menopause.
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Affiliation(s)
- Kai Triebner
- Department of Clinical Science, University of Bergen, Bergen, Norway; Core Facility for Metabolomics, University of Bergen, Bergen, Norway.
| | - Ersilia Bifulco
- Department of Clinical Science, University of Bergen, Bergen, Norway; Core Facility for Metabolomics, University of Bergen, Bergen, Norway
| | - Jose Barrera-Gómez
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | | | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Karl A Franklin
- Department of Surgical and Perioperative Sciences, Surgery, Umea University, Umea, Sweden
| | - Vanessa Garcia-Larsen
- Program in Human Nutrition, Department of International Health, The Johns Hopkins University, Bloomberg School of Public Health, Baltimore, USA
| | - Bénédicte Leynaert
- Team of Epidemiology, French National Institute of Health and Medical Research UMR1152, Paris, France
| | - Eva Lindberg
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Akademiska sjukhuset, Uppsala, Sweden
| | - Jesús Martínez-Moratalla
- Pulmonology Service, Albacete University Hospital Complex, Health Service of Castilla - La Mancha. Albacete, Spain; Faculty of Medicine of Albacete, Castilla-La Mancha University, Albacete, Spain
| | | | - Isabelle Pin
- Department of Paediatrics, University Hospital Grenoble Alpes, Grenoble, France; French National Institute of Health and Medical Research, France; Institute for Advanced Biosciences, Grenoble, France; University Grenoble Alpes, CS 10217, 38043, Grenoble Cedex 9, France
| | - Chantal Raherison
- U1219, Bordeaux Population Health Research, Bordeaux University, 146 Rue Leo Saignat, 33076, Bordeaux, France
| | - Antonio Pereira-Vega
- Service of Pneumology and Allergy, University Hospital Juan Ramón Jiménez, Huelva, Spain
| | - Vivi Schlünssen
- Department of Public Health, Aarhus University, Aarhus, Denmark; National Research Center for the Working Environment, Copenhagen, Denmark
| | - Antonia Valentin
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Steinar Hustad
- Department of Clinical Science, University of Bergen, Bergen, Norway; Core Facility for Metabolomics, University of Bergen, Bergen, Norway
| | - Francisco Gómez Real
- Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Gynaecology and Obstetrics, Haukeland University Hospital, Bergen, Norway
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
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Genetic ancestry, skin pigmentation, and the risk of cutaneous squamous cell carcinoma in Hispanic/Latino and non-Hispanic white populations. Commun Biol 2020; 3:765. [PMID: 33318654 PMCID: PMC7736583 DOI: 10.1038/s42003-020-01461-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 10/23/2020] [Indexed: 11/20/2022] Open
Abstract
Although cutaneous squamous cell carcinoma (cSCC) is one of the most common malignancies in individuals of European ancestry, the incidence of cSCC in Hispanic/Latinos is also increasing. cSCC has both a genetic and environmental etiology. Here, we examine the role of genetic ancestry, skin pigmentation, and sun exposure in Hispanic/Latinos and non-Hispanic whites on cSCC risk. We observe an increased cSCC risk with greater European ancestry (P = 1.27 × 10−42) within Hispanic/Latinos and with greater northern (P = 2.38 × 10−65) and western (P = 2.28 × 10−49) European ancestry within non-Hispanic whites. These associations are significantly, but not completely, attenuated after considering skin pigmentation-associated loci, history of actinic keratosis, and sun-protected versus sun-exposed anatomical sites. We also report an association of the well-known pigment variant Ala111Thr (rs1426654) at SLC24A5 with cSCC in Hispanic/Latinos. These findings demonstrate a strong correlation of northwestern European genetic ancestry with cSCC risk in both Hispanic/Latinos and non-Hispanic whites, largely but not entirely mediated through its impact on skin pigmentation. Eric Jorgenson and Hélène Choquet et al. find that northwestern European genetic ancestry is associated with increased risk of cutaneous squamous cell carcinoma (cSCC) in non-Hispanic whites, and more so in Hispanic/Latinos of the US. The ancestry effect is largely, but not entirely explained by genetic determinants of skin pigmentation in both populations.
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8
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Cosmetic Tattooing and Early Onset Basal Cell Carcinoma: A Population-based Case-Control Study from New Hampshire. Epidemiology 2020; 31:448-450. [PMID: 32079835 DOI: 10.1097/ede.0000000000001179] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cosmetic tattoos use dyes with carcinogenic potential. Skin cancers arising in tattoos have been reported. METHODS We investigated whether risk of early onset basal cell carcinoma was related to the site and colors of cosmetic tattoos as part of a population-based case-control study of cases (ages 25-50 years), identified from a state-wide surveillance system, and age- and gender-matched controls, selected from driver's license records, randomly assigned an anatomic site of the cases. RESULTS One hundred fifty-six cases (17%) with early onset basal cell carcinoma and 213 controls (26%) reported cosmetic tattoos. Among those with tattoos, the adjusted odds ratio of basal cell carcinoma at the tattoo site compared to another site was 1.8 (95% confidence interval = 1.0, 3.2). We observed the strongest associations for yellow and green tattoo colors. CONCLUSION Our preliminary findings support the possibility of an enhanced risk of early onset basal cell carcinomas at the site of cosmetic tattoos.
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Lingham G, Milne E, Yazar S, Mackey DA, Cross D, Lucas RM. Recalling our day in the sun: comparing long-term recall of childhood sun exposure with prospectively collected parent-reported data. Photochem Photobiol Sci 2020; 19:382-389. [PMID: 32010915 DOI: 10.1039/c9pp00240e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
To examine the impact of sun exposure on human health, accurate measures of past sun exposure are required. We investigated how young adults' recall of childhood sun-related behaviours compares with parent-reported measures collected during childhood. The Kidskin-Young Adult Myopia Study (KYAMS) is a follow-up of the Kidskin Study, a sun-protection intervention study conducted from 1995-2001. KYAMS participants, aged 25-30 years, reported time in sun, and use of hats and sunscreen, for each year from ages 5-26 years (n = 244). Using weighted kappa, we assessed agreement between these data and corresponding variables derived from the Kidskin Study parent questionnaires completed when KYAMS participants were aged 6-12 years. Ordinal logistic regression was used to test the association between self-reported sun-behaviours and corresponding parent-reported data. We found slight agreement between self-reported and parent-reported data for all sun-behaviour measures except hat use at 12 years. KYAMS recall of time in sun at 8-12 years was not associated with Kidskin Study parent-reported responses after adjustment for current time in sun. Recall of higher hat and sunscreen use was associated with higher parent-reported hat and sunscreen use (OR[hat] = 1.37, 95% CI: 1.16, 1.62; OR[sunscreen] = 1.23, 95% CI: 1.03, 1.48). However, KYAMS self-reported data were unable to predict corresponding parent-reported responses. Group data from retrospective recall of sun-related behaviours may be of limited value in studying the relationship between sun exposure and health outcomes; however, individual data are likely of little use.
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Affiliation(s)
- Gareth Lingham
- Centrefor Ophthalmology and Visual Science, Lions Eye Institute, The University of Western Australia, Perth, Australia.
| | - Elizabeth Milne
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Seyhan Yazar
- Centrefor Ophthalmology and Visual Science, Lions Eye Institute, The University of Western Australia, Perth, Australia
| | - David A Mackey
- Centrefor Ophthalmology and Visual Science, Lions Eye Institute, The University of Western Australia, Perth, Australia
| | - Donna Cross
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Robyn M Lucas
- Centrefor Ophthalmology and Visual Science, Lions Eye Institute, The University of Western Australia, Perth, Australia.,Telethon Kids Institute, The University of Western Australia, Perth, Australia.,National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australia
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10
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Amorrortu RP, Fenske NA, Cherpelis BS, Vijayan L, Zhao Y, Balliu J, Messina JL, Sondak VK, Giuliano AR, Waterboer T, Pawlita M, Gheit T, Tommasino M, Rollison DE. Viruses in Skin Cancer (VIRUSCAN): Study Design and Baseline Characteristics of a Prospective Clinic-Based Cohort Study. Cancer Epidemiol Biomarkers Prev 2020; 29:39-48. [PMID: 31427307 PMCID: PMC6954275 DOI: 10.1158/1055-9965.epi-19-0446] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 06/26/2019] [Accepted: 08/13/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Accumulating evidence suggests that cutaneous viral infections are risk factors for the development of keratinocyte carcinomas. The Viruses in Skin Cancer (VIRUSCAN) Study, a prospective cohort study, was established in 2014 to investigate the risk of keratinocyte carcinoma associated with cutaneous human papillomavirus and polyomavirus infection and the possible interaction with ultraviolet radiation exposure (UVR). METHODS/RESULTS VIRUSCAN incorporates repeated measures of viral infection using multiple markers of infection and quantitative measures of UVR using a spectrophotometer. Participants were recruited between July 14, 2014 and August 31, 2017 at the University of South Florida Dermatology Clinic in Tampa, FL. After excluding 124 individuals with prevalent keratinocyte carcinomas at baseline, 1,179 participants (53.2% women, 46.8% men, all ages 60 years and older) were followed for up to 4 years with routine skin exams occurring every 6 to 12 months. Here, we present the VIRUSCAN Study design, methods, and baseline characteristics, including demographics, sun exposure behavior, quantitative UVR exposure measurements, and cutaneous viral prevalence, for the full study cohort. CONCLUSIONS The VIRUSCAN Study will provide critical temporal evidence needed to assess the causality of the role cutaneous viral infections play in the development of keratinocyte carcinomas, as well as the potential interaction between cutaneous viral infections and UVR exposure. IMPACT Study findings will be valuable in future development of novel keratinocyte carcinoma prevention strategies.
