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Chambers DB, Ghosh S, Taher MS, Salopek TG. Incidence of Nonmelanoma Skin Cancers in Alberta, Canada, From 2007 to 2018. J Cutan Med Surg 2024:12034754241232677. [PMID: 38374688 DOI: 10.1177/12034754241232677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
BACKGROUND Nonmelanoma skin cancer (NMSC) is the most common malignancy affecting Caucasian populations and has been seeing steady increases in incidence globally for decades. Our previous study (from Alberta, Canada) had shown a plateau in the incidence rates for NMSC. This contrasts with data from other regions within Canada and throughout the world that indicated a continued increase in incidence rates of NMSCs. OBJECTIVES The objective of this study was to provide an update on the trends in incidence of NMSC in Alberta, Canada, from 2007 to 2018. METHODS A retrospective analysis of patients from Alberta diagnosed with NMSC from 2007 to 2018 inclusive was conducted with data retrieved from Alberta Cancer Registry. Sex-, age-, anatomical location-, NMSC subtype-, stage-specific incidence rates and trends were examined. RESULTS From 2007 to 2018, overall incidence rates of NMSC increased by 36%. Invasive squamous cell carcinoma (SCC) and in situ SCC demonstrated the most significant increase, invasive SCC [annual percentage change (APC) 3.48, P = .014] and in situ SCC (APC 5.61, P = .0001). In addition, we were able to determine that females had the most significant increases in NMSC incidence rates from 2007 to 2018 particularly invasive SCC (APC 3.03, P = <.0001) and in situ SCC (APC 5.08, P = <.0001). CONCLUSIONS After initial levelling of NMSC incidence in Alberta in the early part of 21st century, the incidence of NMSC continues to increase over the past decade. The reasons for this change are not clear and likely multifactorial.
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Affiliation(s)
- Daniel B Chambers
- Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Sunita Ghosh
- Department of Medical Oncology, University of Alberta, Edmonton, AB, Canada
| | - Muba S Taher
- Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Thomas G Salopek
- Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
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Wang T, Rho O, Eguiarte-Solomon F, DiGiovanni J. Twist1 as a target for prevention of cutaneous squamous cell carcinoma. Mol Carcinog 2023; 62:62-76. [PMID: 36373194 PMCID: PMC9772054 DOI: 10.1002/mc.23482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/13/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022]
Abstract
Cutaneous squamous cell carcinoma (cSCC) represents an important clinical problem requiring novel approaches for both prevention and treatment. The transcription factor, Twist-related protein 1 (Twist1), has been identified as having a key mechanistic role in the development and progression of cSCC. Studies in relevant mouse models of cSCC have shown that Twist1 regulates epithelial-mesenchymal transition (EMT) and stemness driving progression and metastasis of cSCC. In addition, further research has shown that Twist1 regulates the balance between keratinocyte proliferation and differentiation and therefore impacts earlier stages of cSCC development. Through use of keratinocyte specific Twist1 knockout models, a role for this gene in keratinocyte stem cell homeostasis has been revealed. As a transcription factor, Twist1 regulates a large number of genes both in a positive, as well as a negative manner across several interdependent pathways. Studies in keratinocyte specific knockout models have shown that Twist1 upregulates the expression of genes involved in proliferation, stemness, and EMT while downregulating the expression of genes associated with differentiation. Furthermore, a number of compounds, including naturally occurring compounds, have been identified that target Twist1 and can block its effects in cancer cells and in keratinocytes in vivo. Collectively, the current understanding of Twist1 function in cSCC development and progression suggests that it represents a potential target for prevention and treatment of cSCC.
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Affiliation(s)
- Tingzeng Wang
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Austin, TX 78723, United States
| | - Okkyung Rho
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Austin, TX 78723, United States
| | - Fernando Eguiarte-Solomon
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Austin, TX 78723, United States
| | - John DiGiovanni
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Austin, TX 78723, United States
- Center for Molecular Carcinogenesis and Toxicology, The University of Texas at Austin, Austin, TX 78723, United States
- Livestrong Cancer Institutes, Dell Medical School, The University of Texas at Austin, Austin, TX 78723, United States
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3
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Sutedja EK, Arianto TR, Lesmana R, Suwarsa O, Setiabudiawan B. The Chemoprotective Role of Vitamin D in Skin Cancer: A Systematic Review. Cancer Manag Res 2022; 14:3551-3565. [PMID: 36583029 PMCID: PMC9793722 DOI: 10.2147/cmar.s389591] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Research in mice showed that vitamin D receptor deficiency was correlated with an increased rate of non-melanoma skin cancer. Therapeutic supplemental vitamin D has also been reported to reduce cell growth in both melanoma and non-melanoma skin cancer. This paper aims to describe the existing research studies that discuss the potential and role of vitamin D in the management of skin cancer. Methods Articles were searched from three databases (PubMed, ScienceDirect, Scopus) and manual search. 18 articles were included. These were further divided into in vivo and in vitro studies. The literature search was based on the following Patients, Intervention, Control, and Outcome (PICO) criteria: Patients with any types of skin cancer; Vitamin D and their derivates as the intervention; placebo or standard regimen as control, and survival rate or response rate as primary outcome. Results From the three databases, we obtained 802 studies. Prior to screening of the literature obtained, several studies were excluded. In the eligibility assessment, seven studies were excluded due to their outcomes being not eligible for analysis, and two studies were excluded due to inaccessible full texts. The remaining 18 studies were included. Five studies had a clinical research design (randomized controlled trial or interventional study), which use vitamin D3 as vitamin D derivatives and the results showed that the administration of vitamin D3 reduces the proliferation of skin cancer cells. Similar results were also reported in studies with pre-clinical research designs, either in vivo or in vitro, where six were in vivo studies and nine studies were in vitro studies. Conclusion Our literature review revealed that that vitamin D derivatives, such as 1,25(OH)2D3 or 20(OH)D3 can effectively reduce the proliferation of skin cancer cells by contributing in the inhibition of cell growth and development, highlighting vitamin D's role as good prognostic factor.
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Affiliation(s)
- Eva Krishna Sutedja
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Padjadjaran – Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia,Correspondence: Eva Krishna Sutedja, Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Jl. Pasteur No. 38, Bandung, West Java, 40161, Indonesia, Tel +62222032426 ext. 3449, Fax +62222032426, Email
| | - Tiara Rachmaputeri Arianto
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Padjadjaran – Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia
| | - Ronny Lesmana
- Department of Physiology, Faculty of Medicine Universitas Padjadjaran – Dr. Hasan Sadikin Hospital Bandung, Bandung, West Java, Indonesia
| | - Oki Suwarsa
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Padjadjaran – Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia
| | - Budi Setiabudiawan
- Department of Child Health, Faculty of Medicine Universitas Padjadjaran – Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia
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Abstract
OPINION STATEMENT Advanced non-melanoma skin cancers have been challenging to treat due to limited treatment options. Treatment paradigm has shifted with the approval of immunotherapeutic agents cemiplimab and pembrolizumab which have been a key development and have changed the landscape of advanced or metastatic squamous cell skin cancers. Hedgehog inhibitors, vismodegib and sonidegib, remain upfront options for advanced or metastatic basal cell carcinomas. Current clinical trials are continuing to evaluate the use of immune checkpoint inhibitors and hedgehog pathway inhibitors. There is further need for ongoing research and development of new therapies in both malignancies.
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Affiliation(s)
- Priyanka Reddy
- Department of Hematology and Oncology, Department of Radiation Oncology, Case Comprehensive Cancer Center, 11100 Euclid Ave., Cleveland, OH, 44106, USA
| | - Min Yao
- Department of Radiation Oncology, Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, 11100 Euclid Ave., Cleveland, OH, 44106, USA
| | - Monaliben Patel
- Department of Oncology, Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.
