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Asadi LK, Khalili A, Wang SQ. The sociological basis of the skin cancer epidemic. Int J Dermatol 2023; 62:169-176. [PMID: 35020194 DOI: 10.1111/ijd.15987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 10/09/2021] [Accepted: 11/06/2021] [Indexed: 01/20/2023]
Abstract
Given the precipitous rise in its incidence in recent decades, skin cancer has been recognized as a growing epidemic. We explore the sociological underpinnings of this epidemic, including: (1) aging of the demographic; (2) human ecologic factors (residing in areas with high ambient ultraviolet levels and a depleted ozone layer); (3) large-scale European migration to more equatorial latitudes; (4) social structures that for centuries minimized miscegenation and maximized segregation; (5) gender-based differences in sunbathing, tanning, sunscreen use, and clothing choice; (6) occupational ultraviolet exposure; (7) the complex interplay of socioeconomic status, race, and urbanization on skin cancer incidence and mortality; (8) the effects of war on skin cancer incidence; (9) cultural shifts in clothing, travel, outdoor sports, recreation, and attitudes towards being tan; and (10) the indirect effects of religion. We show that without these sociological factors, the most common type of cancer would not be nearly as common.
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Affiliation(s)
- Leila K Asadi
- Division of Dermatology, Memorial Sloan-Kettering Cancer Center, Basking Ridge, New Jersey, USA
| | - Ahmad Khalili
- Professor Emeritus of Sociology, Department of Interdisciplinary Programs, Slippery Rock University, Slippery Rock, Pennsylvania, USA
| | - Steven Q Wang
- Division of Dermatology, Memorial Sloan-Kettering Cancer Center, Basking Ridge, New Jersey, USA
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2
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Boffetta P, Goldfarb DG, Zeig-Owens R, Kristjansson D, Li J, Brackbill RM, Farfel MR, Cone JE, Yung J, Kahn AR, Qiao B, Schymura MJ, Webber MP, Prezant DJ, Dasaro CR, Todd AC, Hall CB. Temporal Aspects of the Association between Exposure to the World Trade Center Disaster and Risk of Cutaneous Melanoma. JID INNOVATIONS 2022; 2:100063. [PMID: 35146479 PMCID: PMC8801528 DOI: 10.1016/j.xjidi.2021.100063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 11/16/2022] Open
Abstract
Rescue/recovery workers who responded to the World Trade Center (WTC) attacks were exposed to known/suspected carcinogens. Studies have identified a trend toward an elevated risk of cutaneous melanoma in this population; however, few found significant increases. Furthermore, temporal aspects of the association have not been investigated. A total of 44,540 non-Hispanic White workers from the WTC Combined Rescue/Recovery Cohort were studied between March 12, 2002 and December 31, 2015. Cancer data were obtained through linkages with 13 state registries. Poisson regression was used to estimate hazard ratios and 95% confidence intervals using the New York State population as the reference; change points in hazard ratios were estimated using profile likelihood. We observed 247 incident cases of melanoma. No increase in incidence was detected during 2002-2004. From 2005 to 2015, the hazard ratio was 1.34 (95% confidence interval = 1.18-1.52). A dose‒response relationship was observed by arrival time at the WTC site. Risk was elevated just over 3 years after the attacks. Whereas WTC-related exposures to UVR or other agents might have contributed to this result, exposures other than those at the WTC site, enhanced medical surveillance, and lack of a control group with a similar proportion of rescue/recovery workers cannot be discounted. Our results support continued study of this population for melanoma.
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Affiliation(s)
- Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - David G. Goldfarb
- Department of Medicine, Montefiore Medical Center, New York, New York, USA
- Fire Department of the City of New York (FDNY), Brooklyn, New York, USA
- Department of Environmental, Occupational and Geospatial Health Sciences, City University of New York Graduate School of Public Health & Health Policy, New York, New York, USA
| | - Rachel Zeig-Owens
- Department of Medicine, Montefiore Medical Center, New York, New York, USA
- Fire Department of the City of New York (FDNY), Brooklyn, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Dana Kristjansson
- Department of Genetics and Bioinformatics, Norwegian Institute of Public Health, Oslo, Norway
- Center of Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Jiehui Li
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - Robert M. Brackbill
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - Mark R. Farfel
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - James E. Cone
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - Janette Yung
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - Amy R. Kahn
- Bureau of Cancer Epidemiology, New York State Department of Health, Albany, New York, USA
| | - Baozhen Qiao
- Bureau of Cancer Epidemiology, New York State Department of Health, Albany, New York, USA
| | - Maria J. Schymura
- Bureau of Cancer Epidemiology, New York State Department of Health, Albany, New York, USA
| | - Mayris P. Webber
- Department of Medicine, Montefiore Medical Center, New York, New York, USA
- Fire Department of the City of New York (FDNY), Brooklyn, New York, USA
| | - David J. Prezant
- Department of Medicine, Montefiore Medical Center, New York, New York, USA
- Fire Department of the City of New York (FDNY), Brooklyn, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Christopher R. Dasaro
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Andrew C. Todd
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Charles B. Hall
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
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Cheng W, Brown R, Vernez D, Goldberg D. Estimation of Individual Exposure to Erythemal Weighted UVR by Multi-Sensor Measurements and Integral Calculation. SENSORS 2020; 20:s20154068. [PMID: 32707787 PMCID: PMC7435697 DOI: 10.3390/s20154068] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/14/2020] [Accepted: 07/19/2020] [Indexed: 02/07/2023]
Abstract
Ultraviolet radiation (UVR) can be hazardous to humans, especially children, and is associated with sunburn, melanoma, and the risk of skin cancer. Understanding and estimating adults’ and children’s UVR exposure is critical to the design of effective interventions and the production of healthy UVR environments. Currently, there are limitations to the ways computer modeling and field measurements estimate individual UVR exposure in a given landscape. To address these limitations, this study developed an approach of integral calculation using six-directional (up, down, south, north, east, and west) field-measured UVR data and the estimated body exposure ratios (ER) for both children and adults. This approach showed high agreement when compared to a validated approach using ambient UVR and estimated ER data with a high r-square value (90.72% for child and adult models), and a low mean squared error (6.0% for child model and 5.1% for adult model) in an open area. This approach acting as a complementary tool between the climatology level and individual level can be used to estimate individual UVR exposure in a landscape with a complicated shady environment. In addition, measuring daily UVR data from six directions under open sky conditions confirmed that personal dosimeters underestimate actual individual UVR exposure.
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Affiliation(s)
- Wenwen Cheng
- College of Architecture, University of Oklahoma, Norman, OK 73019, USA
- Correspondence:
| | - Robert Brown
- Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX 77843, USA;
| | - David Vernez
- Center for Primary Care and Public Health (Unisanté), Department of Occupational and Environmental Health, University of Lausanne, CH-1015 Lausanne, Switzerland;
| | - Daniel Goldberg
- Department of Geography, Texas A&M University, College Station, TX 77843, USA;
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4
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Garnacho Saucedo GM, Salido Vallejo R, Moreno Giménez JC. [Effects of solar radiation and an update on photoprotection]. An Pediatr (Barc) 2020; 92:377.e1-377.e9. [PMID: 32513601 DOI: 10.1016/j.anpedi.2020.04.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 04/11/2020] [Indexed: 12/22/2022] Open
Abstract
Sunburn, immunodepression, photoaging, and photocarcinogenesis, are some of the most significant adverse effects of solar radiation in humans. Children are population group of special vulnerability, due to the fact that exposure to the sun has more pronounced biological effects compared to adults. Furthermore, childhood is a critical period for promoting the development of photo damage and photocarcinogenesis in the later stages of life if adequate measures at not put into place. This is because it is estimated that between 18 and 20 years of age is when 40% to 50% of the accumulative exposure to ultraviolet radiation up to 60 years of age is received. The most important strategy for the photoprotection of children is changes in behaviour and habits associated with exposure to the sun at all levels (school, society, family, etc.). Resorting to the shade, reduction in overall time of exposure to the sun, and physical protection (clothes, hats, and sunglasses) are the best and least costly photoprotection strategies. The photoprotectors must be incorporated into the daily routine of children in the same way as adults, and must complete a series of requirements in order to make them effective, safe, and in line with the environment.