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MESH Headings
- Aged
- Carcinoma, Basal Cell/epidemiology
- Carcinoma, Basal Cell/etiology
- Carcinoma, Basal Cell/pathology
- Carcinoma, Merkel Cell/diagnosis
- Carcinoma, Merkel Cell/epidemiology
- Carcinoma, Merkel Cell/pathology
- Carcinoma, Merkel Cell/virology
- Carcinoma, Squamous Cell/epidemiology
- Carcinoma, Squamous Cell/etiology
- Carcinoma, Squamous Cell/pathology
- Female
- Follow-Up Studies
- Humans
- Keratinocytes/pathology
- Keratinocytes/radiation effects
- Keratinocytes/virology
- Male
- Middle Aged
- Prevalence
- Prospective Studies
- Research Design
- Risk Factors
- Skin/cytology
- Skin/pathology
- Skin/radiation effects
- Skin/virology
- Skin Neoplasms/diagnosis
- Skin Neoplasms/epidemiology
- Skin Neoplasms/etiology
- Skin Neoplasms/pathology
- Spectrophotometry, Ultraviolet
- Ultraviolet Rays/adverse effects
- Warts/diagnosis
- Warts/epidemiology
- Warts/pathology
- Warts/virology
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Affiliation(s)
| | - Neil A Fenske
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
| | - Basil S Cherpelis
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
| | - Laxmi Vijayan
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Yayi Zhao
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Juliana Balliu
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Jane L Messina
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
- Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Vernon K Sondak
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida
| | - Tim Waterboer
- Infections and Cancer Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Pawlita
- Infections and Cancer Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer-World Health Organization, Lyon, France
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer-World Health Organization, Lyon, France
| | - Dana E Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida.
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida
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11
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Schmitz L, Grinblat B, Novak B, Hoeh AK, Händschke K, von Dobbeler C, Bierhoff E, Szeimies RM, Gambichler T, Torezan L, Festa-Neto C, Stockfleth E, Dirschka T. Somatic mutations in kinetochore gene KNSTRN are associated with basal proliferating actinic keratoses and cutaneous squamous cell carcinoma. J Eur Acad Dermatol Venereol 2019; 33:1535-1540. [PMID: 30972880 DOI: 10.1111/jdv.15615] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 04/01/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Mutations in kinetochore gene KNSTRN accelerate the development of cutaneous squamous cell carcinoma (SCC) and may correlate with different histological classifications of actinic keratosis (AKs). OBJECTIVE To determine KNSTRN gene mutation frequency in healthy skin (HS), actinically damaged skin (ADS), in AKs with different histomorphological gradings and invasive SCCs. METHODS All samples were histologically evaluated. AK lesions were additionally classified according to their upwards (AK I-III) and downwards (PRO I-III) directed growth pattern. Mutation analyses of all samples were performed using the Sanger method. RESULTS With one exception, all detected mutations in KNSTRN gene showed an alanine-to-glutamate substitution at codon 40 (p.Ala40Glu). p.Ala40Glu mutation was found in 6.9% (2/29) of HS, in 16.1% (5/31) of ADS, in 18.3% (20/109) of AKs and in 30.0% (9/30) of invasive SCCs. Further stratification of AKs using the common AK classification of Röwert-Huber revealed the p.Ala40Glu mutation in 14.7% (5/43), 13.3% (4/30) and 24.4% (11/45) (AK I, II and III). In contrast, the new PRO classification showed a distribution of 3.6% (1/28) in PRO I, 21.7% (13/60) in PRO II and 28.6% (6/21) in PRO III. Mutation frequency in HS showed significant differences compared to AKs classified as PRO III and invasive SCCs (P < 0.05). In contrast, there were no statistically significant differences between HS and AKs when classified according to Röwert-Huber. CONCLUSIONS Recurrent somatic mutation p.Ala40Glu in KNSTRN gene is associated with basal proliferating AKs in accordance with invasive SCCs. This supports the impact of basal proliferative pattern in terms of progression.
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Affiliation(s)
- L Schmitz
- Department of Dermatology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| | - B Grinblat
- Department of Dermatology, Hospital das Clínicas, University of São Paulo, São Paulo, SP, Brazil
| | - B Novak
- Department of Animal Physiology, Ruhr-University, Bochum, Germany
| | - A-K Hoeh
- CentroDerm GmbH, Wuppertal, Germany
| | | | | | - E Bierhoff
- Heinz-Werner-Seifert-Institute of Dermatopathology, Bonn, Germany
| | - R-M Szeimies
- Department of Dermatology and Allergology, Vest Hospital, Academic Teaching Hospital University of Bochum, Recklinghausen, Germany
| | - T Gambichler
- Department of Dermatology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| | - L Torezan
- Department of Dermatology, Hospital das Clínicas, University of São Paulo, São Paulo, SP, Brazil
| | - C Festa-Neto
- Department of Dermatology, Hospital das Clínicas, University of São Paulo, São Paulo, SP, Brazil
| | - E Stockfleth
- Department of Dermatology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| | - T Dirschka
- CentroDerm GmbH, Wuppertal, Germany.,Faculty of Health, University Witten-Herdecke, Witten, Germany
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12
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Rayner RL, Carville KJ, Leslie GD, Dhaliwal SS. Clinical purpura and elastosis and their correlation with skin tears in an aged population. Arch Dermatol Res 2019; 311:231-247. [PMID: 30783769 DOI: 10.1007/s00403-019-01899-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/12/2019] [Accepted: 02/14/2019] [Indexed: 01/20/2023]
Abstract
The previous research reported the results of a prospect cohort study that used logistic regression analysis to construct a risk prediction model for skin tears in individuals aged over 65 years. The model identified three baseline individual characteristics (male gender, history of STs, and history of falls) and two baseline skin manifestations (purpura and elastosis) that predicted the risk of dorsal forearm skin tears. This paper outlines the relationships between baseline skin manifestations and the risk of skin tears. Univariable logistic regression analysis was conducted of all the baseline data collected from the same-study participants to identify variables that significantly predicted purpura and elastosis at baseline. Amongst the 173 participants, 71 (41%) developed one or more skin tears, and in these participants, 52 (73.2%) displayed purpura, 41 (57.8%) had elastosis, and 30 (42.3%) exhibited both manifestations of the dorsal forearm at baseline. Four individual characteristics (age, history of skin tears, history of falls, and antiplatelet therapy) and three skin properties (pH, subepidermal low echogenicity band of the forearms, and skin thickness) were found to predict the risk of purpura. Conversely, three individual variables (age, gender, and smoking), three clinical skin variables (uneven skin pigmentation, cutis rhomboidalis nuchae, and history of actinic keratosis) and one skin property variable (collagen type IV) predicted the risk of skin elastosis. Progressive changes to the skin's structural and mechanical properties from the underlying effects of chronological ageing, and environmental and lifestyle-related influences increased the risk of purpura and elastotic skin manifestations and concomitantly increased risk of skin tears amongst participants.
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Affiliation(s)
- R L Rayner
- School of Nursing, Midwifery and Paramedicine, Curtin University, Kent St, Bentley, WA, 6102, Australia. .,Silver Chain Group, 6 Sundercombe St, Osborne Park, WA, 6017, Australia. .,School of Nursing, Midwifery and Paramedicine, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
| | - K J Carville
- School of Nursing, Midwifery and Paramedicine, Curtin University, Kent St, Bentley, WA, 6102, Australia.,Silver Chain Group, 6 Sundercombe St, Osborne Park, WA, 6017, Australia
| | - G D Leslie
- School of Nursing, Midwifery and Paramedicine, Curtin University, Kent St, Bentley, WA, 6102, Australia
| | - S S Dhaliwal
- School of Public Health, Curtin University, Kent St, Bentley, WA, 6102, Australia
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13
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Stratigos AJ, Fargnoli MC, De Nicolo A, Peris K, Puig S, Soura E, Menin C, Calista D, Ghiorzo P, Mandala M, Massi D, Rodolfo M, Del Regno L, Stefanaki I, Gogas H, Bataille V, Tucker MA, Whiteman D, Nagore E, Landi MT. MelaNostrum: a consensus questionnaire of standardized epidemiologic and clinical variables for melanoma risk assessment by the melanostrum consortium. J Eur Acad Dermatol Venereol 2018; 32:2134-2141. [PMID: 30098061 DOI: 10.1111/jdv.15208] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 07/12/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Many melanoma observational studies have been carried out across different countries and geographic areas using heterogeneous assessments of epidemiologic risk factors and clinical variables. AIM To develop a consensus questionnaire to standardize epidemiologic and clinical data collection for melanoma risk assessment. METHODS We used a stepwise strategy that included: compilation of variables from case-control datasets collected at various centres of the MelaNostrum Consortium; integration of variables from published case-control studies; consensus discussion of the collected items by MelaNostrum members; revision by independent experts; addition of online tools and image-based charts; questionnaire testing across centres and generation of a final draft. RESULTS We developed a core consensus questionnaire (MelanoQ) that includes four separate sections: A. general and demographic data; B. phenotypic and ultraviolet radiation exposure risk factors and lifestyle habits; C. clinical examination, medical and family history; and D. diagnostic data on melanoma (cases only). Accompanying online tools, informative tables, and image-based charts aid standardization. Different subsections of the questionnaire are designed for self-administration, patient interviews performed by a physician or study nurse, and data collection from medical records. CONCLUSIONS The MelanoQ questionnaire is a useful tool for the collection and standardization of epidemiologic and clinical data across different studies, centres, cultures and languages. This will expedite ongoing efforts to compile high-quality data for pooled analyses or meta-analyses and offer a solid base for the design of clinical, epidemiologic and translational studies on melanoma.