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Day AT, Salley JR, Nijhawan RI. The Nose Knows That Margins Matter. Ann Surg Oncol 2021; 28:3468-3469. [PMID: 33768397 DOI: 10.1245/s10434-021-09881-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 03/08/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Andrew T Day
- Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, TX, USA.
| | - Jordan R Salley
- Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Rajiv I Nijhawan
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Suneet K, De T, Rangarajan A, Jain S. Magnetic nanofibers based bandage for skin cancer treatment: a non-invasive hyperthermia therapy. Cancer Rep (Hoboken) 2020; 3:e1281. [PMID: 32881425 PMCID: PMC7941538 DOI: 10.1002/cnr2.1281] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The treatment of non-melanoma skin cancer and deadliest malignant melanoma skin cancer are the fifth and ninth most expensive treatments in Medicare, respectively. Moreover, the recurrence of cancer after currently available therapies, that is, surgery or radiotherapy, reduces the patient's life expectancy. AIMS In view of this, we fabricated magnetic nanofibrous mat-based bandage to treat skin cancer non-invasively using an external alternating current (AC) magnetic field induced hyperthermia. METHODS The Fe3 O4 nanoparticles incorporated polycaprolactone (PCL) fibers based bandages were fabricated using the electrospinning technique. The efficacy of the bandage was investigated in vitro using parental/doxorubicin hydrochloride (Dox)-resistant HeLa cells and in vivo using BALB/c mouse model in the presence of an external AC magnetic field (AMF). RESULTS The PCL-Fe3 O4 fibrous mat-based bandages dissipate heat energy locally on the application of an external AMF and increase the surrounding temperature in a controlled way up to 45°C in a few mins. The in vitro study confirms the elevated temperature could kill parental and Dox-resistant HeLa cells significantly. As the activity of Dox enhanced at a higher temperatures, more than 85% of parental HeLa cells were dead when cells incubated with Dox contained fibrous mat in the presence of AMF for 10 minutes. Further, we confirm the full recovery of chemically induced skin tumors on BALB/c mice within a month after five hyperthermic doses for 15 minutes. Also, there was no sign of inflammation and recurrence of cancer post-therapy. CONCLUSION The present study confirms the PCL-Fe3 O4 nanofibrous based bandages are unique and compelling to treat skin cancer.
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Affiliation(s)
- Kaushik Suneet
- Centre for Biosystems Science and Engineering, Indian Institute of Science, Bangalore, Karnataka, India
| | - Tamasa De
- Department of Molecular Reproduction, Development and Genetics, Indian Institute of Science, Bangalore, Karnataka, India
| | - Annapoorni Rangarajan
- Department of Molecular Reproduction, Development and Genetics, Indian Institute of Science, Bangalore, Karnataka, India
| | - Shilpee Jain
- Centre for Biosystems Science and Engineering, Indian Institute of Science, Bangalore, Karnataka, India
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Malaguarnera G, Latteri S, Madeddu R, Catania VE, Bertino G, Perrotta RE, Dinotta F, Malaguarnera M. High Carbohydrate 19-9 Antigen Serum Levels in Patients with Nonmelanoma Skin Cancer and Primary Occult Cancer. Biomedicines 2020; 8:biomedicines8080265. [PMID: 32756322 PMCID: PMC7459904 DOI: 10.3390/biomedicines8080265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 07/27/2020] [Accepted: 07/29/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Non-melanoma skin cancers (NMSC), despite having a favourable prognosis, present an increased risk of occult malignancies. The aim of this study was the evaluation of the usefulness of the mucinous marker carbohydrate 19-9 antigen (CA 19-9) in the diagnosis of occult cancers. (1) Patients and Methods: This is a case control study in which 480 patients with NMSC and 480 matched control subjects with dermatitis were enrolled; 208 patients with NMSC showed upper-normal CA 19-9 values, and 272 showed under-normal CA 19-9 values. (2) Results: The 208 patients positive for CA 19-9 included 87 with basal cell carcinoma (BCC) and 121 with squamous cell carcinoma (SCC). The 272 patients negative for CA 19-9 included 107 with BCC and 165 with SCC. For the SCC patients, CA 19-9 serum levels were significant in 121 of the patients (positive), 66 of which were affected by cancer; CA 19-9 was within the normal range in 165 patients, of which 30 were diagnosed with cancer. In the SCC patients, the CA 19-9 sensitivity was 68%, the specificity was 70%, the positive predictive value (PPV) was 54% (95%) and the negative predictive value (NPV) was 81%. In the BCC patients, the CA 19-9 sensitivity was 70%, the specificity was 66%, the PPV was 48% and the NPV was 83%. In the dermatitis patients (controls), we observed 121 patients that were CA 19-9 positive, with 15 malignancies, and 359 CA 19-9-negative patients, with three malignancies. (3) Conclusions: To confirm the association between CA 19-9 and an elevated risk of malignancies in NMSC, prospective cohort studies should be performed.
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Affiliation(s)
- Giulia Malaguarnera
- Department of Biomedical and Biotechnological Science, University of Catania; 95123 Catania, Italy; (G.M.); (M.M.)
| | - Saverio Latteri
- Department of Medical, Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy;
| | - Roberto Madeddu
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy;
| | - Vito Emanuele Catania
- Department of Medical, Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy;
- Correspondence:
| | - Gaetano Bertino
- Department of Experimental and Clinical Medicine, University of Catania, 95123 Catania, Italy;
| | - Rosario Emanuele Perrotta
- Department of General Surgery and Medical-Surgery Specialties, University of Catania, 95100 Catania, Italy; (R.E.P.); (F.D.)
| | - Francesco Dinotta
- Department of General Surgery and Medical-Surgery Specialties, University of Catania, 95100 Catania, Italy; (R.E.P.); (F.D.)
| | - Michele Malaguarnera
- Department of Biomedical and Biotechnological Science, University of Catania; 95123 Catania, Italy; (G.M.); (M.M.)
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8
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Rhee J, Vance TM, Lim R, Christiani DC, Qureshi AA, Cho E. Association of blood mercury levels with nonmelanoma skin cancer in the U.S.A. using National Health and Nutrition Examination Survey data (2003-2016). Br J Dermatol 2020; 183:480-487. [PMID: 32020585 DOI: 10.1111/bjd.18797] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Some studies have reported increased incidence or mortality of lung and brain cancers associated with occupations involving potential mercury exposure. Epidemiological evidence related to skin cancer is also limited. OBJECTIVES To investigate the association between blood mercury (Hg) levels and nonmelanoma skin cancer (NMSC). METHODS We used National Health and Nutrition Examination Survey data from 2003 to 2016. The exposures were blood total (tHg), inorganic (iHg) and methylmercury (MeHg). The outcome was a self-reported diagnosis of NMSC. We included participants aged ≥ 20 years who had information on blood mercury and sociodemographic factors. We conducted a logistic regression analysis to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of NMSC associated with quartiles of blood Hg, after adjusting for the sociodemographic factors and survey year. RESULTS The number of participants was 29 413; mean age was 49 years and 52% were female. Compared with those with a tHg ≤ 0·47 μg L-1 (Q1), those with a tHg > 1·74 μg L-1 (Q4) had nearly double the odds of NMSC (OR 1·79, 95% CI 1·19-2·71; Ptrend = 0·004). Similarly, those in the highest quartile of MeHg (> 1·44 μg L-1 ) had 1·7 times greater odds of NMSC (OR 1·74, 95% CI 1·13-2·70; Ptrend = 0·01) than those in the lowest quartile (≤ 0·21 μg L-1 ). iHg levels were nonsignificantly positively associated with NMSC (Ptrend = 0·08). CONCLUSIONS We found that higher blood tHg and MeHg levels were associated with a higher prevalence of NMSC. Linked Comment: Taylor. Br J Dermatol 2020; 183:413-414.