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Affiliation(s)
- Gloria M Garnacho Saucedo
- Unidad de Dermatología Pediátrica, Departamento de Dermatología, Hospital Universitario Reina Sofía, Córdoba, España.
| | - Rafael Salido Vallejo
- Unidad de Dermatología Pediátrica, Departamento de Dermatología, Hospital Universitario Reina Sofía, Córdoba, España
| | - Jose Carlos Moreno Giménez
- Unidad de Dermatología Pediátrica, Departamento de Dermatología, Hospital Universitario Reina Sofía, Córdoba, España
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Garnacho Saucedo GM, Salido Vallejo R, Moreno Giménez JC. Effects of solar radiation and an update on photoprotection. An Pediatr (Barc) 2020. [DOI: 10.1016/j.anpede.2020.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Re-engaging an inactive cohort of young adults: evaluating recruitment for the Kidskin Young Adult Myopia Study. BMC Med Res Methodol 2020; 20:127. [PMID: 32448147 PMCID: PMC7245800 DOI: 10.1186/s12874-020-00996-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 04/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recent changes in communication technologies, including increased reliance on mobile phones and the internet, may present challenges and/or opportunities to re-engaging inactive study cohorts. We evaluate our ability to recruit participants for the Kidskin Young Adult Myopia Study (KYAMS), a follow-up of the Kidskin Study. METHODS KYAMS participants were recruited from the Kidskin Study, a sun exposure-intervention study for 5-6 year-olds running from 1995 to 1999 with most recent follow-up in 2005. From 2015 to 2019, the KYAMS used mail-outs, phone calls and social media to contact Kidskin Study participants. Multivariable logistic regression was used to identify variables associated with successful contact of a Kidskin Study participant or family member and KYAMS participation. RESULTS Of 1695 eligible participants, 599 (35.5%) participants (or a family member) were contacted and 303 (17.9%) participated in the KYAMS. KYAMS participation was more likely in those who participated in the 2005 follow-up (odds ratio [OR] = 5.09, 95% confidence interval [CI]: 3.67-7.06) and had a mobile phone number on record (OR = 2.25, CI: 1.57-3.23). Of those contacted, participants who were the first point of contact (OR = 4.84, CI: 2.89-8.10) and who were contacted by letter in the first (OR = 6.53, CI: 3.35-12.75) or second (OR = 5.77, CI: 2.85-11.67) round were more likely to participate in the KYAMS, compared to contact by landline phone. CONCLUSIONS We recruited approximately one-fifth of Kidskin Study participants for the KYAMS. Participants were more likely to participate in the KYAMS if they were contacted directly, rather than through a family member, and if they were contacted by invitation letter. TRIAL REGISTRATION ACTRN12617000812392.
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Abstract
In this article, we summarize the research that eventually led to the classification of the full ultraviolet (UV) radiation spectrum as carcinogenic to humans. We recall the pioneering works that led to the formulation of novel hypotheses on the reasons underlying the increasing burden of melanoma in light-skinned populations. It took long before having compelling evidence on the association between UV and melanoma, in particular, the importance of UV exposure during childhood for both the occurrence of melanoma and death. The role of UVA was established only after 2005. If molecular lesions caused by UV radiation are better known, the precise mechanism by which UV exposure drives melanoma occurrence and progression still needs to be elucidated. More research on the UV-melanoma relationships has led to more evidence-based sun-protection recommendations, especially for children, and to effective control of the artificial UV tanning fashion. Since around 1985-1995, the mortality because of melanoma has started to decrease in younger age groups in most light-skinned populations. If sun protection among children remain on top of public health agendas, there is a fairly great chance that melanoma mortality will stabilize and steadily decrease in all light-skinned populations. The introduction of effective therapies against metastatic disease will improve this reversal in mortality trends.
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Affiliation(s)
- Philippe Autier
- University of Strathclyde Institute of Global Public Health, International Prevention Research Institute (iPRI), Dardilly, France
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8
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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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9
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Tabbakh T, Volkov A, Wakefield M, Dobbinson S. Implementation of the SunSmart program and population sun protection behaviour in Melbourne, Australia: Results from cross-sectional summer surveys from 1987 to 2017. PLoS Med 2019; 16:e1002932. [PMID: 31593565 PMCID: PMC6782093 DOI: 10.1371/journal.pmed.1002932] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 09/02/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Australia has one of the highest skin cancer rates in the world. 'SunSmart' is a multi-component, internationally recognised community-wide skin cancer prevention program implemented in Melbourne, Australia, since summer 1988-1989. Following recent reductions in melanoma rates among younger Australian cohorts, the extent of behaviour change and the potential contribution of prevention programs to this decline in melanoma rates are of interest. Sun protection is a multifaceted behaviour. Measures previously applied to monitor change over time in preventive behaviour for this population focused on individual behaviours. The omission of multiple behaviours that reduce exposure to ultraviolet radiation (UV) may have led to underestimates of behaviour change, meriting further analysis of long-term trends to contribute to this debate. METHODS AND FINDINGS A population-based survey was conducted in Melbourne in the summer before SunSmart commenced (1987-1988) and across summers in 3 subsequent decades (1988-2017). During summer months, residents (14-69 years) were recruited to cross-sectional weekly telephone interviews assessing their tanning attitudes, sun protection behaviour, and sunburn incidence on the weekend prior to interview. Quotas were used to ensure the sample was proportional to the population by age and sex, while younger respondents were oversampled in some years. The majority of the respondents reported their skin was susceptible to sunburn. Changes in sun protection behaviour were analysed for N = 13,285 respondents in multivariable models, cumulating surveys within decades (1987-1988: N = 1,655; 1990s: N = 5,258; 2000s: N = 3,385; 2010s: N = 2,987) and adjusting for relevant ambient weather conditions and UV levels on weekend dates. We analysed specific and composite behaviours including a novel analysis of the use of maximal sun protection, which considered those people who stayed indoors during peak UV hours together with those people well-protected when outdoors. From a low base, use of sun protection increased rapidly in the decade after SunSmart commenced. The odds of use of at least 1 sun protection behaviours on summer weekends was 3 times higher in the 1990s than pre-SunSmart (adjusted odds ratio [AOR] 3.04, 95% CI 2.52-3.68, p < 0.001). There was a smaller increase in use of maximal sun protection including shade (AOR = 1.68, 95% CI 1.44-1.97, p < 0.001). These improvements were sustained into the 2000s and continued to increase in the 2010s. Inferences about program effects are limited by the self-reported data, the absence of a control population, the cross-sectional study design, and the fact that the survey was not conducted in all years. Other potential confounders may include increasing educational attainment among respondents over time and exposure to other campaigns such as tobacco and obesity prevention. CONCLUSIONS With an estimated 20-year lag between sun exposure and melanoma incidence, our findings are consistent with SunSmart having contributed to the reduction in melanoma among younger cohorts.
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10
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Hunkin H, Pollock K, Scupham R. The National SunSmart Schools Program: Impact on sun protection policies and practices in Australian primary schools. Health Promot J Austr 2019; 31:251-257. [PMID: 31466123 DOI: 10.1002/hpja.291] [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: 05/30/2019] [Accepted: 08/21/2019] [Indexed: 11/09/2022] Open
Abstract
ISSUE ADDRESSED Overexposure to ultraviolet radiation during childhood is a significant determinant of lifetime skin cancer risk, but can be mitigated through primary schools' adoption of appropriate sun protection policies and practices. The present study aimed to evaluate the changes in these policies and practices in Australia, and to assess the impact of the National SunSmart Schools Program. METHODS A random sample of primary schools were selected in 2011 and 2016 (N = 1577, 1533), and asked to complete a survey describing their current sun protection policies and practices. Significant changes across the study period, and relative to previously reported data from 2005, were identified. RESULTS Sun protection policies and practices remained relatively stable over the period, although there was a notable decrease in incorporating sun protection material into the curriculum. SunSmart membership was associated with a significantly greater likelihood of several policies and practices being employed. The launch of the SunSmart program in New South Wales was linked with significant improvements to sun protection practices, relative to other states and territories. CONCLUSION The National SunSmart Schools program continues to have a substantial impact in supporting the adoption of appropriate sun protection policies and their practical implementation. SO WHAT?: Even small changes to sun protection practices in Australian primary schools can have a major positive impact on long-term health outcomes. SunSmart membership can be leveraged to broaden existing policies and practices, targeting priority areas such as shade provision and the incorporation of sun protection into school curriculum.