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Affiliation(s)
- Alexander J Stratigos
- First Department of Dermatology, National and Kapodistrian University of Athens School of Medicine, Andreas Sygros Hospital, Athens, Greece
| | | | - Arcangela De Nicolo
- Cancer Genomics Program, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Ketty Peris
- Institute of Dermatology, Catholic University, Rome, Italy
| | - Susana Puig
- Dermatology Department, Melanoma Unit, Hospital Clinic de Barcelona, Universitat de Barcelona, Barcelona, Spain.,Instituto de Investigacion Biomedica August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | - Efthymia Soura
- First Department of Dermatology, National and Kapodistrian University of Athens School of Medicine, Andreas Sygros Hospital, Athens, Greece
| | - Chiara Menin
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Donato Calista
- Dermatology Unit, Maurizio Bufalini Hospital, Cesena, Italy
| | - Paola Ghiorzo
- Department of Internal Medicine and Medical Specialties, University of Genoa and Genetics of Rare Cancers, University Hospital Policlinico San Martino-IRCCS, Genoa, Italy
| | - Mario Mandala
- Unit of Melanoma, Department of Oncology and Hematology, Papa Giovanni XXIII Cancer Center Hospital, Bergamo, Italy
| | - Daniela Massi
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Monica Rodolfo
- Immunotherapy Unit, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Irene Stefanaki
- First Department of Dermatology, National and Kapodistrian University of Athens School of Medicine, Andreas Sygros Hospital, Athens, Greece
| | - Helen Gogas
- Department of Internal Medicine, Laikon Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Veronique Bataille
- Department of Twin Research and Genetic Epidemiology, Kings College, London, UK
| | - Margaret A Tucker
- Human Genetics Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - David Whiteman
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia
| | - Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, València, Spain
| | - Maria Teresa Landi
- Human Genetics Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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14
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Cust AE, Fenton GL, Smit AK, Espinoza D, Dobbinson S, Brodie A, Dang HTC, Kimlin MG. Validation of Questionnaire and Diary Measures of Time Outdoors Against an Objective Measure of Personal Ultraviolet Radiation Exposure. Photochem Photobiol 2018; 94:815-820. [DOI: 10.1111/php.12893] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 12/20/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Anne E Cust
- Cancer Epidemiology and Prevention Research; Sydney School of Public Health; The University of Sydney; Sydney NSW Australia
- Melanoma Institute Australia; The University of Sydney; Sydney NSW Australia
| | - Georgina L Fenton
- Cancer Epidemiology and Prevention Research; Sydney School of Public Health; The University of Sydney; Sydney NSW Australia
| | - Amelia K Smit
- Cancer Epidemiology and Prevention Research; Sydney School of Public Health; The University of Sydney; Sydney NSW Australia
- Melanoma Institute Australia; The University of Sydney; Sydney NSW Australia
| | - David Espinoza
- NHMRC Clinical Trials Centre; The University of Sydney; Sydney NSW Australia
| | | | - Alison Brodie
- The University of the Sunshine Coast; Maroochydore Qld Australia
| | | | - Michael G Kimlin
- The University of the Sunshine Coast; Maroochydore Qld Australia
- Cancer Council Queensland; Brisbane Qld Australia
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15
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Kricker A, Weber M, Sitas F, Banks E, Rahman B, Goumas C, Kabir A, Hodgkinson VS, van Kemenade CH, Waterboer T, Armstrong BK. Early Life UV and Risk of Basal and Squamous Cell Carcinoma in New South Wales, Australia. Photochem Photobiol 2017; 93:1483-1491. [PMID: 28710897 DOI: 10.1111/php.12807] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 06/17/2017] [Indexed: 11/28/2022]
Abstract
Sun exposure is the main cause of squamous (SCC) and basal cell carcinoma (BCC) although pattern and amount differ by cancer type, and sun sensitivity is the major host risk factor. Our study investigated risk factors and residential ambient UV in a population-based sample of Australian 45 and Up Study participants: 916 BCC cases, 433 SCC cases, 1224 controls. Unconditional logistic regression models adjusting for key covariates demonstrated 60% increased BCC risk and two-fold increased SCC risk with sun sensitivity, and three- and four-fold increased risk, respectively, with solar keratoses. BCC but not SCC risk increased with higher early-life residential UV in all participants (odds ratio (OR) = 1.54; 95% CI 1.22-1.96 for intermediate; OR = 1.31; 95% CI 1.03-1.68 for high UV at birthplace) and similarly in Australian-born participants (P-values < 0.05). Risk of SCC but not BCC increased with long-term cumulative sun exposure assessed by self-reported outdoor work (OR 1.74, 95% CI 1.21-2.49). In conclusion, sun sensitivity is important for both cancers, early-life UV but not cumulative UV appears to increase BCC risk, the former an apparently novel finding, and SCC risk appears only to be related to long-term cumulative sun exposure.
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Affiliation(s)
- Anne Kricker
- Sydney Medical School, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Marianne Weber
- Sydney Medical School, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Cancer Research Division, Cancer Council New South Wales, Sydney, NSW, Australia
| | - Freddy Sitas
- Sydney Medical School, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia.,Sax Institute, Sydney, NSW, Australia
| | - Bayzidur Rahman
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Chris Goumas
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Ahsanul Kabir
- Department of Environment and Geography, Faculty of Science, Formerly Geographic Information Systems, Macquarie University, Sydney, NSW, Australia
| | - Verity S Hodgkinson
- Cancer Research Division, Cancer Council New South Wales, Sydney, NSW, Australia
| | | | - Tim Waterboer
- Molecular Diagnostics of Oncogenic Infections Division, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Bruce K Armstrong
- Sydney Medical School, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,School of Population Health, University of Western Australia, Perth, WA, Australia
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16
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Czekalla C, Schönborn KH, Döge N, Jung S, Darvin ME, Lademann J, Meinke MC. Impact of Body Site, Age, and Gender on the Collagen/Elastin Index by Noninvasive in vivo Vertical Two-Photon Microscopy. Skin Pharmacol Physiol 2017; 30:260-267. [PMID: 28803240 DOI: 10.1159/000477854] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 05/24/2017] [Indexed: 01/16/2023]
Abstract
BACKGROUND/AIMS Extrinsic and intrinsic skin aging is subject to constant remodeling and degradation processes, primarily in components of the extracellular matrix. While collagen fibers thin out during the aging process, the amorphous elastin fibers accumulate. These are essential formative components of the dermis. So far, these processes have been detected in vertical histological sections of invasive biopsies and recently in noninvasive horizontal scans. METHODS In this pilot study, a modified noninvasive 2-photon microscope was applied to measure the collagen/elastin index of skin in vivo. The obtained images permit an immediate vertical survey and allow a conclusion on the dermal composition at once. The collagen/elastin index was quantified by the second harmonic to autofluorescence aging index of dermis (SAAID) depending on volunteers' age (18-66 years), gender, and body area. RESULTS The highest SAAID was measured at the volar forearm as compared to the abdominal SAAID, which was significantly lower (p < 0.05). The gluteal region showed the significantly lowest SAAID (p < 0.05). The SAAID in female skin was higher compared to male skin and decreased with increasing age. CONCLUSION These effects are to be considered in subsequent studies to be able to specifically detect and evaluate influences.
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Affiliation(s)
- Carolin Czekalla
- Department of Dermatology, Venereology, and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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17
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Meinke MC, Nowbary CK, Schanzer S, Vollert H, Lademann J, Darvin ME. Influences of Orally Taken Carotenoid-Rich Curly Kale Extract on Collagen I/Elastin Index of the Skin. Nutrients 2017; 9:nu9070775. [PMID: 28753935 PMCID: PMC5537889 DOI: 10.3390/nu9070775] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 07/10/2017] [Accepted: 07/14/2017] [Indexed: 12/17/2022] Open
Abstract
Two differently designed, spatially resolved reflectance spectroscopy-based scanners and two-photon tomography were used for noninvasive in vivo determination of cutaneous carotenoids, and collagen I/elastin aging index of dermis, respectively, in the skin of 29 healthy female volunteers between 40 and 56 years of age. The volunteers received a supplement in the form of a carotenoid-rich natural curly kale extract containing 1650 µg of carotenoids in total (three capsules of 550 µg), once a day. Measurements were taken before, after 5 months and after 10 months of daily supplementation. The results showed significantly increased values for the cutaneous carotenoids and the collagen I/elastin aging index of dermis 5 and 10 months after the beginning of the study. The obtained results show that a natural carotenoid-rich extract could prevent the aging-related collagen I degradation in the dermis and improve the extracellular matrix.