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Affiliation(s)
- J Rhee
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, U.S.A
| | - T M Vance
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, U.S.A
| | - R Lim
- Brown University, Providence, RI, U.S.A
| | - D C Christiani
- Department of Environmental Health, Harvard University, Boston, MA, U.S.A.,Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, MA, U.S.A
| | - A A Qureshi
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, U.S.A.,Department of Epidemiology, Brown School of Public Health, Providence, RI, U.S.A
| | - E Cho
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, U.S.A.,Department of Epidemiology, Brown School of Public Health, Providence, RI, U.S.A.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, U.S.A
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9
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Amorrortu RP, Fenske NA, Cherpelis BS, Vijayan L, Zhao Y, Balliu J, Messina JL, Sondak VK, Giuliano AR, Waterboer T, Pawlita M, Gheit T, Tommasino M, Rollison DE. Viruses in Skin Cancer (VIRUSCAN): Study Design and Baseline Characteristics of a Prospective Clinic-Based Cohort Study. Cancer Epidemiol Biomarkers Prev 2020; 29:39-48. [PMID: 31427307 PMCID: PMC6954275 DOI: 10.1158/1055-9965.epi-19-0446] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 06/26/2019] [Accepted: 08/13/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Accumulating evidence suggests that cutaneous viral infections are risk factors for the development of keratinocyte carcinomas. The Viruses in Skin Cancer (VIRUSCAN) Study, a prospective cohort study, was established in 2014 to investigate the risk of keratinocyte carcinoma associated with cutaneous human papillomavirus and polyomavirus infection and the possible interaction with ultraviolet radiation exposure (UVR). METHODS/RESULTS VIRUSCAN incorporates repeated measures of viral infection using multiple markers of infection and quantitative measures of UVR using a spectrophotometer. Participants were recruited between July 14, 2014 and August 31, 2017 at the University of South Florida Dermatology Clinic in Tampa, FL. After excluding 124 individuals with prevalent keratinocyte carcinomas at baseline, 1,179 participants (53.2% women, 46.8% men, all ages 60 years and older) were followed for up to 4 years with routine skin exams occurring every 6 to 12 months. Here, we present the VIRUSCAN Study design, methods, and baseline characteristics, including demographics, sun exposure behavior, quantitative UVR exposure measurements, and cutaneous viral prevalence, for the full study cohort. CONCLUSIONS The VIRUSCAN Study will provide critical temporal evidence needed to assess the causality of the role cutaneous viral infections play in the development of keratinocyte carcinomas, as well as the potential interaction between cutaneous viral infections and UVR exposure. IMPACT Study findings will be valuable in future development of novel keratinocyte carcinoma prevention strategies.
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MESH Headings
- Aged
- Carcinoma, Basal Cell/epidemiology
- Carcinoma, Basal Cell/etiology
- Carcinoma, Basal Cell/pathology
- Carcinoma, Merkel Cell/diagnosis
- Carcinoma, Merkel Cell/epidemiology
- Carcinoma, Merkel Cell/pathology
- Carcinoma, Merkel Cell/virology
- Carcinoma, Squamous Cell/epidemiology
- Carcinoma, Squamous Cell/etiology
- Carcinoma, Squamous Cell/pathology
- Female
- Follow-Up Studies
- Humans
- Keratinocytes/pathology
- Keratinocytes/radiation effects
- Keratinocytes/virology
- Male
- Middle Aged
- Prevalence
- Prospective Studies
- Research Design
- Risk Factors
- Skin/cytology
- Skin/pathology
- Skin/radiation effects
- Skin/virology
- Skin Neoplasms/diagnosis
- Skin Neoplasms/epidemiology
- Skin Neoplasms/etiology
- Skin Neoplasms/pathology
- Spectrophotometry, Ultraviolet
- Ultraviolet Rays/adverse effects
- Warts/diagnosis
- Warts/epidemiology
- Warts/pathology
- Warts/virology
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Affiliation(s)
| | - Neil A Fenske
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
| | - Basil S Cherpelis
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
| | - Laxmi Vijayan
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Yayi Zhao
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Juliana Balliu
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Jane L Messina
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
- Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Vernon K Sondak
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida
| | - Tim Waterboer
- Infections and Cancer Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Pawlita
- Infections and Cancer Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer-World Health Organization, Lyon, France
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer-World Health Organization, Lyon, France
| | - Dana E Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida.
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida
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Zhang J, Jiang H, Xu D, Wu WJ, Chen HD, He L. DNA-PKcs Mediates An Epithelial-Mesenchymal Transition Process Promoting Cutaneous Squamous Cell Carcinoma Invasion And Metastasis By Targeting The TGF-β1/Smad Signaling Pathway. Onco Targets Ther 2019; 12:9395-9405. [PMID: 31807020 PMCID: PMC6844265 DOI: 10.2147/ott.s205017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 08/26/2019] [Indexed: 01/07/2023] Open
Abstract
Purpose DNA-dependent protein kinase catalytic subunit (DNA-PKcs) has attracted extensive attention in various types of malignant tumors. However, the role of DNA-PKcs in cutaneous squamous cell carcinoma (cSCC) development has not been elucidated. In this study, we investigated the role of DNA-PKcs in cSCC and the molecular mechanisms of TGF-β1-induced cSCC progression mediated by DNA-PKcs. Methods We performed bioinformatic analysis and RT-PCR to examine the DNA-PKcs expression level in cSCC. Then, we downregulated DNA-PKcs using a DNA-PK-specific inhibitor or small interfering RNA (siRNA) to explore the effects of DNA-PKcs on SCL-1 cell migration and invasion. To further investigate the mechanism by which DNA-PKcs promotes cSCC progression, TGF-β1 and the TGF-β receptor (TGF-βR) I/II dual inhibitor LY2109761 were used to examine whether DNA-PKcs participates in TGF-β1/Smad signaling. Results DNA-PKcs expression was upregulated in cSCC. DNA-PK inhibition or expression knockdown resulted in inhibited migration and invasion and altered epithelial-mesenchymal transition (EMT) marker expression patterns in SCL-1 cells. Importantly, TGF-β1 mediated EMT induction in cSCC cells, and DNA-PKcs was identified as a TGF-β1-responsive gene. TGF-β1 promoted DNA-PKcs transcription, and DNA-PKcs enhanced the TGF-β1-induced EMT program involved in cSCC invasion and metastasis by phosphorylating Smad3. Conclusion This study is the first to show that DNA-PKcs mediates EMT to promote cSCC aggressiveness by targeting the TGF-β1/Smad signaling pathway, which provides insight into how DNA-PKcs impacts cSCC progression and identifies a new therapeutic target.
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Affiliation(s)
- Juan Zhang
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Institute of Dermatology & Venereology of Yunnan Province, Kunming, People's Republic of China
| | - Hui Jiang
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Institute of Dermatology & Venereology of Yunnan Province, Kunming, People's Republic of China
| | - Dan Xu
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Institute of Dermatology & Venereology of Yunnan Province, Kunming, People's Republic of China
| | - Wen-Juan Wu
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Institute of Dermatology & Venereology of Yunnan Province, Kunming, People's Republic of China
| | - Hong-Duo Chen
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, People's Republic of China
| | - Li He
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Institute of Dermatology & Venereology of Yunnan Province, Kunming, People's Republic of China
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11
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Abstract
Nonmelanoma skin cancer (NMSC) is a major health concern due to its high incidence rate, its negative impact on the quality of life of patients as well as the associated economic burden to the healthcare system. Surgery is currently the primary treatment offered for skin cancer patients but not applicable or available in all cases. Radiation therapy (RT), with its long successful history in the management of cancer, has shown to be an effective alternative or complementary method in cutaneous oncology. Specifically, for dermatology applications, RT is very often the preferred option due to its favorable cosmetic results, besides the excellent control rate of the tumor. During the last 120 years since the introduction of treatments based on ionizing radiation, several techniques in this area have been developed. Radionuclide brachytherapy, electronic brachytherapy, X-ray therapies with kilovolt (kV) to megavolt (MV) photons and electron beam therapy are the established methods that are currently used on skin cancer patients. The purpose of this article is to overview these techniques and discuss the pros and cons of these methods in dermatology practices. Additionally, a new approach of beta RT of superficial skin tumors is discussed, which may offer exciting features in the management of NMSC.