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Affiliation(s)
- Hugh Hunkin
- Behavioural Research and Evaluation Unit, Cancer Council SA, Eastwood, SA, Australia
| | - Kate Pollock
- Behavioural Research and Evaluation Unit, Cancer Council SA, Eastwood, SA, Australia
| | - Rebecca Scupham
- Behavioural Research and Evaluation Unit, Cancer Council SA, Eastwood, SA, Australia
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11
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Wallace M, Khlat M, Guillot M. Mortality advantage among migrants according to duration of stay in France, 2004-2014. BMC Public Health 2019; 19:327. [PMID: 30898125 PMCID: PMC6427872 DOI: 10.1186/s12889-019-6652-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 03/13/2019] [Indexed: 11/21/2022] Open
Abstract
Background The migrant mortality advantage is generally interpreted as reflecting the selection of atypically healthy individuals from the country of origin followed by the wearing off of selection effects over time, a process theorised to be accelerated by progressive and negative acculturation in the host country. However, studies examining how migrant mortality evolves over duration of stay, which could provide insight into these two processes, are relatively scarce. Additionally, they have paid little attention to gender-specific patterns and the confounding effect of age. In this study, we analyze all-cause mortality according to duration of stay among male and female migrants in France, with a particular focus on the role of age in explaining duration of stay effects. Methods We use the Échantillon Démographique Permanent (Permanent Demographic Sample; EDP), France’s largest socio-demographic panel and a representative 1% sample of its population. Mortality was followed-up from 2004 to 2014, and parametric survival models were fitted for males and females to study variation in all-cause mortality among migrants over duration of stay. Estimates were adjusted for age, duration of stay, year, education level and marital status. Duration of stay patterns were examined for both open-ended and fixed age groups. Results We observe a migrant mortality advantage, which is most pronounced among recent arrivals and converges towards the mortality level of natives with duration of stay. We show this pattern to be robust to the confounding effect of age and find the pattern to be consistent among males and females. Conclusions Our novel findings show an intrinsic pattern of convergence of migrant mortality towards native-born mortality over time spent in France, independent from the ages at which mortality is measured. The consistent pattern in both genders suggests that males and females experience the same processes associated with generating the migrant mortality advantage. These patterns adhere to the selection-acculturation hypothesis and raise serious concerns about the erosion of migrant health capital with increasing exposure to conditions in France. Electronic supplementary material The online version of this article (10.1186/s12889-019-6652-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Matthew Wallace
- Demography Unit, Department of Sociology, Stockholm University, Stockholm, Sweden.
| | - Myriam Khlat
- Institut national d'études démographiques, French National Demographic Institute, 133 Boulevard Davout, 75020, Paris, France
| | - Michel Guillot
- Institut national d'études démographiques, French National Demographic Institute, 133 Boulevard Davout, 75020, Paris, France.,Population Studies Center, University of Pennsylvania, 242 McNeil Building, Philadelphia, PA19104, USA
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12
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Cust AE, Mishra K, Berwick M. Melanoma - role of the environment and genetics. Photochem Photobiol Sci 2018; 17:1853-1860. [PMID: 30113042 DOI: 10.1039/c7pp00411g] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Melanoma rates have increased in populations that are mainly European. The main etiologic factor is ultraviolet radiation, from the sun as well as artificial tanning devices. Host factors such as skin color, number of nevi, hair and eye color and tanning ability are critical factors in modifying an individual's response to the sun. Genetic factors interact with host factors and environmental factors to increase risk. This review summarizes our current knowledge of environment and genetics on melanoma risk and on gene-environment interaction.
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Affiliation(s)
- Anne E Cust
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Australia
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13
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Kassouf N, Kay CWM, Volkov A, Chiang SC, Birch-Machin MA, El-Khamisy SF, Haywood RM. UVA-induced carbon-centred radicals in lightly pigmented cells detected using ESR spectroscopy. Free Radic Biol Med 2018; 126:153-165. [PMID: 30055236 DOI: 10.1016/j.freeradbiomed.2018.07.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 07/19/2018] [Accepted: 07/24/2018] [Indexed: 12/20/2022]
Abstract
Ultraviolet-A and melanin are implicated in melanoma, but whether melanin in vivo screens or acts as a UVA photosensitiser is debated. Here, we investigate the effect of UVA-irradiation on non-pigmented, lightly and darkly pigmented melanocytes and melanoma cells using electron spin resonance (ESR) spectroscopy. Using the spin trap 5,5 Dimethyl-1-pyrroline N-oxide (DMPO), carbon adducts were detected in all cells. However, higher levels of carbon adducts were detected in lightly pigmented cells than in non-pigmented or darkly pigmented cells. Nevertheless, when melanin levels were artificially increased in lightly pigmented cells by incubation with L-Tyrosine, the levels of carbon adducts decreased significantly. Carbon adducts were also detected in UVA-irradiated melanin-free cell nuclei, DNA-melanin systems, and the nucleoside 2'-deoxyguanosine combined with melanin, whereas they were only weakly detected in irradiated synthetic melanin and not at all in irradiated 2'-deoxyguanosine. The similarity of these carbon adducts suggests they may be derived from nucleic acid- guanine - radicals. These observations suggest that melanin is not consistently a UVA screen against free-radical formation in pigmented cells, but may also act as a photosensitizer for the formation of nucleic acid radicals in addition to superoxide. The findings are important for our understanding of the mechanism of damage caused by the UVA component of sunlight in non-melanoma and melanoma cells, and hence the causes of skin cancer.
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Affiliation(s)
- Nick Kassouf
- RAFT Institute, Mount Vernon Hospital, Northwood, Middlesex HA6 2RN, UK
| | - Christopher W M Kay
- Institute of Structural & Molecular Biology and London Centre for Nanotechnology, University College London, Gower Street, London WC1E 6BT, UK; Department of Chemistry, University of Saarland, Saarbrücken 66123, Germany
| | - Arsen Volkov
- RAFT Institute, Mount Vernon Hospital, Northwood, Middlesex HA6 2RN, UK
| | - Shih-Chieh Chiang
- Department of Molecular Biology and Biotechnology, University of Sheffield, Western Bank, Sheffield S10 2TN, UK
| | - Mark A Birch-Machin
- Dermatological Sciences, Institute of Cellular Medicine, The Medical School, Newcastle University, NE2 4HH, UK
| | - Sherif F El-Khamisy
- Department of Molecular Biology and Biotechnology, University of Sheffield, Western Bank, Sheffield S10 2TN, UK
| | - Rachel M Haywood
- RAFT Institute, Mount Vernon Hospital, Northwood, Middlesex HA6 2RN, UK.
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Aitken JF, Youlden DR, Baade PD, Soyer HP, Green AC, Smithers BM. Generational shift in melanoma incidence and mortality in Queensland, Australia, 1995-2014. Int J Cancer 2017; 142:1528-1535. [PMID: 29105744 DOI: 10.1002/ijc.31141] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 10/18/2017] [Accepted: 10/24/2017] [Indexed: 11/05/2022]
Affiliation(s)
- Joanne F. Aitken
- Cancer Council Queensland; Brisbane QLD Australia
- Institute for Resilient Regions, University of Southern Queensland; Brisbane QLD Australia
- School of Public Health and Social Work; Queensland University of Technology; Brisbane QLD Australia
| | - Danny R. Youlden
- Cancer Council Queensland; Brisbane QLD Australia
- Menzies Health Institute, Griffith University; Gold Coast QLD Australia
| | - Peter D. Baade
- Cancer Council Queensland; Brisbane QLD Australia
- School of Mathematical Sciences; Queensland University of Technology; Brisbane QLD Australia
| | - H. Peter Soyer
- Dermatology Research Centre, The University of Queensland, The University of Queensland Diamantina Institute; Brisbane QLD Australia
- Department of Dermatology; Princess Alexandra Hospital; Brisbane QLD Australia
| | - Adèle C. Green
- QIMR Berghofer Medical Research Institute; Brisbane QLD Australia
- CRUK Manchester Institute and Division of Musculoskeletal & Dermatological Sciences; University of Manchester; Manchester United Kingdom
- Australian Skin and Skin Cancer Research Centre; Brisbane QLD Australia
| | - B. Mark Smithers
- Queensland Melanoma Project, Princess Alexandra Hospital; Brisbane QLD Australia
- Discipline of Surgery, Faculty of Medicine; The University of Queensland; Brisbane QLD Australia
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15
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Cestari T, Buster K. Photoprotection in specific populations: Children and people of color. J Am Acad Dermatol 2016; 76:S110-S121. [PMID: 28038884 DOI: 10.1016/j.jaad.2016.09.039] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 09/19/2016] [Accepted: 09/24/2016] [Indexed: 10/20/2022]
Abstract
Improved education on appropriate photoprotection in children is vital. Photoprotection for these individuals should include seeking shade, the use of physical agents (clothing, hat, sunglasses), and application of sunscreens on exposed areas. Avoidance of the use of tanning beds is an important component of education for teenagers. Ultraviolet radiation exposure induces DNA damage and photoaging in all skin types, including people of color. The extent of such damage is inversely related to constitutive skin pigmentation. Therefore, personalized photoprotection recommendations concerning skin cancer risk factors, desired treatment outcomes, health needs (eg, vitamin D), and photoaging based on the needs and preferences of the patient are essential. It is clear that additional research is needed on optimal levels of protection against ultraviolet radiation for people of color.