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Affiliation(s)
- Martina C Meinke
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center of Experimental and Applied Cutaneous Physiology (CCP), Department of Dermatology, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany.
| | - Ceylan K Nowbary
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center of Experimental and Applied Cutaneous Physiology (CCP), Department of Dermatology, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany.
| | - Sabine Schanzer
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center of Experimental and Applied Cutaneous Physiology (CCP), Department of Dermatology, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany.
| | - Henning Vollert
- Bioactive Food GmbH, Am Ihlsee 36a, 23795 Bad Segeberg, Germany.
| | - Jürgen Lademann
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center of Experimental and Applied Cutaneous Physiology (CCP), Department of Dermatology, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany.
| | - Maxim E Darvin
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center of Experimental and Applied Cutaneous Physiology (CCP), Department of Dermatology, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany.
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Kuklinski LF, Zens MS, Perry AE, Green AC, Karagas MR. Skin microtopography as a measure of photoaging and risk of squamous cell carcinoma of the skin in a US population. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2017; 33:41-48. [PMID: 27864996 PMCID: PMC5408582 DOI: 10.1111/phpp.12280] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/10/2016] [Indexed: 01/24/2023]
Abstract
BACKGROUND Skin microtopography as a measure of photoaging is a noninvasive approach to measuring chronic ultraviolet radiation exposure and reflects the degree of dermal elastosis in populations of European descent in the subtropics. Less is known about the utility of this approach in populations at different latitudes, and whether it relates to skin cancer risk. METHODS A population-based case-control study of 342 squamous cell carcinoma (SCC) cases and 331 age- and gender-matched controls were evaluated for histologic evidence of solar damage and severity of photoaging based on microtopography on a six-grade scale. Odds ratios (OR) for SCC associated with degree of photoaging were estimated using logistic regression analysis adjusted for potentially confounding factors. RESULTS After adjustment for known risk factors, SCC was associated with increasing photoaging grade (OR = 1.7, 95% CI = 0.9-3.0 for severe photoaging; OR = 2.8, 95% CI = 1.6-5.0 for very severe photoaging). Associations remained among those with actinic keratosis (OR = 3.4, 95% CI = 0.9-12.4 for severe photoaging, OR = 5.7, 95% CI = 1.7-19.6 for very severe photoaging). LIMITATIONS There was limited statistical power, particularly for subgroup analyses. CONCLUSION Our findings provide further evidence of microtopography as an independent, objective indicator of risk of SCC.
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Affiliation(s)
| | - Michael Scot Zens
- Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, US
| | - Ann E Perry
- Department of Pathology, The Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, US
| | - Adele C Green
- Cancer and Population Studies, Queensland Institute of Medical Research, Brisbane, Qld, Australia
- Cancer Research UK Manchester Institute and Institute of Inflammation and Repair, University of Manchester, Manchester, UK
| | - Margaret R Karagas
- Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, US
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Kuklinski LF, Zens MS, Perry AE, Gossai A, Nelson HH, Karagas MR. Sex hormones and the risk of keratinocyte cancers among women in the United States: A population-based case-control study. Int J Cancer 2016; 139:300-9. [PMID: 26941014 DOI: 10.1002/ijc.30072] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 02/19/2016] [Indexed: 12/20/2022]
Abstract
Men are at a higher risk of developing both squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) than women, but there is emerging evidence that women may be experiencing greater increases in the incidence rates of these malignancies than men. One possible explanation is the expanding use of sex steroids among women, although only a few studies have examined this hypothesis. As part of a population-based, case-control study of women in New Hampshire, USA, we sought to evaluate the risk of SCC, BCC, and early-onset BCC in relation to exogenous and endogenous sex hormones. We found that oral contraceptive (OC) use was associated with an increased risk of SCC (OR = 1.4, 95% CI = 1.1-1.8) and BCC (OR = 1.4, 95% CI = 1.0-1.8), particularly high estrogen dose (>50 mg) OC use. Hormone replacement therapy (HRT) use also related to SCC, with an elevated OR largely for progestin use (OR = 1.4, 95% CI = 1.1-1.8). Additionally, both OC use and combination HRT use were associated with more aggressive BCC subtypes. In contrast, menstrual and reproductive history did not appear to influence keratinocyte cancer risk in our data. Our findings provide evidence that use of sex steroids may enhance risk of keratinocyte cancer.
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Affiliation(s)
| | - Michael S Zens
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH
| | - Ann E Perry
- Department of Pathology, Geisel School of Medicine at Dartmouth, Lebanon, NH
| | - Anala Gossai
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH
| | - Heather H Nelson
- Division of Epidemiology and Community Health, Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH
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Zhu GA, Raber I, Sakshuwong S, Li S, Li AS, Tan C, Chang ALS. Estimation of individual cumulative ultraviolet exposure using a geographically-adjusted, openly-accessible tool. BMC DERMATOLOGY 2016; 16:1. [PMID: 26790927 PMCID: PMC4721109 DOI: 10.1186/s12895-016-0038-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 01/06/2016] [Indexed: 12/22/2022]
Abstract
Background Estimates of an individual’s cumulative ultraviolet (UV) radiation exposure can be useful since ultraviolet radiation exposure increases skin cancer risk, but a comprehensive tool that is practical for use in the clinic does not currently exist. The objective of this study is to develop a geographically-adjusted tool to systematically estimate an individual’s self-reported cumulative UV radiation exposure, investigate the association of these estimates with skin cancer diagnosis, and assess test reliability. Methods A 12-item online questionnaire from validated survey items for UV exposure and skin cancer was administered to online volunteers across the United States and results cross-referenced with UV radiation indices. Cumulative UV exposure scores (CUES) were calculated and correlated with personal history of skin cancer in a case–control design. Reliability was assessed in a separate convenience sample. Results 1,118 responses were included in the overall sample; the mean age of respondents was 46 (standard deviation 15, range 18 – 81) and 150 (13 %) reported a history of skin cancer. In bivariate analysis of 1:2 age-matched cases (n = 149) and controls (n = 298), skin cancer cases were associated with (1) greater CUES prior to first skin cancer diagnosis than controls without skin cancer history (242,074 vs. 205,379, p = 0.003) and (2) less engagement in UV protective behaviors (p < 0.01). In a multivariate analysis of age-matched data, individuals with CUES in the lowest quartile were less likely to develop skin cancer compared to those in the highest quartile. In reliability testing among 19 volunteers, the 2-week intra-class correlation coefficient for CUES was 0.94. We have provided the programming code for this tool as well as the tool itself via open access. Conclusions CUES is a useable and comprehensive tool to better estimate lifetime ultraviolet exposure, so that individuals with higher levels of exposure may be identified for counseling on photo-protective measures. Electronic supplementary material The online version of this article (doi:10.1186/s12895-016-0038-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gefei A Zhu
- Department of Dermatology, Stanford University School of Medicine, 450 Broadway St., Redwood City, CA, 94063, USA.
| | - Inbar Raber
- Department of Dermatology, Stanford University School of Medicine, 450 Broadway St., Redwood City, CA, 94063, USA.
| | | | - Shufeng Li
- Department of Dermatology, Stanford University School of Medicine, 450 Broadway St., Redwood City, CA, 94063, USA.
| | - Angela S Li
- Department of Dermatology, Stanford University School of Medicine, 450 Broadway St., Redwood City, CA, 94063, USA.
| | - Caroline Tan
- Department of Dermatology, Stanford University School of Medicine, 450 Broadway St., Redwood City, CA, 94063, USA.
| | - Anne Lynn S Chang
- Department of Dermatology, Stanford University School of Medicine, 450 Broadway St., Redwood City, CA, 94063, USA.