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Affiliation(s)
- Ali Pashazadeh
- Chair for Intelligent Catheter and Image Guided Procedures, Otto von Guericke University , Magdeburg , Germany
| | - Axel Boese
- Chair for Intelligent Catheter and Image Guided Procedures, Otto von Guericke University , Magdeburg , Germany
| | - Michael Friebe
- Chair for Intelligent Catheter and Image Guided Procedures, Otto von Guericke University , Magdeburg , Germany
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12
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Abstract
Basal cell carcinoma (BCC) is the most common skin cancer worldwide, with incidence rates continuing to increase. Ultraviolet radiation is the major environmental risk factor and dysregulation of the Hedgehog (Hh) signaling pathway has been identified in most BCCs. The treatment of locally advanced and metastatic BBCs is still a challenge and requires a better animal model than the widely used rodents for drug development and testing. Chinese tree shrews (Tupaia belangeri chinensis) are closely related to primates, bearing many physiological and biochemical advantages over rodents for characterizing human diseases. Here, we successfully established a Chinese tree shrew BCC model by infecting tail skins with lentiviral SmoA1, an active form of Smoothened (Smo) used to constitutively activate the Hh signaling pathway. The pathological characteristics were verified by immunohistochemical analysis. Interestingly, BCC progress was greatly enhanced by the combined usage of lentiviral SmoA1 and shRNA targeting Chinese tree shrew p53. This work provides a useful animal model for further BCC studies and future drug discoveries.
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Affiliation(s)
- Li-Ping Jiang
- Key Laboratory of Animal Models and Human Disease Mechanisms, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming Yunnan 650223, China; Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming Yunnan 650204, China
| | - Qiu-Shuo Shen
- Key Laboratory of Animal Models and Human Disease Mechanisms, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming Yunnan 650223, China; Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming Yunnan 650204, China
| | - Cui-Ping Yang
- Key Laboratory of Animal Models and Human Disease Mechanisms, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming Yunnan 650223, China; Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming Yunnan 650204, China.
| | - Yong-Bin Chen
- Key Laboratory of Animal Models and Human Disease Mechanisms, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming Yunnan 650223, China; Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming Yunnan 650204, China.
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13
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Latteri S, Catania VE, Malaguarnera G, Peri A, Bertino G, Frazzetto G, Borzì AM, Biondi A, Perrotta RE, Malaguarnera M. Carcinoembryonic Antigen Serum Levels in Nonmelanoma Skin Cancer. Biomedicines 2018; 6:biomedicines6010024. [PMID: 29473860 PMCID: PMC5874681 DOI: 10.3390/biomedicines6010024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 02/21/2018] [Accepted: 02/21/2018] [Indexed: 02/08/2023] Open
Abstract
Background: Carcinoembryonic antigen (CEA) is a glycoprotein, which is present in the foetal colon, some benign conditions and different malignancies, particularly in colon adenocarcinoma. We focused this study on non-melanoma skin cancer (NMSC). NMSC is a common malignancy and it is an important source of morbidity and death in the world. In this study we evaluated whether CEA level increases in NMSC. Patients and Methods: A total of 566 patients with non-melanoma skin cancer (NMSC) were enrolled; 286 patients with NMSC showed CEA levels above normal values, and 280 showed CEA levels below normal values. Patients with high levels of CEA underwent abdominal ultrasound, gastro endoscopy, colonoscopy, and abdominal CT scans. Results: We studied 566 patients, 286 were positive to CEA and 280 were negative. Of the 286 patients positive to CEA, 132 had basal cell carcinoma (64 patients had an associated cancer) and 154 had squamous cell carcinoma (75 patients were affected by cancer). Of the 280 patients negative to CEA, 130 had basal cell carcinoma (12 were associated with cancer), and 150 had squamous cell carcinoma (18 were associated with cancer). The mean age of the 566 case control subjects were 65–81 years. Of the 10 subjects that were the positive control for CEA, two had cancer. Of the 556 subjects that were the negative control for CEA, three had cancer. Conclusions: In patients that present high serum levels of CEA, we give attention to adenocarcinoma tumour first. The pattern of association may be attributable to bias because the group with NMSC were frequently evaluated than those with no history of NMSC. Our results showed that out of 286 patients that were CEA-positive, 139 had cancer, and of the 280 that were CEA-negative, 30 had cancer. Therefore, 20% of patients do not follow the trend. Other markers should be investigated.
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Affiliation(s)
- Saverio Latteri
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, 95123 Catania, Italy.
| | - Vito Emanuele Catania
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, 95123 Catania, Italy.
| | - Giulia Malaguarnera
- Department of Biomedical and Biotechnological Science, University of Catania, 95123 Catania, Italy.
- Research Centre "The Great Senescence", University of Catania, 95120 Catania, Italy.
| | - Andrea Peri
- Department of General Surgery, Policlinico "San Matteo", University of Pavia, 27100 Pavia, Italy.
| | - Gaetano Bertino
- Hepatology Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
| | - Giuseppe Frazzetto
- Research Centre "The Great Senescence", University of Catania, 95120 Catania, Italy.
| | - Antonio Maria Borzì
- Research Centre "The Great Senescence", University of Catania, 95120 Catania, Italy.
| | - Antonio Biondi
- Department of General Surgery and Medical-Surgery Specialties, University of Catania, 95100 Catania, Italy.
| | - Rosario Emanuele Perrotta
- Department of General Surgery and Medical-Surgery Specialties, University of Catania, 95100 Catania, Italy.
| | - Michele Malaguarnera
- Department of Biomedical and Biotechnological Science, University of Catania, 95123 Catania, Italy.
- Research Centre "The Great Senescence", University of Catania, 95120 Catania, Italy.
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14
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Abstract
Basal cell carcinoma (BCC) is the most common malignancy worldwide, arising from non-keratinizing cells within the basal layer of the epidermis. The incidence of BCC continues to rise annually, increasing the burden of management of these carcinomas and the morbidity associated with their treatment. While surgical interventions such as Mohs micrographic surgery and surgical excision are the standard of care and yield the highest cure rates, the number of non-surgical interventions approved for the treatment of BCC continues to expand. We review various surgical and non-surgical approaches to the treatment of BCC, focusing on targeted molecular therapies that are approved for locally advanced or recurrent disease.