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Affiliation(s)
- Tania Cestari
- Department of Dermatology, Federal University of Rio Grande do Sul, School of Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
| | - Kesha Buster
- Buster Dermatology, Tulsa, Oklahoma; University of Alabama at Birmingham, Birmingham, Alabama
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16
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Wasti QH, Kopf AW, Marghoob AA, Stefanato CM, Romero JB, Rao BK, Bart RS. Anatomic Distribution of Cutaneous Melanomas and Painful Sunburns in Adults. J Cutan Med Surg 2016. [DOI: 10.1177/120347549600100204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Data show that intermittent painful sunburns are an important causative factor for cutaneous malignant melanoma. Objective: This study was undertaken to determine whether the differences in the anatomic distribution of melanomas in men, compared to women, could be accounted for by the distribution of sunburns and whether the high incidence of melanomas on the lower extremities of women is associated with the distribution of sunburns. Methods: One hundred and fifty nonmelanoma patients, men and women aged 20 to 60 years, recalled having painful sunburns within the previous 6 months. The locations of the sunburns were indicated on body surface diagrams. The locations of 1168 melanomas as recorded in the NYU-Melanoma Cooperative Group data base were plotted on anatomic diagrams. The anatomic distribution of melanomas and of sunburns for men and women were compared. Results: There was no statistically significant difference in the distribution of sunburns on any anatomic location in men as compared to women. However, there was a disproportionately high number of melanomas on the backs of men and on the legs of women. In both men and women, there was a significant difference between the anatomic distribution of painful sunburns and melanomas. Conclusion: Since the anatomic distribution of painful sunburns is similar in men and women, whereas the anatomic distribution of melanomas differ, it would appear that factors in addition to sunburns in adults account for the differences in the anatomic distribution of melanomas in men and women.
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Affiliation(s)
| | | | - Ashfaq A. Marghoob
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine and the Oncology Section, Charles C. Harris Skin and Cancer Pavilion, New York University Medical Center, New York; the New York University Melanoma Cooperative Group; and the Department of Dermatology, the State University of New York at Stony Brook, Stony Brook, New York
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17
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Boog MC, Nederend A, Ultee J. Sun Exposure and Sun Protection at Primary Schools in The Netherlands: A Cross-Sectional Study. Pediatr Dermatol 2016; 33:38-43. [PMID: 26572778 DOI: 10.1111/pde.12711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND In The Netherlands, skin cancer incidence rates have dramatically increased during the last decades. Exposure to ultraviolet radiation is the most important environmental risk factor for developing skin cancer. AIMS The present study aimed to determine the level of sun exposure and sun protection of children at Dutch primary schools. MATERIALS AND METHODS Registered members of an Internet panel of a private research company with a child 6 to 12 years of age completed a standardized questionnaire on sun exposure, sun protection and sunburn for their child on school days during the spring and summer. RESULTS A total of 1103 parents completed the questionnaire. Most parents reported that their child spent 31 minutes to 1 hour (39.7%) or 1 hour to 1.5 hours (26.1%) outside at school during the spring and summer, 29.3% reported that sunscreen is always or often applied to the skin of their child in the morning on school days, 37% reported that they always or often paid attention to sun protection when selecting their child's outfit, 19.3% of the parents stated that their child could not play in the shade outside at school, and 19.9% of the parents reported that their child had ever had a sunburn at school. DISCUSSION With most children, this consistent and repetitive pattern of sun exposure at school will probably lead to damage of exposed skin, because sun protection is insufficiently achieved among children during school days in the spring and summer. CONCLUSIONS Future school-based interventions are necessary to alert and change behavior of parents, children, and primary school teachers.
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18
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Greinert R, de Vries E, Erdmann F, Espina C, Auvinen A, Kesminiene A, Schüz J. European Code against Cancer 4th Edition: Ultraviolet radiation and cancer. Cancer Epidemiol 2015; 39 Suppl 1:S75-83. [PMID: 26096748 DOI: 10.1016/j.canep.2014.12.014] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 10/10/2014] [Accepted: 12/14/2014] [Indexed: 12/31/2022]
Abstract
Ultraviolet radiation (UVR) is part of the electromagnetic spectrum emitted naturally from the sun or from artificial sources such as tanning devices. Acute skin reactions induced by UVR exposure are erythema (skin reddening), or sunburn, and the acquisition of a suntan triggered by UVR-induced DNA damage. UVR exposure is the main cause of skin cancer, including cutaneous malignant melanoma, basal-cell carcinoma, and squamous-cell carcinoma. Skin cancer is the most common cancer in fair-skinned populations, and its incidence has increased steeply over recent decades. According to estimates for 2012, about 100,000 new cases of cutaneous melanoma and about 22,000 deaths from it occurred in Europe. The main mechanisms by which UVR causes cancer are well understood. Exposure during childhood appears to be particularly harmful. Exposure to UVR is a risk factor modifiable by individuals' behaviour. Excessive exposure from natural sources can be avoided by seeking shade when the sun is strongest, by wearing appropriate clothing, and by appropriately applying sunscreens if direct sunlight is unavoidable. Exposure from artificial sources can be completely avoided by not using sunbeds. Beneficial effects of sun or UVR exposure, such as for vitamin D production, can be fully achieved while still avoiding too much sun exposure and the use of sunbeds. Taking all the scientific evidence together, the recommendation of the 4th edition of the European Code Against Cancer for ultraviolet radiation is: "Avoid too much sun, especially for children. Use sun protection. Do not use sunbeds."
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Affiliation(s)
- Rüdiger Greinert
- Center of Dermatology, Department of Molecular Cell Biology, Elbekliniken Stade/Buxtehude, Am Krankenhaus 1, D-21614 Buxtehude, Germany
| | - Esther de Vries
- Department of Public Health, Erasmus MC/Section of Cancer Information, Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
| | - Friederike Erdmann
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon, France
| | - Carolina Espina
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon, France
| | - Anssi Auvinen
- School of Health Sciences, University of Tampere, FI-33014 Tampere, Finland; STUK - Radiation and Nuclear Safety Authority, Research and Environmental Surveillance, Helsinki, Finland
| | - Ausrele Kesminiene
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon, France
| | - Joachim Schüz
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon, France.
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19
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Autier P, Koechlin A, Boniol M. The forthcoming inexorable decline of cutaneous melanoma mortality in light-skinned populations. Eur J Cancer 2015; 51:869-78. [DOI: 10.1016/j.ejca.2015.01.056] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 01/13/2015] [Accepted: 01/16/2015] [Indexed: 10/23/2022]
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20
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Arévalo SP, Tucker KL, Falcón LM. Life events trajectories, allostatic load, and the moderating role of age at arrival from Puerto Rico to the US mainland. Soc Sci Med 2014; 120:301-10. [PMID: 25265208 PMCID: PMC4256941 DOI: 10.1016/j.socscimed.2014.09.040] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 09/16/2014] [Accepted: 09/19/2014] [Indexed: 01/28/2023]
Abstract
Our aim was to examine the effects of trajectories of stressful life events on allostatic load, measured over a two year time period, and to investigate the roles of language acculturation and age at migration in this association, in a sample of Puerto Rican migrants. We used data from the Boston Puerto Rican Health Study; a population-based prospective cohort of older Puerto Ricans recruited between the ages of 45 and 75 years. The Institutional Review Boards at Tufts Medical Center and Northeastern University approved the study. We used latent growth mixture modeling (LGMM) to identify different classes of two-year trajectories of stressful life events; analysis of variance to examine group differences by stress trajectory; and linear regression to test for the modifying effects of age at arrival on the association of stress trajectory with allostatic load at follow-up. In LGMM analysis, we identified three distinct stress trajectories; low, moderate ascending, and high. Unexpectedly, participants in the low stress group had the highest allostatic load at follow-up (F=4.4, p=0.01) relative to the other two groups. Age at arrival had a statistically significant moderating effect on the association. A reported two year period of moderate but repetitive and increasingly bad life events was associated with increases in allostatic load for participants who arrived to the U.S. mainland after the age of 5 years, and was particularly strong for those arriving between 6 and 11 years, but not for those arriving earlier or later. Results from this study highlight the complex effects of stress during the life course, and point to certain vulnerable periods for immigrant children that could modify long term effects of stress.