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Barton DT, Zens MS, Nelson HH, Christensen BC, Storm CA, Perry AE, Karagas MR. Distinct Histologic Subtypes and Risk Factors for Early Onset Basal Cell Carcinoma: A Population-Based Case Control Study from New Hampshire. J Invest Dermatol 2015; 136:533-535. [PMID: 26967485 PMCID: PMC4790460 DOI: 10.1016/j.jid.2015.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Dorothea T Barton
- Section of Dermatology, Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA; Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
| | - Michael S Zens
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Heather H Nelson
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Brock C Christensen
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Department of Pharmacology and Toxicology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Craig A Storm
- Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Ann E Perry
- Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
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Werner R, Stockfleth E, Connolly S, Correia O, Erdmann R, Foley P, Gupta A, Jacobs A, Kerl H, Lim H, Martin G, Paquet M, Pariser D, Rosumeck S, Röwert-Huber HJ, Sahota A, Sangueza O, Shumack S, Sporbeck B, Swanson N, Torezan L, Nast A. Evidence- and consensus-based (S3) Guidelines for the Treatment of Actinic Keratosis - International League of Dermatological Societies in cooperation with the European Dermatology Forum - Short version. J Eur Acad Dermatol Venereol 2015; 29:2069-79. [DOI: 10.1111/jdv.13180] [Citation(s) in RCA: 188] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 04/02/2015] [Indexed: 12/22/2022]
Affiliation(s)
- R.N. Werner
- Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - E. Stockfleth
- Department of Dermatology, Venerology and Allergology; Skin Cancer Center (HTCC); Charité - Universitätsmedizin Berlin; Berlin Germany
| | - S.M. Connolly
- Department of Dermatology; Mayo Clinic; Scottsdale Arizona USA
| | - O. Correia
- Centro Dermatologia Epidermis; Instituto CUF and Faculty of Medicine of University of Porto; Porto Portugal
| | - R. Erdmann
- Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - P. Foley
- Skin and Cancer Foundation Victoria; Carlton Victoria Australia
- St. Vincent's Hospital Melbourne; Fitzroy Victoria Australia
- The University of Melbourne; Melbourne Victoria Australia
| | - A.K. Gupta
- Division of Dermatology; Department of Medicine; University of Toronto; Toronto Ontario Canada
- Mediprobe Research Inc.; London Ontario Canada
| | - A. Jacobs
- Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - H. Kerl
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - H.W. Lim
- Department of Dermatology; Henry Ford Hospital; Detroit Michigan USA
| | - G. Martin
- Dermatology Laser Center of Maui; Kihei Hawaii USA
| | - M. Paquet
- Mediprobe Research Inc.; London Ontario Canada
| | - D.M. Pariser
- Division of Dermatology and Virginia Clinical Research Inc; Eastern Virginia Medical School; Norfolk Virginia USA
| | - S. Rosumeck
- Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - H.-J. Röwert-Huber
- Division of Dermatopathology; Department of Dermatology, Venerology and Allergology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - A. Sahota
- Department of Dermatology; Whipps Cross University Hospital; London UK
| | - O.P. Sangueza
- Department of Pathology; Wake Forest Baptist Medical Center; Winston-Salem North Carolina USA
- Department of Dermatology; Wake Forest Baptist Medical Center; Winston-Salem North Carolina USA
| | - S. Shumack
- Department of Dermatology; Northern Medical School; University of Sydney; Sydney New South Wales Australia
| | - B. Sporbeck
- Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - N.A. Swanson
- Dermatology, Surgery, and Otolaryngology; Oregon Health and Science University; Portland Oregon USA
- Surgical and Cosmetic Dermatology and Clinical Operations; Oregon Health and Science University Knight Cancer Institute; Portland Oregon USA
| | - L. Torezan
- Faculty of Medicine; Hospital das Clínicas; Universidade de São Paulo; São Paulo Brazil
| | - A. Nast
- Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology; Charité - Universitätsmedizin Berlin; Berlin Germany
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Cheng J, Zens MS, Duell E, Perry AE, Chapman MS, Karagas MR. History of allergy and atopic dermatitis in relation to squamous cell and Basal cell carcinoma of the skin. Cancer Epidemiol Biomarkers Prev 2015; 24:749-54. [PMID: 25670807 DOI: 10.1158/1055-9965.epi-14-1243] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 01/30/2015] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Little is known about whether history of allergies and atopy is related to the occurrence of keratinocyte cancers. Thus, we evaluated the association between history of allergies and atopy and the incidence of squamous cell carcinoma (SCC) and early onset basal cell carcinoma (BCC). METHODS As part of a population-based case-control study, interviews were conducted with 1,050 residents of New Hampshire (375 early onset BCC cases and 251 controls, 254 SCC cases and 432 controls). ORs of SCC and early onset BCC and history of allergy and atopic dermatitis were computed using logistic regression, while controlling for potential confounding factors. RESULTS An overall inverse association was observed between a history of allergy and early onset BCC [OR, 0.61; 95% confidence interval (CI), 0.38-0.97] but not SCC (OR, 1.18; 95% CI, 0.78-1.79). Among women, we found reduced ORs of both early onset BCC and of SCC in relation to allergy history (early onset BCC OR, 0.53; 95% CI, 0.31-0.92 and SCC OR, 0.59; 95% CI, 0.29-1.19). Among men, we observed no clear association with early onset BCC (OR, 0.87; 95% CI, 0.39-1.99) and an increased risk of SCC (OR, 1.58; 95% CI, 0.93-2.69). CONCLUSION Our findings suggest that allergies and atopy may influence risk of early onset BCC and SCC, and that effects may be gender specific. IMPACT A deeper understanding of the immune mechanisms underlying allergies and atopy may provide new routes of preventing keratinocyte cancers.
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Affiliation(s)
- Judy Cheng
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - M Scot Zens
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Eric Duell
- Unit of Nutrition, Environment, and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Ann E Perry
- Department of Pathology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - M Shane Chapman
- Section of Dermatology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
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Karagas MR, Zens MS, Li Z, Stukel TA, Perry AE, Gilbert-Diamond D, Sayarath V, Stephenson RS, Barton D, Nelson HH, Spencer SK. Early-onset basal cell carcinoma and indoor tanning: a population-based study. Pediatrics 2014; 134:e4-12. [PMID: 24958589 PMCID: PMC4067637 DOI: 10.1542/peds.2013-3559] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/15/2014] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Indoor tanning with UV radiation-emitting lamps is common among adolescents and young adults. Rising incidence rates of basal cell carcinoma (BCC) have been reported for the United States and elsewhere, particularly among those diagnosed at younger ages. Recent epidemiologic studies have raised concerns that indoor tanning may be contributing to early occurrence of BCC, and younger people may be especially vulnerable to cancer risk associated with this exposure. Therefore, we sought to address these issues in a population-based case-control study from New Hampshire. METHODS Data on indoor tanning were obtained on 657 cases of BCC and 452 controls ≤50 years of age. RESULTS Early-onset BCC was related to indoor tanning, with an adjusted odds ratio (OR) of 1.6 (95% confidence interval, 1.3-2.1). The strongest association was observed for first exposure as an adolescent or young adult, with a 10% increase in the OR with each age younger at first exposure (OR per year of age ≤23 = 1.1; 95% confidence interval, 1.0-1.2). Associations were present for each type of device examined (ie, sunlamps, tanning beds, and tanning booths). CONCLUSIONS Our findings suggest early exposure to indoor tanning increases the risk of early development of BCC. They also underscore the importance of counseling adolescents and young adults about the risks of indoor tanning and for discouraging parents from consenting minors to this practice.
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Affiliation(s)
- Margaret R Karagas
- Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire;Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Geisel School of Medicine, Hanover, New Hampshire;
| | - M Scot Zens
- Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire;Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Geisel School of Medicine, Hanover, New Hampshire
| | - Zhigang Li
- Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire;Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Geisel School of Medicine, Hanover, New Hampshire
| | - Therese A Stukel
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Ann E Perry
- Department of Pathology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire; and
| | - Diane Gilbert-Diamond
- Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire;Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Geisel School of Medicine, Hanover, New Hampshire
| | - Vicki Sayarath
- Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire;Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Geisel School of Medicine, Hanover, New Hampshire
| | - Rita S Stephenson
- Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire;Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Geisel School of Medicine, Hanover, New Hampshire
| | - Dorothea Barton
- Department of Pathology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire; and
| | - Heather H Nelson
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Steven K Spencer
- Department of Pathology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire; and
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Cook LS, Moon BL, Dong Y, Neilson HK. Reliability of self-reported sun exposure in Canadian women and estimation of lifetime exposure to vitamin D from sun and diet. Public Health Nutr 2014; 17:747-55. [PMID: 23885709 PMCID: PMC10282289 DOI: 10.1017/s136898001300178x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Revised: 03/25/2013] [Accepted: 06/04/2013] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To assess the inter-method reliability of the Ovarian Cancer in Alberta (OVAL) survey developed to estimate adult vitamin D exposure from sun and diet for every tenth year, against the longer Geraldton Skin Cancer Prevention Survey (the assumed 'gold standard'). We also estimated total vitamin D exposure using the OVAL survey. DESIGN A randomized crossover design to assess the inter-method reliability of sun exposure (OVAL v. Geraldton survey), using intra-class correlation and estimated total vitamin D exposure from sun and diet. SETTING Calgary, Alberta, Canada. SUBJECTS Randomly selected women (n 90) aged 40-79 years. RESULTS The average lifetime sun exposure of 13,913 h (average 411 h/year) from the Geraldton survey was not significantly different from the 13,034 h (average 385 h/year) from the OVAL survey for periods with sufficient UV radiation to stimulate vitamin D production. The intra-class correlation coefficient for average lifetime sun exposure was 0.77 (95% CI 0.69, 0.86); the annual average was 0.60 (95% CI 0.47, 0.74). Estimated vitamin D from diet and supplements increased with age. CONCLUSIONS Our OVAL survey reliably estimated adult sun exposure relative to the Geraldton survey, suggesting that assessing sun exposure every tenth year is a reliable and efficient method for estimating sun contributions to lifetime vitamin D exposure.