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Affiliation(s)
- Mariam Totonchy
- Department of Dermatology, Yale University School of Medicine, 333 Cedar Street, P.O. Box 208059, New Haven, CT 06520-8059, Connecticut, USA
| | - David Leffell
- Department of Dermatology, Section of Cutaneous Oncology and Dermatologic Surgery , Yale University School of Medicine, 40 Temple Street 5A, New Haven, Connecticut, USA
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15
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Teegarden MD, Campbell AR, Cooperstone JL, Tober KL, Schwartz SJ, Oberyszyn TM. 25-Hydroxyvitamin D 3 and its C-3 epimer are elevated in the skin and serum of Skh-1 mice supplemented with dietary vitamin D 3. Mol Nutr Food Res 2017; 61. [PMID: 28589636 DOI: 10.1002/mnfr.201700293] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 05/23/2017] [Accepted: 05/24/2017] [Indexed: 11/05/2022]
Abstract
SCOPE UV exposure is a risk factor for keratinocyte carcinoma (KC) while critical for endogenous vitamin D production. We investigated dietary modulation of skin and serum 25-hydroxyvitamin D3 (25OHD3 ) and its C-3 epimer (C3epi) in a mouse model of KC. C3epi is an under-investigated metabolite of vitamin D with respect to its biological implications. METHODS AND RESULTS Male and female Skh-1 mice were supplemented with 25, 150 or 1000 IU/kg diet vitamin D3 for 25 weeks, with some exposed to UV light. Skin and serum vitamin D metabolites were quantitated using HPLC-MS/MS (n = 3 per dose/sex/UV treatment). Serum and skin 25OHD3 and C3epi significantly increased with dose (P<0.0001), but with different response patterns. UV exposure significantly attenuated serum, but not skin, levels of both metabolites (P<0.001, P = 0.0287), while up-regulating expression of renal Cyp24a1 (P < 0.01). A dose by sex interaction trended toward significance with serum and skin levels of C3epi, wherein male mice attained higher levels of C3epi with higher dietary vitamin D3 . This reflected a similar, but non-significant pattern in average tumor size. CONCLUSION The complex relationship between vitamin D and KC requires further investigation. This study provides insight into modulation of local and systemic vitamin D status with dietary supplementation.
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Affiliation(s)
- Matthew D Teegarden
- Department of Food Science and Technology, The Ohio State University, Columbus, OH, USA
| | - Amanda R Campbell
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Jessica L Cooperstone
- Department of Food Science and Technology, The Ohio State University, Columbus, OH, USA
| | - Kathleen L Tober
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Steven J Schwartz
- Department of Food Science and Technology, The Ohio State University, Columbus, OH, USA
| | - Tatiana M Oberyszyn
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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16
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Lamberg AL, Sølvsten H, Lei U, Vinding GR, Stender IM, Jemec GBE, Vestergaard T, Thormann H, Hædersdal M, Dam TN, Olesen AB. The Danish Nonmelanoma Skin Cancer Dermatology Database. Clin Epidemiol 2016; 8:633-636. [PMID: 27822110 PMCID: PMC5094616 DOI: 10.2147/clep.s99464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim of database The Danish Nonmelanoma Skin Cancer Dermatology Database was established in 2008. The aim of this database was to collect data on nonmelanoma skin cancer (NMSC) treatment and improve its treatment in Denmark. NMSC is the most common malignancy in the western countries and represents a significant challenge in terms of public health management and health care costs. However, high-quality epidemiological and treatment data on NMSC are sparse. Study population The NMSC database includes patients with the following skin tumors: basal cell carcinoma (BCC), squamous cell carcinoma, Bowen’s disease, and keratoacanthoma diagnosed by the participating office-based dermatologists in Denmark. Main variables Clinical and histological diagnoses, BCC subtype, localization, size, skin cancer history, skin phototype, and evidence of metastases and treatment modality are the main variables in the NMSC database. Information on recurrence, cosmetic results, and complications are registered at two follow-up visits at 3 months (between 0 and 6 months) and 12 months (between 6 and 15 months) after treatment. Descriptive data In 2014, 11,522 patients with 17,575 tumors were registered in the database. Of tumors with a histological diagnosis, 13,571 were BCCs, 840 squamous cell carcinomas, 504 Bowen’s disease, and 173 keratoakanthomas. Conclusion The NMSC database encompasses detailed information on the type of tumor, a variety of prognostic factors, treatment modalities, and outcomes after treatment. The database has revealed that overall, the quality of care of NMSC in Danish dermatological clinics is high, and the database provides the necessary data for continuous quality assurance.
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Affiliation(s)
| | | | - Ulrikke Lei
- Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Gentofte
| | | | | | - Gregor Borut Ernst Jemec
- Department of Dermatology, Roskilde Hospital, Health Sciences Faculty, University of Copenhagen, Roskilde, Zealand Region
| | | | | | - Merete Hædersdal
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Capital Region of Denmark
| | | | - Anne Braae Olesen
- Department of Dermatology, University Hospital of Aarhus, Aarhus, Central Denmark Region, Denmark
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17
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Rowell D, Gordon LG, Olsen CM, Whiteman DC. A comparison of the direct medical costs for individuals with or without basal or squamous cell skin cancer: A study from Australia. SAGE Open Med 2016; 4:2050312116646030. [PMID: 27231550 PMCID: PMC4871202 DOI: 10.1177/2050312116646030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 03/28/2016] [Indexed: 12/31/2022] Open
Abstract
Objectives: The composition of the medical costs incurred by people treated for basal cell and squamous cell carcinomas (hereafter keratinocyte cancers) is not adequately understood. We sought to compare the medical costs of individuals with or without keratinocyte cancers. Methods: We used national health insurance data to analyze the direct medical costs of 2000 cases and 2000 controls nested within the QSkin prospective cohort study (n = 43,794) conducted in Australia. We reconstructed the medical history of patients using medical and pharmaceutical item codes and then compared the health service costs of individuals treated for keratinocyte cancers with those not treated for keratinocyte cancers. Results: Individuals treated for keratinocyte cancers consumed on average AUD$1320 per annum more in medical services than those without keratinocyte cancers. Only 23.2% of costs were attributed to the explicit treatment of keratinocyte cancers. The principal drivers of the residual costs were medical attendances, surgical procedures on the skin, and histopathology services. We found significant positive associations between history of treatment for keratinocyte cancers with treatments for other health conditions, including melanoma, cardiovascular disease, lipidemia, osteoporosis, rheumatoid arthritis, colorectal cancer, prostate cancer, and tuberculosis. Conclusion: Individuals treated for keratinocyte cancers have substantially higher medical costs overall than individuals without keratinocyte cancers. The direct costs of skin cancer excision account for only one-fifth of this difference.
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Affiliation(s)
- David Rowell
- The University of Queensland, Queensland Brain Institute, Asia-Pacific Centre for Neuromodulation, St Andrews War Memorial Hospital, Brisbane, QLD, Australia
| | - Louisa G Gordon
- Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Catherine M Olsen
- QIMR Berghofer Medical Research Institute, Population Health Department, Royal Brisbane Hospital, Brisbane, QLD, Australia
| | - David C Whiteman
- QIMR Berghofer Medical Research Institute, Population Health Department, Royal Brisbane Hospital, Brisbane, QLD, Australia
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18
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Della Vittoria Scarpati G, Perri F, Pisconti S, Costa G, Ricciardiello F, Del Prete S, Napolitano A, Carraturo M, Mazzone S, Addeo R. Concomitant cetuximab and radiation therapy: A possible promising strategy for locally advanced inoperable non-melanoma skin carcinomas. Mol Clin Oncol 2016; 4:467-471. [PMID: 27073643 DOI: 10.3892/mco.2016.746] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 12/17/2015] [Indexed: 12/20/2022] Open
Abstract
Non-melanoma skin cancers (NMSCs) include a heterogeneous group of malignancies arising from the epidermis, comprising squamous cell carcinoma (SCC), basal cell carcinoma (BCC), Merkel cell carcinoma and more rare entities, including malignant pilomatrixoma and sebaceous gland tumours. The treatment of early disease depends primarily on surgery. In addition, certain patients present with extensive local invasion or metastasis, which renders these tumours surgically unresectable. Improving the outcome of radiotherapy through the use of concurrent systemic therapy has been demonstrated in several locally advanced cancer-treatment paradigms. Recently, agents targeting the human epidermal growth factor receptor (EGFR) have exhibited a consolidated activity in phase II clinical trials and case series reports. Cetuximab is a monoclonal antibody that binds to and completely inhibits the EGFR, which has been revealed to be up-regulated in a variety of SCCs, including NMSCs. The present review aimed to summarize the role of anti-EGFR agents in the predominant types of NMSC, including SCC and BCC, and focuses on the cetuximab-based studies, highlighting the biological rationale of this therapeutic option. In addition, the importance of the association between cetuximab and radiotherapy for locally advanced NMSC is discussed.