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Affiliation(s)
- Sandra P Arévalo
- College of Health Sciences, Clinical Laboratory and Nutritional Sciences, University of Massachusetts at Lowell, 3 Solomont Way, Suite 4, Weed Hall, Lowell, MA 01854, USA.
| | - Katherine L Tucker
- College of Health Sciences, Clinical Laboratory and Nutritional Sciences, University of Massachusetts at Lowell, 3 Solomont Way, Suite 4, Weed Hall, Lowell, MA 01854, USA
| | - Luis M Falcón
- College of Fine Arts, Humanities and Social Sciences, University of Massachusetts at Lowell, 150 Wilder St., Lowell, MA 01854, USA
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21
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22
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Stewart LM, Holman CDJ, Finn JC, Preen DB, Hart R. Association between in-vitro fertilization, birth and melanoma. Melanoma Res 2013; 23:489-95. [PMID: 24048222 DOI: 10.1097/cmr.0000000000000019] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A link between reproductive hormones and melanoma has long been suspected, and has been examined for numerous hormonal exposures, but the association between in-vitro fertilization (IVF) and melanoma has not been studied in depth. We used whole-population linked hospital and registry data to carry out a cohort study of women aged 20-44 years seeking hospital investigation and treatment for infertility in Western Australia from 1982 to 2002 with follow-up to 2010. The cohort comprised a total of 21 604 women followed for an average of 17.2 years. Of these, 7524 had IVF treatment, 14 870 gave birth and 149 women were diagnosed with an incident invasive melanoma. Using Cox regression analysis, we estimated hazard ratios (HRs) for melanoma associated with IVF and parity. Women who had IVF and gave birth had an increased rate of invasive melanoma compared with women who had IVF and remained nulliparous (HR 3.61; 95% confidence interval 1.79-7.26). There was little or no increase in the rate of invasive melanoma associated with giving birth in women who had non-IVF infertility treatment (HR 1.39; 95% confidence interval 0.88-2.20). These results suggest an association between reproductive factors and melanoma in the subgroup of women undergoing IVF treatment.
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Affiliation(s)
- Louise M Stewart
- aSchool of Population Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Crawley bSchool of Women's and Infant's Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Subiaco cFaculty of Health Sciences, Curtin University, Perth dFertility Specialists of Western Australia, Bethesda Hospital, Claremont, Western Australia eDepartment of Epidemiology and Preventive Medicine, The Alfred Centre, Monash University, Melbourne, Victoria, Australia
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23
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Levine H, Afek A, Shamiss A, Derazne E, Tzur D, Astman N, Keinan-Boker L, Mimouni D, Kark JD. Country of origin, age at migration and risk of cutaneous melanoma: a migrant cohort study of 1,100,000 Israeli men. Int J Cancer 2013; 133:486-94. [PMID: 23319364 DOI: 10.1002/ijc.28031] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 12/21/2012] [Indexed: 11/07/2022]
Abstract
Cutaneous melanoma (CM) is a common cancer with increasing incidence in many parts of the world where light-skinned populations live. We conducted a large-scale nationally representative migrant cohort study to assess country of origin and age at migration as predictors of CM, controlling for possible confounders. Data on 1,086,569 Israeli Jewish males, who underwent a general health examination before compulsory military service at ages 16-19 between the years 1967-2005, were linked to Israel National Cancer Registry to obtain incident CM up to 2006. Cox proportional hazards was used to model time to event. Overall, 1562 incident cases were detected during 19.3 million person-years of follow-up. Origin was a strong independent predictor of CM. Incidence was higher for European (hazard ratio [HR] = 4.08, 95% confidence interval [CI]: 3.55-4.67) and Israeli origin (HR = 2.92, 95% CI: 2.25-3.79) compared to N. African/Asian origin, adjusted for year of birth, years of education, residential socio-economic position, rural residence and body surface area (or height). Among those of European origin, the adjusted risk was significantly lower for those who immigrated after the age of 10 years (HR = 0.58, 95% CI: 0.45-0.73) but not for younger ages (HR = 1.02, 95% CI 0.84-1.23) compared to Israeli born. The high rates of CM among men of European origin and the almost twofold lower risk among those immigrating after age 10 provide solid support for the deleterious role of childhood sun exposure as a risk factor for melanoma. These findings will serve in directing public health and research efforts.
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Erdmann F, Lortet-Tieulent J, Schüz J, Zeeb H, Greinert R, Breitbart EW, Bray F. International trends in the incidence of malignant melanoma 1953-2008-are recent generations at higher or lower risk? Int J Cancer 2012; 132:385-400. [PMID: 22532371 DOI: 10.1002/ijc.27616] [Citation(s) in RCA: 421] [Impact Index Per Article: 35.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Accepted: 03/30/2012] [Indexed: 11/06/2022]
Affiliation(s)
- Friederike Erdmann
- Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France.
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25
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Anikeeva O, Bi P, Hiller JE, Ryan P, Roder D, Han GS. Trends in cancer mortality rates among migrants in Australia: 1981–2007. Cancer Epidemiol 2012; 36:e74-82. [DOI: 10.1016/j.canep.2011.10.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Revised: 10/24/2011] [Accepted: 10/25/2011] [Indexed: 01/19/2023]
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Rasulo D, Spadea T, Onorati R, Costa G. The impact of migration in all-cause mortality: the Turin Longitudinal Study, 1971-2005. Soc Sci Med 2012; 74:897-906. [PMID: 22326305 DOI: 10.1016/j.socscimed.2011.10.045] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Revised: 09/24/2011] [Accepted: 10/27/2011] [Indexed: 11/18/2022]
Abstract
North-western Italy has a long history of domestic influx, however little is known on how migrant mortality compares to mortality at the local level. While geographic mortality gradients may play a role, conceptualizations developed for international migration may also be relevant. Using this theoretical framework, the study investigated immigrant-native differentials in the north-western city of Turin through a 34-year follow-up that was facilitated by the Turin Longitudinal Study. The study population comprised inhabitants of age 30-74 years at the 1971 census. Survival trajectories were modelled through the Gompertz distribution and were examined for nativity status, birthplace, length of stay and age at arrival (the last two variables were combined). All estimates were adjusted for socio-economic factors. Overall, the risk of dying for internal migrants was lower, compared to locals, and consistent with geographic gradients. However, this pattern hid significant differences mediated by both age at arrival and length of stay. The advantage appeared to be exclusive to young and adult migrants, despite differentials narrowing over time. Immigrants who arrived after age 44 suffered instead a progressively greater excess risk, compared to natives, as residence increased. The dissipation of the health advantage found in internal migrants, along with poor health outcomes amongst people older at arrival, raises concern about immigrants from developing countries who need to endure a more demanding journey and adjustment to the new environment. The study indicated, through lengthy longitudinal data, that immigrant-native differentials were best explained by the stratified variable 'length of stay by age at arrival' and this should inform future studies.
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Affiliation(s)
- Domenica Rasulo
- Regional Epidemiology Unit, ASL TO3 Piedmont Region, Via Sabaudia 164, 10095 Grugliasco, Turin, Italy.
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27
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Berwick M. How do solar UV irradiance and smoking impact the diagnosis of second cancers after diagnosis of melanoma?: No answer yet. DERMATO-ENDOCRINOLOGY 2012; 4:18-19. [PMID: 22870348 PMCID: PMC3408987 DOI: 10.4161/derm.19832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
It may be useful to look at the risk patterns for developing a second primary malignancy after a first primary melanoma diagnosis in order to understand the etiology and mortality due to melanoma. In this volume, W.B. Grant has proposed the interesting hypothesis that solar UV radiation and smoking may be inversely associated with the development of melanoma through the presence of dermal or solar elastosis. However, this association is inconsistent and may be explained by confounding by outdoor activity, physical exercise, obesity, diet and underlying immune or genetic factors.