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Affiliation(s)
- Linda S Cook
- Division of Epidemiology and Biostatistics, Department of Internal Medicine, MSC10 5550, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA
- Alberta Health Services, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Bevin L Moon
- Division of Epidemiology and Biostatistics, Department of Internal Medicine, MSC10 5550, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA
| | - Yan Dong
- Division of Epidemiology and Biostatistics, Department of Internal Medicine, MSC10 5550, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA
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Niwano Y, Kanno T, Iwasawa A, Ayaki M, Tsubota K. Blue light injures corneal epithelial cells in the mitotic phase in vitro. Br J Ophthalmol 2014; 98:990-2. [PMID: 24682182 DOI: 10.1136/bjophthalmol-2014-305205] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Yoshimi Niwano
- Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Taro Kanno
- Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Atsuo Iwasawa
- Department of Bioengineering, Tokyo Institute of Technology, Yokohama, Japan
| | - Masahiko Ayaki
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
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Cahoon EK, Wheeler DC, Kimlin MG, Kwok RK, Alexander BH, Little MP, Linet MS, Freedman DM. Individual, environmental, and meteorological predictors of daily personal ultraviolet radiation exposure measurements in a United States cohort study. PLoS One 2013; 8:e54983. [PMID: 23405102 PMCID: PMC3566166 DOI: 10.1371/journal.pone.0054983] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Accepted: 12/17/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Individual exposure to ultraviolet radiation (UVR) is challenging to measure, particularly for diseases with substantial latency periods between first exposure and diagnosis of outcome, such as cancer. To guide the choice of surrogates for long-term UVR exposure in epidemiologic studies, we assessed how well stable sun-related individual characteristics and environmental/meteorological factors predicted daily personal UVR exposure measurements. METHODS We evaluated 123 United States Radiologic Technologists subjects who wore personal UVR dosimeters for 8 hours daily for up to 7 days (N = 837 days). Potential predictors of personal UVR derived from a self-administered questionnaire, and public databases that provided daily estimates of ambient UVR and weather conditions. Factors potentially related to personal UVR exposure were tested individually and in a model including all significant variables. RESULTS The strongest predictors of daily personal UVR exposure in the full model were ambient UVR, latitude, daily rainfall, and skin reaction to prolonged sunlight (R(2) = 0.30). In a model containing only environmental and meteorological variables, ambient UVR, latitude, and daily rainfall were the strongest predictors of daily personal UVR exposure (R(2) = 0.25). CONCLUSIONS In the absence of feasible measures of individual longitudinal sun exposure history, stable personal characteristics, ambient UVR, and weather parameters may help estimate long-term personal UVR exposure.
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Affiliation(s)
- Elizabeth Khaykin Cahoon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institute of Health, Department of Health and Human Services, Bethesda, MD, USA.
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Good test–retest reproducibility for an instrument to capture self-reported melanoma risk factors. J Clin Epidemiol 2012; 65:1329-36. [DOI: 10.1016/j.jclinepi.2012.06.014] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 06/26/2012] [Accepted: 06/26/2012] [Indexed: 11/24/2022]
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Bodelon C, Cushing-Haugen KL, Wicklund KG, Doherty JA, Rossing MA. Sun exposure and risk of epithelial ovarian cancer. Cancer Causes Control 2012; 23:1985-94. [PMID: 23065074 DOI: 10.1007/s10552-012-0076-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 10/03/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE Associations between sun exposure (a primary source of vitamin D) and risk of ovarian cancer have been inconsistent. Furthermore, studies have not investigated whether sun exposure at different periods in the lifetime of a person results in differences in risk associations, and little is known about differences according to histological subtype. METHODS Using a population-based case-control study of 1,334 non-Hispanic white women diagnosed with epithelial ovarian cancer in western Washington State between 2002 and 2009 and 1,679 non-Hispanic white controls, we assessed the relation of epithelial ovarian cancer with constitutional pigmentation characteristics, sun exposure behaviors, and an index of ultraviolet (UV) exposure based on residential history. Information was collected through in-person interviews. Logistic regression was used to compute odds ratios, 95 % confidence intervals, and trend p values (P(trend)). RESULTS We noted no association with residence-based measures of UV exposure or self-reported sun exposure, either over the lifetime or within specific age intervals. Also, we observed little evidence of association between constitutional pigmentation characteristics and risk, save for a suggestion of increased risk among women who reported increased ability to suntan upon prolonged sun exposure (P(trend) = 0.03). CONCLUSIONS Results from this study suggest that sun exposure has little influence on the risk of epithelial ovarian cancer. Additional studies in populations with a wider gradient of sun exposure may yet be warranted.
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Affiliation(s)
- Clara Bodelon
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
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Cargill J, Lucas RM, Gies P, King K, Swaminathan A, Allen MW, Banks E. Validation of Brief Questionnaire Measures of Sun Exposure and Skin Pigmentation Against Detailed and Objective Measures Including Vitamin D Status. Photochem Photobiol 2012; 89:219-26. [DOI: 10.1111/j.1751-1097.2012.01221.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 08/07/2012] [Indexed: 11/27/2022]
Affiliation(s)
- Jessica Cargill
- National Centre for Epidemiology and Population Health; The Australian National University; Canberra; Australia
| | - Robyn M. Lucas
- National Centre for Epidemiology and Population Health; The Australian National University; Canberra; Australia
| | - Peter Gies
- Australian Radiation Protection and Nuclear Safety Agency; Melbourne; Australia
| | - Kerryn King
- Australian Radiation Protection and Nuclear Safety Agency; Melbourne; Australia
| | - Ashwin Swaminathan
- National Centre for Epidemiology and Population Health; The Australian National University; Canberra; Australia
| | - Martin W. Allen
- MacDiarmid Institute for Advanced Materials and Nanotechnology; University of Canterbury; Christchurch; New Zealand
| | - Emily Banks
- National Centre for Epidemiology and Population Health; The Australian National University; Canberra; Australia
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A population-based exposure assessment of risk factors associated with gastrointestinal pathogens: a Campylobacter study. Epidemiol Infect 2012; 141:976-86. [PMID: 22877359 DOI: 10.1017/s0950268812001641] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
A questionnaire survey was undertaken to determine the exposure of a study population to campylobacteriosis source risk factors (environmental, water, food) and results were stratified by age, population density and deprivation. Data were gathered using an exposure assessment carried out by telephone in the Grampian region of Scotland. Univariate analysis showed that children aged 5-14 years, living in low population density (0-44.4 persons/km2) and affluent areas had elevated exposure to environmental and water risk factors. Multivariate logistic regression analysis revealed that younger age groups and lower population density were significant indicators for most environmental risk factors. The results compared to reported disease incidence in Grampian showed that greater exposure to risk factors does not necessarily coincide with greater disease incidence for age groups, particularly for the 0-4 years age group. Further research is required to explain the relationship between exposure and disease incidence.
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Wurm E, Longo C, Curchin C, Soyer H, Prow T, Pellacani G. In vivo assessment of chronological ageing and photoageing in forearm skin using reflectance confocal microscopy. Br J Dermatol 2012; 167:270-9. [DOI: 10.1111/j.1365-2133.2012.10943.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Jennings L, Karia PS, Jambusaria-Pahlajani A, Whalen FM, Schmults CD. The Sun Exposure and Behaviour Inventory (SEBI): validation of an instrument to assess sun exposure and sun protective practices. J Eur Acad Dermatol Venereol 2012; 27:706-15. [PMID: 22487012 DOI: 10.1111/j.1468-3083.2012.4541.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Skin cancer is the most common cancer worldwide. Sun exposure is the most important risk factor for its development. The amount of exposure required to cause skin cancer has not been quantified, and the impact of sun protective practices is unknown. OBJECTIVES To develop a brief self-administered questionnaire to estimate past and current sun exposure, sun protective practices, and assess the questionnaire's reliability and validity. METHODS The study had three stages: (1) questionnaire formulation, (2) internal reliability and construct validity testing and questionnaire refinement, (3) test-retest and further internal reliability testing. The final Sun Exposure and Behaviour Inventory (SEBI) is composed of 15 questions assessing three domains; current sun behaviour, current sun exposure and prior sun exposure. RESULTS A total of 251 subjects completed Stage 2 testing and 57 completed Stage 3. Final Cronbach's α-scores ranged from 0.71 to 0.84 and k-scores demonstrated excellent to fair/good agreement, indicating acceptable internal consistency and test-retest reliability. Construct validity was evidenced by significantly higher prior sun exposure scores and lower current sun behaviour scores in subjects with a history of non-melanoma skin cancer. LIMITATIONS Self-reported questionnaires, though efficient and low cost, may be subject to recall error and bias. Further work remains to determine if the SEBI maintains its reliability and validity in different populations. CONCLUSION The SEBI is a brief self-administered questionnaire, which appears to be reliable and valid. It may provide useful measures of past and present sun exposure and current sun behaviour, which may be useful in studies of skin cancer incidence and risk modification.
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Affiliation(s)
- L Jennings
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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McDowell TY, Amr S, Culpepper WJ, Langenberg P, Royal W, Bever C, Bradham DD. Sun exposure, vitamin D intake and progression to disability among veterans with progressive multiple sclerosis. Neuroepidemiology 2011; 37:52-7. [PMID: 21822026 DOI: 10.1159/000329258] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Accepted: 05/11/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Early life events have been suggested to influence multiple sclerosis (MS) susceptibility, and to potentially modulate its clinical course. We assessed vitamin D-related exposures from childhood to disease onset and their associations with MS progression. METHODS Among veterans in the Multiple Sclerosis Surveillance Registry, 219 reported having the progressive form and met the inclusion criteria. Participants reported their past sun exposure, vitamin D-related intake and age at disability milestones using the Patient-Determined Disease Steps (PDDS). The Cox proportional hazards model was used to examine the association between vitamin D-related exposures and time (years) to disability. RESULTS Low average sun exposure in the fall/winter before disease onset was associated with an increased risk of progressing to a PDDS score of 8 (hazard ratio, HR: 2.13, 95% confidence interval, CI: 1.20-3.78), whereas use of cod liver oil during childhood and adolescence was associated with a reduced risk (HR: 0.44, 95% CI: 0.20-0.96). CONCLUSIONS These results suggest that exposure to vitamin D before MS onset might slow disease-related neurodegeneration and thus delay progression to disability among patients with the progressive subtype.