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Affiliation(s)
- Giuseppina Della Vittoria Scarpati
- D.A.I. Diagnostica Morfologica e Funzionale, Radioterapia e Medicina Legale, Università degli Studi di Napoli 'Ferderico II', I-80138 Napoli, Italy
| | - Francesco Perri
- Unità Operativa di Oncologia, Ospedale 'San Giuseppe Moscati' di Taranto, I-74100 Taranto, Italy
| | - Salvatore Pisconti
- Unità Operativa di Oncologia, Ospedale 'San Giuseppe Moscati' di Taranto, I-74100 Taranto, Italy
| | - Giuseppe Costa
- Dipartimento di Salute Mentale Fisica e Medicina Preventiva, SUN Napoli, I-80138 Napoli, Italy
| | | | - Salvatore Del Prete
- Oncology Unit, 'San Giovanni di Dio' Hospital, A.S.L. Napoli 2 Nord, I-80027 Frattamaggiore (NA), Italy
| | | | | | - Salvatore Mazzone
- Dipartimento di Salute Mentale Fisica e Medicina Preventiva, SUN Napoli, I-80138 Napoli, Italy
| | - Raffaele Addeo
- Oncology Unit, 'San Giovanni di Dio' Hospital, A.S.L. Napoli 2 Nord, I-80027 Frattamaggiore (NA), Italy
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19
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Wu X, Elkin EB, Jason Chen CS, Marghoob A. Traditional versus streamlined management of basal cell carcinoma (BCC): A cost analysis. J Am Acad Dermatol 2015; 73:791-8. [PMID: 26341142 PMCID: PMC5031151 DOI: 10.1016/j.jaad.2015.07.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 06/26/2015] [Accepted: 07/20/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Facing rising incidence of basal cell carcinoma (BCC) and increasing pressure to contain health care spending, physicians need to contemplate cost-effective paradigms for managing BCC. OBJECTIVE We sought to perform a cost analysis comparing the traditional BCC management scheme with a simplified detect-and-treat scheme that eliminates the biopsy before initiating definitive treatment. METHODS A decision analytic model was developed to compare the costs of traditional BCC management with the detect-and-treat scheme, under which qualifying lesions diagnosed clinically were either treated with shave removal or referred to Mohs micrographic surgery for on-site histologic check. Values for model parameters were based on literature and our institutional data analysis. Costs were based on 2014 Medicare fee schedule. RESULTS The average cost per lesion with detect-and-treat scheme was $449 for non-Mohs micrographic surgery-indicated lesions (vs $566 with traditional management, $117 in savings) and $819 for Mohs micrographic surgery-indicated lesions (vs $864 with traditional management, $45 in savings). The combined weighted average savings per case was $95 (15% of total average cost). Conclusions were similar under various plausible scenarios. LIMITATIONS Model parameter values may vary based on individual practices. CONCLUSIONS A simplified management strategy eliminating routine pretreatment biopsy can reduce BCC treatment cost without compromising quality of care.
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Affiliation(s)
- Xinyuan Wu
- Dermatology Service, Memorial Sloan Kettering Cancer Center, Hauppauge, New York
| | - Elena B Elkin
- Center for Health Policy and Outcomes, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Chih-Shan Jason Chen
- Dermatology Service, Memorial Sloan Kettering Cancer Center, Hauppauge, New York
| | - Ashfaq Marghoob
- Dermatology Service, Memorial Sloan Kettering Cancer Center, Hauppauge, New York.
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20
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Doran CM, Ling R, Byrnes J, Crane M, Searles A, Perez D, Shakeshaft A. Estimating the economic costs of skin cancer in New South Wales, Australia. BMC Public Health 2015; 15:952. [PMID: 26400024 PMCID: PMC4581089 DOI: 10.1186/s12889-015-2267-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Accepted: 09/14/2015] [Indexed: 11/30/2022] Open
Abstract
Background Skin cancer is one of the most common cancers in the world. The increased incidence of skin cancer, combined with limited health care resources and tight budgetary conditions, has increased the importance of understanding the economic impact of skin cancer. This research estimates the economic cost of skin cancer in the Australian state of New South Wales. Method An incidence based approach is used to estimate lifetime costs of skin cancer. Both direct and indirect costs are considered - direct costs include resources associated with the management of skin cancer and indirect costs refer to productivity costs associated with morbidity and premature mortality. Diagnosis of skin cancer was determined according to ICD-10 codes using principal diagnosis. Linked administrative data and regression modelling are used to calculate costs; presented as Australian dollars for the year 2010. The human capital approach is used to value present and future productivity losses. Results The lifetime cost of the 150,000 incident cases of skin cancer diagnosed in NSW in 2010 is estimated at $536 million ($44,796 per melanoma and $2459 per non-melanoma). Direct costs accounted for 72 % of costs ($10,230 per melanoma and $2336 per non-melanoma) and indirect costs accounted for 28 % of costs ($34,567 per melanoma and $123 per non-melanoma). Direct costs are, on average, higher for females than males with indirect costs, on average, higher for males than females. Conclusion This research provides new evidence on the economic cost of skin cancer and provides policy makers with information of the potential monetary savings that may arise from efforts to reduce the incidence of skin cancer.
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Affiliation(s)
- Christopher M Doran
- Hunter Medical Research Institute, University of Newcastle, Locked Bag 1000, New Lambton, NSW, 2305, Australia.
| | - Rod Ling
- Hunter Medical Research Institute, University of Newcastle, Locked Bag 1000, New Lambton, NSW, 2305, Australia.
| | - Joshua Byrnes
- Centre for Applied Health Economics, Griffith University, Logan Campus L03 2.15, Meadowbrook, 4131, Australia.
| | - Melanie Crane
- Cancer Institute NSW, PO Box 41, Alexandria, NSW, 1435, Australia. .,School of Public Health, University of Sydney, Level 6, The Hub, Charles Perkins Centre (D17), Sydney, NSW, 2006, Australia.
| | - Andrew Searles
- Hunter Medical Research Institute, University of Newcastle, Locked Bag 1000, New Lambton, NSW, 2305, Australia.
| | - Donna Perez
- Cancer Institute NSW, PO Box 41, Alexandria, NSW, 1435, Australia.
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, 2052, Australia.
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21
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Abstract
Exposure to ultraviolet (UV) radiation is associated with approximately 65% of melanoma cases, and 90% of non-melanoma skin cancers (NMSC), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). While the incidence of most other malignancies has either stabilized or declined, that of NMSC has increased and is developing even in younger age groups. NMSCs account for nearly 15,000 deaths, 3.5 million new cases, and more than 3 billion dollars a year in medical costs in the United States alone, representing a major public health concern. As sun protection efforts have not been proven effective, targeted chemoprevention strategies are much needed. Skin carcinogenesis by DNA damage is considered a predominant paradigm for UV toxicity. Exposure to UV radiation can activate various oncogenes while inactivating tumor suppressor genes, resulting in inappropriate survival and proliferation of keratinocytes that harbor these damages. Moreover, increasing evidence demonstrate that inflammatory responses by the immune cells within the tumor microenvironment also contribute significantly to skin tumorigenesis. Initiation and progression of skin carcinogenesis mediated by UV radiation involve complex pathways, including those of apoptosis, proliferation, autophagy, DNA repair, checkpoint signaling, metabolism, and inflammation. In this review, we highlight the recent advances in two of these key molecular processes that result in UV-mediated skin carcinogenesis. In particular, we discuss 1) pathways that regulate DNA damage repair and 2) the regulation of the inflammatory process its crosstalk with DNA repair potentially leading to non-melanoma skin carcinogenesis.