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Affiliation(s)
- Marianne Berwick
- University of New Mexico Cancer Center; Department of Internal Medicine; University of New Mexico; Albuquerque, NM USA
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28
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UV and children's skin. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2011; 107:386-8. [PMID: 21907231 DOI: 10.1016/j.pbiomolbio.2011.08.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 08/25/2011] [Indexed: 12/17/2022]
Abstract
There is indicative epidemiological evidence that exposures of children younger than about 10 years are linked with an increased risk of the development of malignant melanoma as well as non-melanocytic skin cancers later in life. However, an important area of uncertainty relates to lack of knowledge of the sun-sensitivity of children's skin both absolutely and relative to that of adult's skin. For example the thickness of children's skin is very similar to that of adults but due to the nature of the anatomical structure of children's skin, there are indications of children's skin being adversely exposed on the top of the papilla before a significant exposure manifests itself as visible damage to the skin (for example erythema). This might also affect the induction of heavily UV-damaged cells persisting in the basal layer of the epidermis after UV-exposure which are supposed to be keratinocytic epidermal stem cells and may characterize an initiation step of non-melanoncytic skin cancer. For malignant melanoma the number of nevi received in dependence of UV-exposure in childhood is a clear risk factor. Recent data show that the bulge region of hair follicles hosting melanocytic stem cells are located deeper (more protected) in the skin in adults (terminal hair) as compared to pre-pubertal children (vellus hair). This may be an explanation for enhanced risk of malignant melanoma due to UV-exposure in pre-pubertal childhood.
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29
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Greinert R, Boniol M. Skin cancer--primary and secondary prevention (information campaigns and screening)--with a focus on children & sunbeds. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2011; 107:473-6. [PMID: 21906618 DOI: 10.1016/j.pbiomolbio.2011.08.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 08/25/2011] [Indexed: 10/17/2022]
Abstract
Solar and artificial (sunbed) UV-exposure is the main risk factor for the development of epithelial skin cancer (basal cell carcinoma, BCC, and squamous cell carcinoma, SCC) as well for malignant melanoma (MM). UV exposure in childhood and adolescence is especially important. Therefore, adequate methods of primary prevention have continuously to be used and to be developed further to target these age-groups in order to reduce the risks of intensive UV-exposure. Primary prevention can effectively be combined with secondary prevention (early detection, screening) to reduce the burden of skin cancer and to decrease incidence, morbidity and mortality.
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Affiliation(s)
- Rüdiger Greinert
- Department Molecular Cellbiology, Dermatology Center Buxtehude, Elbekliniken Stade/Buxtehude, Klinikum Buxtehude, Buxtehude, Germany.
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30
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Callister P, Galtry J, Didham R. The risks and benefits of sun exposure: should skin colour or ethnicity be the main variable for communicating health promotion messages in New Zealand? ETHNICITY & HEALTH 2011; 16:57-71. [PMID: 21213156 DOI: 10.1080/13557858.2010.527925] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Using New Zealand as a case study, to determine whether ethnicity is appropriate for communicating sun exposure health promotion messages. DESIGN This study reviews recent literature on minimising skin cancer risk and achieving sufficient serum vitamin D levels. It draws on a variety of scientific literature, reports and media statements to determine appropriate sun exposure messages for minimising skin cancer risk and achieving sufficient vitamin D status among the New Zealand population, which is diverse with regards to both ethnicity and skin colour. RESULT(S) Due to a unique combination of factors, New Zealand and Australia lead the world in melanoma incidence. Devising ways of minimising skin cancer risk and achieving optimal vitamin D blood levels among the New Zealand population provide major challenges for researchers and health promoters. These challenges include the many unknowns and uncertainties about vitamin D, such as determining what constitutes an optimal level as well as its association with specific diseases. There is strong evidence that skin cancer, including melanoma, is caused by excess harmful sun exposure with skin colour having long been established as a risk factor. More recently, there has been significant focus in New Zealand on the potential beneficial aspects of sun exposure, mainly in assisting vitamin D synthesis, especially for Maori and Pacific people. But research also shows that Maori and Pacific people are increasingly at risk of developing melanoma. In New Zealand, where there is a high rate of ethnic intermarriage and ethnicity is culturally constructed, there is likely to have been a weakening of the relationship between ethnicity and skin colour. Skin colour information is required to understand both the risks and benefits of sun exposure. In the immediate future, ethnicity appears likely to remain an important reference point for assessing the risks and benefits of sun exposure in New Zealand. However, we contend that while ethnic-based channels may be useful for communicating appropriate sun exposure messages, there are dangers in such advice based on membership of particular ethnic group(s). Rather skin colour, along with other key variables, such as season and time of day, should be the core considerations for assessing and discussing risk. In the longer term, direct measures of skin type are needed when assessing the risks and benefits of sun exposure, including the potential protective effects against various illnesses. CONCLUSION While ethnic-based dissemination channels may be useful for communicating about the risks and benefits of sun exposure in New Zealand, discussion of risk factors should focus on skin colour.
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Affiliation(s)
- Paul Callister
- Institute of Policy Studies, Victoria University, Wellington, New Zealand.
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31
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McGee HM, Malley RC, Muller HK, Woods GM. Neonatal exposure to UVR alters skin immune system development, and suppresses immunity in adulthood. Immunol Cell Biol 2011; 89:767-76. [DOI: 10.1038/icb.2010.170] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Heather M McGee
- Cancer and Immunology Research Group, Menzies Research Institute, University of Tasmania Hobart Tasmania Australia
| | - Roslyn C Malley
- School of Medicine, University of Tasmania Hobart Tasmania Australia
| | - H Konrad Muller
- School of Medicine, University of Tasmania Hobart Tasmania Australia
| | - Gregory M Woods
- Cancer and Immunology Research Group, Menzies Research Institute, University of Tasmania Hobart Tasmania Australia
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32
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Skin cancer risk factors among primary school children: investigations in Western Hungary. Prev Med 2010; 51:320-4. [PMID: 20637225 DOI: 10.1016/j.ypmed.2010.07.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Revised: 05/15/2010] [Accepted: 07/07/2010] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the factors associated with sunburns and with sun protection practice in Hungarian primary school children. METHOD We investigated children's (the median age: 8, range 5 to 12 years) and parents' assessment of sun sensitivity and sun protection characteristics in cities Gyor and Zalaegerszeg (Hungary) in 2004. This cross-sectional study was part of a programme intended to increase children's and parents' awareness of harmful effects of excessive sunbathing. Analyses were based on 1804 multiple choice questionnaires. RESULTS At multivariate analysis a significant association between sunburns and fairness of complexion, freckles, use of sunscreens and T-shirts, and higher school-class level was observed. Sunburn was inversely associated with hat-wearing. Parents were more likely to apply sunscreen to children with light eyes and to the younger ones, to protect fair skinned children with T-shirts; to protect males and children with fair skin and light eyes with hats. CONCLUSION Since environmental factors play an important role in the development of skin cancer, morbidity could be reduced by primary prevention. Sun protection habits should therefore be taught early in life, and parents' behaviour adapted. Phenotype is not only related to sunburns but it also appears to influence parents' sun safety behaviour.
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Vitamin D: bone and beyond, rationale and recommendations for supplementation. Am J Med 2009; 122:793-802. [PMID: 19699370 DOI: 10.1016/j.amjmed.2009.02.029] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2008] [Revised: 01/11/2009] [Accepted: 02/27/2009] [Indexed: 01/05/2023]
Abstract
Adequate vitamin D status is necessary and beneficial for health, although deficiency plagues much of the world's population. In addition to reducing the risk for bone disease, vitamin D plays a role in reduction of falls, as well as decreases in pain, autoimmune diseases, cancer, heart disease, mortality, and cognitive function. On the basis of this emerging understanding, improving patients' vitamin D status has become an essential aspect of primary care. Although some have suggested increased sun exposure to increase serum vitamin D levels, this has the potential to induce photoaging and skin cancer, especially in patients at risk for these conditions. Vitamin D deficiency and insufficiency can be both corrected and prevented safely through supplementation.
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Ott JJ, Paltiel AM, Winkler V, Becher H. The impact of duration of residence on cause-specific mortality: a cohort study of migrants from the Former Soviet Union residing in Israel and Germany. Health Place 2009; 16:79-84. [PMID: 19758834 DOI: 10.1016/j.healthplace.2009.08.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2009] [Revised: 08/24/2009] [Accepted: 08/24/2009] [Indexed: 12/31/2022]
Abstract
A cohort study of migrants from the Former Soviet Union in Israel (N=528,848) and in Germany (N=34,393) was conducted. The impact of length of residence on cause-specific mortality was investigated using Poisson regression and differences between the migrant groups were assessed. In both migrant cohorts, all cause mortality in males but not in females significantly decreased with increasing duration of residence (RR=0.76, 95% CI: 0.73-0.79 for 9+years of residence compared to 0-3 years), specifically in Israel for infectious diseases, cancer and CVD. For male and female migrants in Israel there was a large reduction in external cause mortality. The cancer risk in male migrants declined from 1 to 0.76 (95% CI: 0.69-0.83) and in female migrants to 0.85 (95% CI: 0.78-0.93) after nine and more years of stay. Adjusting for several covariables, there were differences between migrants in the cause of death patterns in the two host countries, which may be associated with differences in their initial conditions or with effects of the destination country. The study highlights the need for migrant-specific prevention approaches.