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Affiliation(s)
- Tzu-Yun McDowell
- MS Center of Excellence-East, Baltimore VAMC, University of Maryland, Baltimore School of Medicine, Baltimore, MD, USA.
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Baillie L, Askew D, Douglas N, Soyer H. Strategies for assessing the degree of photodamage to skin: a systematic review of the literature. Br J Dermatol 2011; 165:735-42. [DOI: 10.1111/j.1365-2133.2011.10416.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- L. Baillie
- Dermatology Research Centre, The University of Queensland, School of Medicine, Princess Alexandra Hospital, 199 Ipswich Road, Brisbane, Qld 4102, Australia
| | - D. Askew
- Dermatology Research Centre, The University of Queensland, School of Medicine, Princess Alexandra Hospital, 199 Ipswich Road, Brisbane, Qld 4102, Australia
| | - N. Douglas
- Dermatology Research Centre, The University of Queensland, School of Medicine, Princess Alexandra Hospital, 199 Ipswich Road, Brisbane, Qld 4102, Australia
| | - H.P. Soyer
- Dermatology Research Centre, The University of Queensland, School of Medicine, Princess Alexandra Hospital, 199 Ipswich Road, Brisbane, Qld 4102, Australia
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Hughes M, Bredoux C, Salas F, Lombard D, Strutton G, Fourtanier A, Green A. Comparison of Histological Measures of Skin Photoaging. Dermatology 2011; 223:140-51. [DOI: 10.1159/000332425] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Accepted: 08/26/2011] [Indexed: 12/27/2022] Open
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Thomas NE, Kricker A, From L, Busam K, Millikan RC, Ritchey ME, Armstrong BK, Lee-Taylor J, Marrett LD, Anton-Culver H, Zanetti R, Rosso S, Gallagher RP, Dwyer T, Goumas C, Kanetsky PA, Begg CB, Orlow I, Wilcox H, Paine S, Berwick M. Associations of cumulative sun exposure and phenotypic characteristics with histologic solar elastosis. Cancer Epidemiol Biomarkers Prev 2010; 19:2932-41. [PMID: 20802019 DOI: 10.1158/1055-9965.epi-10-0686] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Solar elastosis adjacent to melanomas in histologic sections is regarded as an indicator of sun exposure, although the associations of UV exposure and phenotype with solar elastosis are yet to be fully explored. METHODS The study included 2,589 incident primary melanoma patients with assessment of histologic solar elastosis in the population-based Genes, Environment, and Melanoma study. Ambient erythemal UV (UVE) at places of residence and sun exposure hours, including body site-specific exposure, were collected. We examined the association of cumulative site-specific and non-site-specific sun exposure hours and ambient UVE with solar elastosis in multivariable models adjusted for age, sex, center, pigmentary characteristics, nevi, and, where relevant, body site. RESULTS Solar elastosis was associated most strongly with site-specific UVE [odds ratio (OR) for top exposure quartile, 5.20; 95% confidence interval (95% CI), 3.40-7.96; P for trend <0.001] and also with site-specific sun exposure (OR for top quartile, 5.12; 95% CI, 3.35-7.83; P for trend <0.001). Older age (OR at >70 years, 7.69; 95% CI, 5.14-11.52; P for trend < 0.001) and having more than 10 back nevi (OR, 0.77; 95% CI, 0.61-0.97; P = 0.03) were independently associated with solar elastosis. CONCLUSION Solar elastosis had a strong association with higher site-specific UVE dose, older age, and fewer nevi. IMPACT Solar elastosis could be a useful biomarker of lifetime site-specific UV. Future research is needed to explore whether age represents more than simple accumulation of sun exposure and to determine why people with more nevi may be less prone to solar elastosis.
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Affiliation(s)
- Nancy E Thomas
- Department of Dermatology, University of North Carolina, Chapel Hill, NC 27599, USA.
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Kricker A, Armstrong BK, Goumas C, Kanetsky P, Gallagher RP, Begg CB, Millikan RC, Dwyer T, Rosso S, Marrett LD, Thomas NE, Berwick M. MC1R genotype may modify the effect of sun exposure on melanoma risk in the GEM study. Cancer Causes Control 2010; 21:2137-47. [PMID: 20721616 DOI: 10.1007/s10552-010-9633-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Accepted: 08/07/2010] [Indexed: 01/06/2023]
Abstract
We investigated whether MC1R genotype modifies the effect of sun exposure on melanoma risk in 1,018 cases with multiple melanomas (MPM) and 1,875 controls with one melanoma (SPM). There was some suggestion that MC1R genotype modified the effect of beach and water activities on MPM risk: ORs were 1.94 (95% CI 1.40-2.70) for any activities for no R variants and 1.39 (95% CI 1.05-1.84) with R variants (R151C, R160W, D294H, and D84E) (p for interaction 0.08). MC1R modification of sun exposure effects appeared most evident for MPM of the head and neck: for early life ambient UV, the OR was 4.23 (95% CI 1.76-10.20) with no R and 1.04 (95% CI 0.40-2.68) with R (p for interaction = 0.01; p for three-way interaction = 0.01). Phenotype modified the effect of sun exposure and MPM in a similar manner. We conclude that MC1R and pigmentary phenotype may modify the effects of sun exposure on melanoma risk on more continuously sun-exposed skin. Possible explanations include that risk may saturate with higher sun sensitivity for melanomas on continuously sun-exposed sites but continue to increase as sun exposure increases with lower sun sensitivity, or that sun-sensitive people adapt their behavior by increasing sun protection when exposed.
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Affiliation(s)
- Anne Kricker
- Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia.
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Karagas MR, Waterboer T, Li Z, Nelson HH, Michael KM, Bavinck JNB, Perry AE, Spencer SK, Daling J, Green AC, Pawlita M. Genus beta human papillomaviruses and incidence of basal cell and squamous cell carcinomas of skin: population based case-control study. BMJ 2010; 341:c2986. [PMID: 20616098 PMCID: PMC2900549 DOI: 10.1136/bmj.c2986] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate the association between genus beta human papillomaviruses and the incidence of non-melanocytic skin cancer in the general population. DESIGN Population based case-control study. SETTING New Hampshire, USA. PARTICIPANTS 2366 skin cancer cases and controls from the general population aged 25 to 74 years (663 squamous cell carcinoma, 898 basal cell carcinoma, 805 controls), with plasma samples tested for L1 antibodies to 16 genus beta human papillomaviruses by multiplex serology. MAIN OUTCOME MEASURES Odds ratios for squamous cell carcinoma and basal cell carcinoma associated with seropositivity to beta human papillomaviruses. RESULTS Squamous cell carcinoma, but not basal cell carcinoma, cases had a higher prevalence of each of the individual beta human papillomaviruses assayed compared with controls. The odds ratios for squamous cell carcinoma increased with the number of beta types positive (odds ratio for one type positive 0.99 (95% confidence interval 0.74 to 1.33); two to three types positive 1.44 (1.03 to 2.01); four to eight types positive 1.51 (1.03 to 2.20); more than eight types positive 1.71 (1.12 to 2.62); P for trend (categorical)<0.001; P for trend (continuous)=0.003). With limited statistical power, the association was stronger among long term users of systemic glucocorticoids (odds ratio 3.21, 1.22 to 8.44) than among non-users (1.23, 0.97 to 1.55). CONCLUSIONS These findings support a relation between genus beta human papillomavirus infection and the incidence of squamous cell carcinoma of the skin in the general population, as well as potential enhancement of risk by immunosuppression.
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Affiliation(s)
- Margaret R Karagas
- Section of Biostatistics and Epidemiology, Department of Community and Family Medicine and Norris Cotton Cancer Center, Dartmouth Medical School, Lebanon, NH 03756, USA.
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Lazovich D, Vogel RI, Berwick M, Weinstock MA, Anderson KE, Warshaw EM. Indoor tanning and risk of melanoma: a case-control study in a highly exposed population. Cancer Epidemiol Biomarkers Prev 2010; 19:1557-68. [PMID: 20507845 DOI: 10.1158/1055-9965.epi-09-1249] [Citation(s) in RCA: 279] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Indoor tanning has been only weakly associated with melanoma risk; most reports were unable to adjust for sun exposure, confirm a dose-response, or examine specific tanning devices. A population-based case-control study was conducted to address these limitations. METHODS Cases of invasive cutaneous melanoma, diagnosed in Minnesota between 2004 and 2007 at ages 25 to 59, were ascertained from a statewide cancer registry; age-matched and gender-matched controls were randomly selected from state driver's license lists. Self-administered questionnaires and telephone interviews included information on ever use of indoor tanning, types of device used, initiation age, period of use, dose, duration, and indoor tanning-related burns. Odds ratios (OR) and 95% confidence intervals (CI) were adjusted for known melanoma risk factors. RESULTS Among 1,167 cases and 1,101 controls, 62.9% of cases and 51.1% of controls had tanned indoors (adjusted OR 1.74; 95% CI, 1.42-2.14). Melanoma risk was pronounced among users of UVB-enhanced (adjusted OR, 2.86; 95% CI, 2.03-4.03) and primarily UVA-emitting devices (adjusted OR, 4.44; 95% CI, 2.45-8.02). Risk increased with use: years (P < 0.006), hours (P < 0.0001), or sessions (P = 0.0002). ORs were elevated within each initiation age category; among indoor tanners, years used was more relevant for melanoma development. CONCLUSIONS In a highly exposed population, frequent indoor tanning increased melanoma risk, regardless of age when indoor tanning began. Elevated risks were observed across devices. IMPACT This study overcomes some of the limitations of earlier reports and provides strong support for the recent declaration by the IARC that tanning devices are carcinogenic in humans.