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Affiliation(s)
- InYoung Kim
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Yu-Ying He
- Section of Dermatology, Department of Medicine, University of Chicago, Chicago, IL, USA
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22
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Pilgrim W, Hayes R, Hanson DW, Zhang B, Boudreau B, Leonfellner S. Skin Cancer (Basal Cell Carcinoma, Squamous Cell Carcinoma, and Malignant Melanoma): New Cases, Treatment Practice, and Health Care Costs in New Brunswick, Canada, 2002–2010. J Cutan Med Surg 2014; 18:320-31. [DOI: 10.2310/7750.2014.13162] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: In Canada, there is no formal process for registering nonmelanoma skin cancer (NMSC); thus, the epidemiology, treatment practices, and associated health costs are not well known. Objectives: To investigate trends in new cases of skin cancer, treatment practices, and health care costs in New Brunswick, Canada. Methods: Data were extracted from the Provincial Cancer Registry and New Brunswick administrative health databases for 2002–2010. Results: New cases: Basal Cell Carcinoma (BCC) was the most common skin cancer diagnosed, and incidence rates significantly increased between 1992 and 2010. Treatment practice: Dermatologists managed the majority (45%) of the overall skin cancer treatments. Health care costs: NMSC accounted for ˜80% of the health care costs for skin cancer and was dominated by BCC. Conclusions: Development of best practice treatment guidelines for NMSC in New Brunswick would improve future health care efficiencies, and standard protocols for registering new cases of NMSC in Canada would strengthen surveillance and reporting capacity.
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Affiliation(s)
- Wilfred Pilgrim
- From the New Brunswick Department of Health and private practice, Fredericton, NB
| | - Robert Hayes
- From the New Brunswick Department of Health and private practice, Fredericton, NB
| | - Dana W. Hanson
- From the New Brunswick Department of Health and private practice, Fredericton, NB
| | - Bin Zhang
- From the New Brunswick Department of Health and private practice, Fredericton, NB
| | - Bonnie Boudreau
- From the New Brunswick Department of Health and private practice, Fredericton, NB
| | - Suzanne Leonfellner
- From the New Brunswick Department of Health and private practice, Fredericton, NB
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23
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Abstract
Skin cancer is both common and responsible for significant morbidity and mortality. Opportunities for both primary and secondary prevention are available to both dermatologists and non-dermatologists. Counseling selected patients about ultraviolet avoidance and proper use of sunscreens is recommended. Due to technical and financial barriers, no study has conclusively confirmed the benefits of skin cancer screening. Both dermatologists and non-dermatologists often do not perform total body skin examinations during clinical encounters, despite high acceptance rates by patients. Many non-dermatologists would benefit from additional education pertaining to the diagnosis of cutaneous malignancy. Teledermatology may have a role in areas with poor access to dermatologists. There are ample opportunities for more to be learned in the future.
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Affiliation(s)
- Daniel G Federman
- VA Connecticut Healthcare System, West Haven, CT and Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA.
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24
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Abstract
Over the past two decades, advances in the fields of cancer genetics and molecular biology have elucidated molecular pathways that cause numerous cutaneous malignancies. This in turn has spurred the rational design of molecularly targeted therapies. In this review, we discuss the molecular pathways critical to the development of nonmelanoma skin cancers and the novel pharmacologic agents that target them. Included is a review of vismodegib for basal cell carcinoma, cetuximab for squamous cell carcinomas, imatinib for dermatofibrosarcoma protuberans, and sirolimus for Kaposi's sarcoma.
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Affiliation(s)
- Lucinda S Liu
- Department of Dermatology, Yale School of Medicine, New Haven, CT 06520-8059, USA
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Jung GW, Dover DC, Salopek TG. Risk of second primary malignancies following a diagnosis of cutaneous malignant melanoma or nonmelanoma skin cancer in Alberta, Canada from 1979 to 2009. Br J Dermatol 2014; 170:136-43. [PMID: 24443913 DOI: 10.1111/bjd.12694] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND Recent studies have revealed geographical variations with respect to the risk of second primary malignancies (SPMs) following cutaneous malignant melanoma (CMM) and nonmelanoma skin cancer (NMSC). OBJECTIVES To provide the largest analysis of the risk of SPM following skin cancers in Canada and to detect associations that may shed light on common pathogeneses between linked malignancies. METHODS Relative risks for development of SPMs following a diagnosis of CMM or NMSC were calculated via a retrospective analysis of data retrieved from the Alberta Cancer Registry (ACR) from 1979 to 2009. RESULTS From 1979 to 2009, 85,967 NMSC and 6884 CMM incident cases were recorded in the ACR. In total 19,869 SPMs were identified following a primary NMSC (7709 cutaneous and 12,160 noncutaneous), while 1437 SPMs (908 cutaneous and 529 noncutaneous) followed CMM. Patients with a previous history of skin cancer had a 60% increased risk of developing an SPM compared with those without [observed/expected ratio (O/E) 1.6, 95% confidence interval (CI) 1.6-1.7; P < 0.001]. Thirty and 10 different SPMs were significantly identified to follow a diagnosis of NMSC and CMM, respectively. Patients under the age of 40 years with a prior history of CMM had a marked increased expectancy for SPM [O/E 5.6, 95% CI 4.5-7.0; P < 0.001). CONCLUSIONS Further studies are warranted to identify environmental and molecular connections among linked cutaneous and noncutaneous malignancies, which may lead to earlier detection of related neoplasms via expanded screening protocols and development of shared treatment regimens. Heightened surveillance for the development of SPMs in patients with CMM under the age of 40 years should be considered.
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Affiliation(s)
- G W Jung
- Division of Dermatology and Cutaneous Sciences, Department of Medicine, University of Alberta, Edmonton, AB, Canada
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Kakagia D, Trypsiannis G, Karanikas M, Mitrakas A, Lyratzopoulos N, Polychronidis A. Patient-related delay in presentation for cutaneous squamous cell carcinoma. A cross-sectional clinical study. ACTA ACUST UNITED AC 2013; 36:738-44. [PMID: 24356565 DOI: 10.1159/000356834] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Delayed diagnosis of squamous cell carcinoma (SCC) increases recurrence, metastatic potential, and management costs. This study aims to identify risk factors of patient-related delayed presentation in cutaneous SCC. PATIENTS AND METHODS A total of 513 patients, who first sought care for cutaneous lesions that were subsequently removed and histologically confirmed as SCCs, were included. Attitude to symptoms, psychosocial profile, and reasons for delayed presentation were obtained via a structured questionnaire-based interview. First presentation > 3 months from the onset of symptoms was considered as delayed. RESULTS Mean presentation time was 3.90 ± 2.05 months, while 186 patients delayed presentation. Multivariate logistic regression analysis revealed that serious co-morbidity (p = 0.003), low education level (p < 0.001), non-recognition of the seriousness of symptoms (p < 0.001), a 'wait and see' attitude (p < 0.001), and fatalism (p = 0.005) were independent determinants of significantly higher risk for delayed presentation. In contrast, female sex (p = 0.006), new lesion (p = 0.012), accessible topography (p = 0.019), size increase (p = 0.002), color change (p = 0.017), non-healing wound (p = 0.048), and presence of social support/advice (p < 0.001) were independent determinants significantly associated with early presentation. CONCLUSION Recognition of symptom seriousness and elimination of factors hindering self-referral may increase awareness and promote early patient presentation and diagnosis of cutaneous SCC.