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Affiliation(s)
- J J Ott
- Unit of Epidemiology and Biostatistics, Institute of Public Health, Medical Faculty of University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany.
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Dobbinson SJ, White V, Wakefield MA, Jamsen KM, White V, Livingston PM, English DR, Simpson JA. Adolescents' use of purpose built shade in secondary schools: cluster randomised controlled trial. BMJ 2009; 338:b95. [PMID: 19223344 PMCID: PMC2645844 DOI: 10.1136/bmj.b95] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine whether students use or avoid newly shaded areas created by shade sails installed at schools. DESIGN Cluster randomised controlled trial with secondary schools as the unit of randomisation. SETTING 51 secondary schools with limited available shade, in Australia, assessed over two spring and summer terms. PARTICIPANTS Students outside at lunch times. INTERVENTION Purpose built shade sails were installed in winter 2005 at full sun study sites to increase available shade for students in the school grounds. MAIN OUTCOME MEASURE Mean number of students using the primary study sites during weekly observations at lunch time. RESULTS Over the study period the mean change in students using the primary study site from pre-test to post-test was 2.63 (95% confidence interval 0.87 to 4.39) students in intervention schools and -0.03 (-1.16 to 1.09) students in control schools. The difference in mean change between groups was 2.67 (0.65 to 4.68) students (P=0.011). CONCLUSIONS Students used rather than avoided newly shaded areas provided by purpose built shade sails at secondary schools in this trial, suggesting a practical means of reducing adolescents' exposure to ultraviolet radiation. TRIAL REGISTRATION Exempt.
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Affiliation(s)
- Suzanne J Dobbinson
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 1 Rathdowne Street, Carlton, Vic 3053, Australia.
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McGee HM, Dharmadasa T, Woods GM. Solar simulated ultraviolet radiation damages murine neonatal skin and alters Langerhans cell development, but does not induce inflammation. Photochem Photobiol Sci 2009; 8:881-6. [DOI: 10.1039/b822591e] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Valiukeviciene S, Gollnick H, Stang A. Body-site distribution of common acquired melanocytic nevi associated with severe sunburns among children in Lithuania. Int J Dermatol 2008; 46:1242-9. [PMID: 18173516 DOI: 10.1111/j.1365-4632.2007.03369.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aim of this cross-sectional study is to provide information on subsite-specific densities of melanocytic nevi by age, sex, and in relation to the history of severe sunburns. MATERIALS AND METHODS This study was conducted in Kaunas, Lithuania, on a sample of 484 children aged 1-2 years, 4-5 years, 9-10 years, and 14-15 years. The questionnaire provided information about the history of severe sunburns since birth. Site-specific numbers and densities of melanocytic nevi of all sizes and nevi 2 mm or greater were studied. We used log-linear and Poisson regression models to estimate the effects of age, sex, and severe sunburns on the nevus density. RESULTS The predicted total body density of nevi shows a considerable increase up to the age of roughly 10 years. Thereafter, the density increase tapered off. Median densities of nevi were highest on the face. The median density of nevi on the upper arms is higher than on the forearms. Similarly, the median density of nevi on the thighs is higher than on the lower legs. Estimates of the relative nevus densities related to the history of severe sunburns tend to be small with the exception of the legs for nevi 2 mm or greater (relative nevus density = 2.09, 95% CI 1.49-2.93). CONCLUSION Nevus densities are highest on maximally or intermittently sun-exposed skin areas. With the exception of the legs among women, the subsite-specific ranking of nevus densities among adolescents follows a similar ranking as the skin melanoma incidence in Lithuania.
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Muller HK, Malley RC, McGee HM, Scott DK, Wozniak T, Woods GM. Effect of UV Radiation on the Neonatal Skin Immune System- Implications for Melanoma†. Photochem Photobiol 2007; 84:47-54. [DOI: 10.1111/j.1751-1097.2007.00246.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Grange F, Grob JJ. Soleil, nævus et risque de mélanome. Ann Dermatol Venereol 2007. [DOI: 10.1016/s0151-9638(07)89243-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Carter OBJ, Donovan RJ. Public (Mis)understanding of the UV Index. JOURNAL OF HEALTH COMMUNICATION 2007; 12:41-52. [PMID: 17365348 DOI: 10.1080/10810730601093371] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The ultraviolet index (UVI) has been regularly reported in Australia for a decade but utilisation remains extremely low ( approximately 5%). Blunden, Lower, and Slevin, in a 2004 Journal of Health communication article, suggest that Australians' understanding of the UVI is "good," and education to increase awareness of the index is therefore no longer warranted. To test this position, focus groups were conducted followed by an intercept survey of 404 residents of Perth, Western Australia, aged 16-44 years, to explore understanding and familiarity with the UVI. Results suggested that far from being "good," the familiarity and understanding of the UVI of at least half of Australians is poor. This was exemplified by the following: mean estimations of average UVI values in summer and winter being highly exaggerated (19.8 and 11.8, respectively); 61.2% not appreciating that the UVI is independent of temperature; at least 55.0% not appreciating that UV conditions peak at solar noon; and 23.3% of 22-44 year olds confusing the UVI with a "burn-time" measure. People who do not understand the UVI are unlikely to utilise it effectively. It therefore remains possible that utilisation of the UVI remains low because understanding is poor. Future efforts to improve utilisation of the UVI, particularly among those looking at new display formats, may therefore be ineffective, unless they also incorporate strategies to facilitate understanding of the measure.
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Affiliation(s)
- Owen B J Carter
- Centre for Behavioural Research in Cancer Control, Curtin University of Technology, Perth, Western Australia.
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Le Marchand L, Saltzman BS, Hankin JH, Wilkens LR, Franke AA, Morris SJ, Kolonel LN. Sun exposure, diet, and melanoma in Hawaii Caucasians. Am J Epidemiol 2006; 164:232-45. [PMID: 16524953 DOI: 10.1093/aje/kwj115] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Much uncertainty remains about the type of sunlight exposure that most increases risk of cutaneous melanoma and the role of diet. The authors conducted a population-based case-control study (1986-1992) of Caucasians living on Oahu, Hawaii; included were 278 cases and age- and sex-matched controls. Plasma samples were measured for retinol, carotenoids, and alpha-tocopherol by high-pressure liquid chromatography. Selenium was measured in blood and toenails by neutron activation. Celtic and English ancestries, migration to Hawaii before age 20 years, fair complexion, inability to tan, and family history of skin cancer, as well as height, hours spent in the summer sun, blistering sunburns during adolescence, and moles, all increased melanoma risk. With regard to diet and biomarkers, only alcohol was associated with risk. The odds ratios for increasing tertiles of lifetime ethanol intake were 1.0, 1.2 (95% confidence interval (CI): 0.6, 2.2), and 2.3 (95% CI: 1.2, 4.4) (p for trend = 0.01) for men and 1.0, 1.1 (95% CI: 0.5, 2.4), and 1.7 (95% CI: 0.7, 3.8) (p for trend = 0.19) for women. Dietary lipids were unrelated to risk, but polyunsaturated fat intake appeared to modify the effects of alcohol and toenail selenium on melanoma risk. These data provide additional evidence for the association of constitutional susceptibility factors, intense sun exposure (particularly before age 20 years), and alcohol consumption with melanoma risk.
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Affiliation(s)
- Loïc Le Marchand
- Epidemiology Program, Cancer Research Center of Hawaii, University of Hawaii, Honolulu, 96813, USA.