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Affiliation(s)
- DeAnn Lazovich
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55454, USA.
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Waterboer T, Neale R, Michael KM, Sehr P, de Koning MNC, Weißenborn SJ, Sampogna F, Abeni D, Green AC, Bouwes Bavinck JN, Pawlita M, The Epi-Hpv-Uv-Ca Group. Antibody responses to 26 skin human papillomavirus types in the Netherlands, Italy and Australia. J Gen Virol 2009; 90:1986-1998. [PMID: 19386782 DOI: 10.1099/vir.0.010637-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Solar UV radiation is the main risk factor for cutaneous squamous cell carcinoma (SCC), but infections with skin human papillomavirus (HPV) types have also been linked to the development of SCC. Little is known about the natural history of these infections and whether the seroprevalence of skin HPV types is affected by ambient or individual levels of sun exposure. This study investigated this by analysing sera for antibodies to 26 skin HPV types from five phylogenetic genera obtained from 807 healthy individuals from the Netherlands, Italy and Australia, countries with strong differences in sunlight intensity. Overall HPV seroprevalence was similar across the three countries (50-57 % for beta-HPV types, 40-48 % for gamma-HPV types), and the most frequent beta-HPV and gamma-HPV types were the same in all countries. The highest seroprevalences for 24 of the 26 skin HPV types were observed in Italy (14 types) and Australia (ten types). Seroprevalence among men was generally higher than among women, and the male sex was significantly associated with both beta-HPV [odds ratio (OR) 2.81, 95 % confidence interval (CI) 1.64-4.82] and gamma-HPV (OR 2.42, 95 % CI 1.40-4.18) antibodies in Australia. The only measure of sun sensitivity or UV exposure significantly associated with skin HPV seroprevalence was found for weekend sun exposure in Australia and beta-HPV antibodies. It was concluded that type spectra and HPV seroprevalence are similar in countries with different sunlight intensity, and that levels of UV exposure do not play a strong role in the development of skin HPV antibodies in this study population.
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Affiliation(s)
- Tim Waterboer
- Department of Genome Modifications and Carcinogenesis, Infections and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rachel Neale
- Queensland Institute of Medical Research, Brisbane, Australia
| | - Kristina M Michael
- Department of Genome Modifications and Carcinogenesis, Infections and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Peter Sehr
- Department of Genome Modifications and Carcinogenesis, Infections and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Maurits N C de Koning
- Department of Medical Microbiology, Center of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands.,DDL Diagnostic Laboratory, Voorburg, The Netherlands
| | | | | | - Damiano Abeni
- Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, Italy
| | - Adele C Green
- Queensland Institute of Medical Research, Brisbane, Australia
| | | | - Michael Pawlita
- Department of Genome Modifications and Carcinogenesis, Infections and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - The Epi-Hpv-Uv-Ca Group
- Department of Genome Modifications and Carcinogenesis, Infections and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Yu CL, Li Y, Freedman DM, Fears TR, Kwok R, Chodick G, Alexander B, Kimlin MG, Kricker A, Armstrong BK, Linet MS. Assessment of lifetime cumulative sun exposure using a self-administered questionnaire: reliability of two approaches. Cancer Epidemiol Biomarkers Prev 2009; 18:464-71. [PMID: 19190171 DOI: 10.1158/1055-9965.epi-08-0894] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Few studies have evaluated the reliability of lifetime sun exposure estimated from inquiring about the number of hours people spent outdoors in a given period on a typical weekday or weekend day (the time-based approach). Some investigations have suggested that women have a particularly difficult task in estimating time outdoors in adulthood due to their family and occupational roles. We hypothesized that people might gain additional memory cues and estimate lifetime hours spent outdoors more reliably if asked about time spent outdoors according to specific activities (an activity-based approach). Using self-administered, mailed questionnaires, test-retest responses to time-based and to activity-based approaches were evaluated in 124 volunteer radiologic technologist participants from the United States: 64 females and 60 males 48 to 80 years of age. Intraclass correlation coefficients (ICC) were used to evaluate the test-retest reliability of average number of hours spent outdoors in the summer estimated for each approach. We tested the differences between the two ICCs, corresponding to each approach, using a t test with the variance of the difference estimated by the jackknife method. During childhood and adolescence, the two approaches gave similar ICCs for average numbers of hours spent outdoors in the summer. By contrast, compared with the time-based approach, the activity-based approach showed significantly higher ICCs during adult ages (0.69 versus 0.43, P = 0.003) and over the lifetime (0.69 versus 0.52, P = 0.05); the higher ICCs for the activity-based questionnaire were primarily derived from the results for females. Research is needed to further improve the activity-based questionnaire approach for long-term sun exposure assessment.
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Affiliation(s)
- Chu-Ling Yu
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD 20892-7238, USA.
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Neidecker MV, Davis-Ajami ML, Balkrishnan R, Feldman SR. Pharmacoeconomic considerations in treating actinic keratosis. PHARMACOECONOMICS 2009; 27:451-464. [PMID: 19640009 DOI: 10.2165/00019053-200927060-00002] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Actinic keratosis is among the most commonly treated skin conditions in the outpatient setting. Its prevalence spans the globe, with greater distribution in fair skinned individuals and the immunocompromised. With high prevalence, increasing incidence and the risk of transformation to a cancerous lesion, prevention and timely treatment present opportunities to rein in costs. The purpose of this article is to review published economic studies relating to the treatment of actinic keratosis, to summarize results discussing the cost drivers of current treatment modalities and to identify parameters most likely to influence the cost effectiveness of treatment. We systematically conducted a published literature search for pharmacoeconomic research of actinic keratosis using title, abstract or full-text searches with the following search terms ([actinic OR solar] AND [keratosis OR keratoses]) AND (economic OR cost OR pharmacoeconomics OR decision). We included published articles referencing actinic keratosis in a standalone study or in a broader study referencing non-melanoma skin cancer and articles evaluating cost-of-illness, cost-of-treatment, cost minimization, cost effectiveness, cost utility, cost-benefit analysis and cost consequence. Our review of the literature found nine studies devoted to pharmacoeconomic considerations of actinic keratosis treatments, with one article investigating both cost-of-illness and cost-of-treatment, two measuring cost-of-illness, two evaluating cost-of-treatment, one focusing on cost minimization, and three focusing on cost effectiveness. The literature compared a broad range of actinic keratosis treatments including topical medications, cryotherapy, photodynamic therapy, excision and a combination of treatment modalities. The direct cost of actinic keratosis management in the US was estimated at $US1.2 billion per year, with indirect costs totalling $US295 million (year 2004 values). The primary drivers of cost were physician office visits and associated procedures. Pharmacoeconomic research defining standards, outcomes and areas of efficiencies in the treatment of actinic keratosis is in its infancy. To move towards more comprehensive analysis, research needs to focus on updating epidemiological data, evolving evidence-based standards, delineating cost drivers in immunocompetent and immunocompromised populations, and on health outcomes.
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Affiliation(s)
- Marjorie V Neidecker
- Division of Pharmacy Practice and Administration, Ohio State University College of Pharmacy, Columbus, Ohio, USA
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Worswick SD, Cockburn M, Peng D. Measurement of Ultraviolet Exposure in Epidemiological Studies of Skin and Skin Cancers. Photochem Photobiol 2008; 84:1462-72. [DOI: 10.1111/j.1751-1097.2008.00367.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Millen AE, Bodnar LM. Vitamin D assessment in population-based studies: a review of the issues. Am J Clin Nutr 2008; 87:1102S-5S. [PMID: 18400742 DOI: 10.1093/ajcn/87.4.1102s] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
In the past decade, research on the relation between vitamin D exposure and disease in population-based studies has increased exponentially. These studies have involved measurement of vitamin D exposure by means of several methods: blood assays, self-reported dietary and supplemental intakes, and sunlight exposure questionnaires or diaries. As with all exposure measurements, researchers must consider the validity of their assessment tools for capturing vitamin D exposure. The purpose of this article is to summarize our current understanding of the various approaches to measuring vitamin D status within populations as reviewed at the 2007 Experimental Biology symposium, "Assessment of Vitamin D in Population-Based Studies." In summary, serum 25-hydroxyvitamin D is the accepted biomarker for short-term vitamin D status, but estimates of long-term dietary and supplemental intakes of vitamin D and long-term sunlight exposure may be the most logistically feasible indicators of lifetime vitamin D exposure in population-based studies. Also discussed are issues investigators should consider when analyzing relations between vitamin D exposure and disease outcomes in population-based studies as well as research avenues that need further exploration. The best method for assessing vitamin D status in population-based studies will depend primarily on the research question asked and the critical window of vitamin D exposure hypothesized to be most important.
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Affiliation(s)
- Amy E Millen
- University at Buffalo, School of Public Health and Health Professions, Department of Social and Preventive Medicine, Buffalo, NY 14214-8001, USA.
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Affiliation(s)
- Margaret A Tucker
- Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Boulevard, Room 7122, Bethesda, MD 20892-7236, USA.
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