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Giblin AV, Thomas JM. Incidence, mortality and survival in cutaneous melanoma. J Plast Reconstr Aesthet Surg 2006; 60:32-40. [PMID: 17126264 DOI: 10.1016/j.bjps.2006.05.008] [Citation(s) in RCA: 121] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2006] [Revised: 04/25/2006] [Accepted: 05/02/2006] [Indexed: 11/26/2022]
Abstract
Cutaneous melanoma remains a challenge despite increased levels of awareness, education and targeted health policies. Worldwide incidence rates for cutaneous melanoma have risen faster than those for any other malignancy in Caucasian populations over the last 30 years. Despite improving survival rates (defined as the ratio of those who survive the disease against incidence) over this period, mortality rates, generally, have continued to climb. Mortality from melanoma is greater than that caused by all other types of skin cancer, especially in men. In Britain the percentage of increase in the male age standardised mortality rate surpassed that of all other malignancies assessed (1993-2002) by Cancer Research UK. A literature-based study was conducted with review of publications identified through Medline and EMBase, 1980-December 2005, databases. We present a review of the current literature on incidence, mortality and survival rates of melanoma including a discussion on the aetiological factors, behaviour modification associated with public education campaigns and recent health policies and the effect these are having on melanoma figures. It is likely that any fall in mortality rates from melanoma in the near future will be secondary to early detection. Changes resulting from primary prevention are unlikely to be noticeable for several decades.
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Affiliation(s)
- A-V Giblin
- Melanoma and Sarcoma Surgical Unit, Royal Marsden Hospital, 203 Fulham Road, London SW3 6JJ, UK.
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Pearce J, Barnett R, Kingham S. Slip! Slap! Slop! Cutaneous malignant melanoma incidence and social status in New Zealand, 1995-2000. Health Place 2006; 12:239-52. [PMID: 16546691 DOI: 10.1016/j.healthplace.2004.11.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/20/2004] [Indexed: 10/25/2022]
Abstract
Numerous studies have noted a strong social gradient in many types of ill health. In particular, people in more deprived areas tend to be less healthy than those in more affluent communities, even once the demographic and socio-economic differences of the people in those areas have been taken into account. The social gradient is evident for many types of health outcomes, including diseases such as cancer. However, this positive relationship is not evident for rates of melanoma incidence and mortality, with rates of the disease tending to decrease with measures of disadvantage. In this study, we assess the relationship between the incidence of melanoma and deprivation in New Zealand, a country with particularly high rates of the disease. In the light of greater public awareness of the risk factors associated with melanoma, through public awareness campaigns such as 'Slip! Slap! Slop' and 'No Suntan is Safe', we analyse small-area data on standardised rates of melanoma for the period 1995-2000. We found that melanoma rates increase with social status, even once other confounding factors are controlled for, but that the relationship is very small. Furthermore, the relationship between melanoma incidence and deprivation is context-dependent. Possible explanations for the relationship between melanoma and deprivation are discussed, including more frequent exposure to intermittent sunshine among less disadvantaged groups and the underreporting of melanoma incidence in the New Zealand cancer registry among individuals in lower social groups.
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Affiliation(s)
- Jamie Pearce
- Department of Geography, University of Canterbury, Private Bag 4800, Christchurch 8020, New Zealand.
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Zeller S, Lazovich D, Forster J, Widome R. Do adolescent indoor tanners exhibit dependency? J Am Acad Dermatol 2006; 54:589-96. [PMID: 16546579 DOI: 10.1016/j.jaad.2005.12.038] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2005] [Revised: 12/13/2005] [Accepted: 12/16/2005] [Indexed: 01/27/2023]
Abstract
BACKGROUND Indoor tanning is a common adolescent risk behavior that has been hypothesized to be motivated and maintained by the mood-altering effects of ultraviolet light. OBJECTIVE Our purpose was to explore heretofore anecdotal reports that indoor tanning leads to dependency. METHODS A telephone interview was conducted among 1275 adolescents, ages 14 to 17 years. Self-reported difficulty in quitting indoor tanning was assessed among 267 adolescents (20.9% of total) who tanned indoors more than once in the previous year in relation to age of initiation, frequency of use, and positive or negative consequences of the practice. RESULTS Difficulty in quitting was more likely with younger age at initiation (age 13 years or younger vs ages 16 to 17; odds ratio = 4.3, 95% confidence interval 1.3-14.7) and higher frequency of use (P = .009), even after accounting for positive or negative consequences of indoor tanning and other demographic characteristics. LIMITATIONS This was a cross-sectional study design with a limited outcome measure. CONCLUSION Although preliminary, our findings for age at initiation and frequency of use in relation to difficulty in quitting indoor tanning are consistent with other potentially addictive behaviors taken up during adolescence.
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Affiliation(s)
- Sarah Zeller
- School of Public Health University of Minnesota, Minneapolis, Minnesota, USA
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Kojo K, Jansen CT, Nybom P, Huurto L, Laihia J, Ilus T, Auvinen A. Population exposure to ultraviolet radiation in Finland 1920-1995: Exposure trends and a time-series analysis of exposure and cutaneous melanoma incidence. ENVIRONMENTAL RESEARCH 2006; 101:123-31. [PMID: 16290819 DOI: 10.1016/j.envres.2005.09.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2005] [Accepted: 09/26/2005] [Indexed: 05/05/2023]
Abstract
Ultraviolet radiation (UVR) is the principal cause of cutaneous malignant melanoma (CMM). However, the relation between CMM and UVR exposure is not clear. We present the trends of population exposure to UVR and conduct a time-series analysis of the relation between UVR exposure and incidence of CMM. Data on CMM incidence were obtained from the Finnish Cancer Registry. Clothing coverage of the body was scored from archival photographs and the proportion of uncovered skin was used as a measure of solar exposure. Information on the number of sunny resort holidays, duration of annual holidays, and sunscreen sales were obtained from various sources. Exposed skin area doubled from 1920 to 1985. The average duration of annual holidays increased 30-fold. The number of sunny resort holidays and the sales of sunscreens increased rapidly from 1980. CMM was most strongly associated with solar exposure of 5-19 years earlier. There is a considerable decrease in clothing coverage during the 20th century. UVR exposure preceding CMM occurrence 4 years or less does not appear relevant, whereas the period 5-19 years prior to CMM occurrence might be the most relevant period. However, findings of ecological studies may not be applicable at the individual level.
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Affiliation(s)
- Katja Kojo
- STUK-Radiation and Nuclear Safety Authority, 00881 Helsinki, Finland.
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Role of Sun Exposure in Melanoma. Dermatol Surg 2006. [DOI: 10.1097/00042728-200604000-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
BACKGROUND Malignant melanoma is the third most common skin cancer in the United States. It is commonly thought that sun exposure is causative in these tumors. Recently, however, the significance of the role of sun exposure in melanoma has come into question. Some have suggested that other factors, such as genetics, play a larger role, and that sun protection may even be harmful. OBJECTIVE AND METHODS To investigate the role of sun exposure in melanoma etiology. An extensive review of basic science and clinical literature on this subject was conducted. RESULTS Although exceptions exist, sun exposure likely plays a large role in most melanomas. The pattern of this exposure, however, is not fully known, and controversy exists, especially in the use of sunscreens. Sun exposure may interact with genetic factors to cause melanomas, and sun protective measures appear to be prudent. CONCLUSIONS The cause of melanoma is probably variable and multifactorial. Sun exposure may play a primary or supporting role in most melanoma tumors.
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Affiliation(s)
- Gil B Ivry
- Department of Dermatology, USC Keck School of Medicine, Los Angeles, California, USA
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Abstract
BACKGROUND As skin cancer education programmes directed to children and adolescents continue to expand, an epidemiological basis for these programmes is necessary to target efforts and plan for further evaluation. AIMS To summarise the epidemiological evidence on sun exposure during childhood and adolescence and melanoma risk. METHODS A literature review was conducted using Medline (1966 to December 2004) to identify articles relating to sun exposure and melanoma. The review was restricted to studies that included sun exposure information on subjects 18 years of age or younger. RESULTS Migrant studies generally indicate an increased melanoma risk in individuals who spent childhood in sunny geographical locations, and decreasing melanoma risk with older age at arrival. Individuals who resided in geographical locations close to the equator or close to the coast during childhood and/or adolescence have an increased melanoma risk compared to those who lived at higher latitudes or never lived near the coast. The intermittent exposure hypothesis remains controversial; some studies indicate that children and adolescents who received intermittent sun exposure during vacation, recreation, or occupation are at increased melanoma risk as adults, but more recent studies suggest intermittent exposure to have a protective effect. The majority of sunburn studies suggest a positive association between early age sunburn and subsequent risk of melanoma. CONCLUSION Future research efforts should focus on: (1) clarifying the relation between sun exposure and melanoma; (2) conducting prospective studies; (3) assessing sun exposure during different time periods of life using a reliable and quantitative method; (4) obtaining information on protective measures; and (5) examining the interrelations between ability to tan, propensity to burn, skin type, history of sunburns, timing and pattern of sun exposure, number of nevi, and other host factors in the child and adolescent populations.
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Affiliation(s)
- S A Oliveria
- Department of Medicine, Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
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