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Affiliation(s)
- Despoina Kakagia
- First Department of Surgery, Democritus University of Thrace, Dragana, Alexandroupolis, Greece
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McKay KM, Sambrano BL, Fox PS, Bassett RL, Chon S, Prieto VG. Thickness of superficial basal cell carcinoma (sBCC) predicts imiquimod efficacy: a proposal for a thickness-based definition of sBCC. Br J Dermatol 2013; 169:549-54. [PMID: 23627639 DOI: 10.1111/bjd.12402] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most common malignancy in the white population. It is an important driver of healthcare costs and causes significant morbidity. Topical imiquimod is a good noninvasive treatment alternative for surgical excision in superficial BCC (sBCC). However, there are currently no uniform histological definitions of sBCC. A definition based on tumour thickness might be a good alternative. OBJECTIVES To determine whether tumour thickness in sBCC is a predictor of treatment failure. METHODS We retrospectively examined 127 histological biopsy specimens of sBCC treated primarily with imiquimod five times a week for 6 weeks. Mean follow-up was 34 months (range 3-91). Recurrence was evaluated clinically with histological verification. RESULTS Among nonrecurrent cases the median tumour thickness was 0·26 mm (range 0·09-0·61), while for recurrent cases the median tumour thickness was 0·57 mm (range 0·41-1·41, P < 0·0001). Among lesions ≤ 0·40 mm in thickness, none recurred, whereas for lesions > 0·40 mm the recurrence rate was 58% (P < 0·0001). CONCLUSIONS We recommend the use of tumour thickness to define the superficial pattern in pathology reports for BCC as this can help to determine treatment response of sBCC to imiquimod.
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Affiliation(s)
- K M McKay
- Departments of Dermatology and Pathology, The University of Alabama at Birmingham, Birmingham, AL, U.S.A
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Glanz K, Steffen AD, Schoenfeld E, Tappe KA. Randomized trial of tailored skin cancer prevention for children: the Project SCAPE family study. J Health Commun 2013; 18:1368-1383. [PMID: 23806094 PMCID: PMC3815976 DOI: 10.1080/10810730.2013.778361] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This study evaluated a tailored intervention to promote sun protection in parents and their children, hypothesizing that the tailored intervention would lead to improved skin cancer prevention behaviors compared to generic materials. Families were recruited through schools and community centers and were included if there was 1 child in Grades 1-3 at moderate to high risk for skin cancer. Participants were randomized into one of two intervention groups: a tailored intervention, in which they received personalized skin cancer education through the mail; or a control group who received generic skin cancer information materials. Before and after intervention, parents completed questionnaires about their and their children's skin cancer risk and prevention knowledge and behaviors. Parents also completed 4-day sun exposure and protection diaries for their child and themselves. Tailored group participants demonstrated significantly greater positive changes in prevention behavior after the intervention, including children's use of sunscreen, shirts, and hats, and parents' use of shade, and skin examinations. Effect sizes were small and perceived benefits and social norms mediated intervention effects. Findings from this study support the efficacy of focusing tailored communications to families in order to change skin cancer prevention practices in young children.
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Affiliation(s)
- Karen Glanz
- a University of Pennsylvania Schools of Medicine and Nursing , Philadelphia , Pennsylvania , USA
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Abstract
UV radiation (UV) is classified as a "complete carcinogen" because it is both a mutagen and a non-specific damaging agent and has properties of both a tumor initiator and a tumor promoter. In environmental abundance, UV is the most important modifiable risk factor for skin cancer and many other environmentally-influenced skin disorders. However, UV also benefits human health by mediating natural synthesis of vitamin D and endorphins in the skin, therefore UV has complex and mixed effects on human health. Nonetheless, excessive exposure to UV carries profound health risks, including atrophy, pigmentary changes, wrinkling and malignancy. UV is epidemiologically and molecularly linked to the three most common types of skin cancer, basal cell carcinoma, squamous cell carcinoma and malignant melanoma, which together affect more than a million Americans annually. Genetic factors also influence risk of UV-mediated skin disease. Polymorphisms of the melanocortin 1 receptor (MC1R) gene, in particular, correlate with fairness of skin, UV sensitivity, and enhanced cancer risk. We are interested in developing UV-protective approaches based on a detailed understanding of molecular events that occur after UV exposure, focusing particularly on epidermal melanization and the role of the MC1R in genome maintenance.
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Affiliation(s)
- John D’Orazio
- Graduate Center for Toxicology and the Departments of Pediatrics, Biomedical and Molecular Pharmacology and Physiology, Markey Cancer Center, University of Kentucky College of Medicine, 800 Rose Street, Lexington, KY 40536, USA
| | - Stuart Jarrett
- Markey Cancer Center, University of Kentucky College of Medicine, 800 Rose Street, Lexington, KY 40536, USA; E-Mail:
| | - Alexandra Amaro-Ortiz
- Graduate Center for Toxicology, University of Kentucky College of Medicine, 800 Rose Street, Lexington, KY 40536, USA; E-Mail: (A.A.-O.); (T.S.)
| | - Timothy Scott
- Graduate Center for Toxicology, University of Kentucky College of Medicine, 800 Rose Street, Lexington, KY 40536, USA; E-Mail: (A.A.-O.); (T.S.)
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Abstract
An overview of where nonmelanoma cancers appear in the hierarchy of cancers is succinctly presented, as well as their incidence, etiology, and costs. The examination and treatment of these cancers are summarized.
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Song F, Qureshi AA, Giovannucci EL, Fuchs CS, Chen WY, Stampfer MJ, Han J. Risk of a second primary cancer after non-melanoma skin cancer in white men and women: a prospective cohort study. PLoS Med 2013; 10:e1001433. [PMID: 23630459 PMCID: PMC3635863 DOI: 10.1371/journal.pmed.1001433] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 03/15/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Previous studies suggest a positive association between history of non-melanoma skin cancer (NMSC) and risk of subsequent cancer at other sites. The purpose of this study is to prospectively examine the risk of primary cancer according to personal history of NMSC. METHODS AND FINDINGS In two large US cohorts, the Health Professionals Follow-up Study (HPFS) and the Nurses' Health Study (NHS), we prospectively investigated this association in self-identified white men and women. In the HPFS, we followed 46,237 men from June 1986 to June 2008 (833,496 person-years). In the NHS, we followed 107,339 women from June 1984 to June 2008 (2,116,178 person-years). We documented 29,447 incident cancer cases other than NMSC. Cox proportional hazard models were used to calculate relative risks (RRs) and 95% confidence intervals (CIs). A personal history of NMSC was significantly associated with a higher risk of other primary cancers excluding melanoma in men (RR=1.11; 95% CI 1.05-1.18), and in women (RR=1.20; 95% CI 1.15-1.25). Age-standardized absolute risk (AR) was 176 in men and 182 in women per 100,000 person-years. For individual cancer sites, after the Bonferroni correction for multiple comparisons (n=28), in men, a personal history of NMSC was significantly associated with an increased risk of melanoma (RR=1.99, AR=116 per 100,000 person-years). In women, a personal history of NMSC was significantly associated with an increased risk of breast (RR=1.19, AR=87 per 100,000 person-years), lung (RR=1.32, AR=22 per 100,000 person-years), and melanoma (RR=2.58, AR=79 per 100,000 person-years). CONCLUSION This prospective study found a modestly increased risk of subsequent malignancies among individuals with a history of NMSC, specifically breast and lung cancer in women and melanoma in both men and women.
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Affiliation(s)
- Fengju Song
- Department of Epidemiology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Abrar A. Qureshi
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Edward L. Giovannucci
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Charlie S. Fuchs
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, United States of America
| | - Wendy Y. Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, United States of America
| | - Meir J. Stampfer
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, United States of America
| | - Jiali Han
- Department of Epidemiology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
- * E-mail:
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Kreul SM, Havighurst T, Kim K, Mendonça EA, Wood GS, Snow S, Borich A, Verma A, Bailey HH. A phase III skin cancer chemoprevention study of DFMO: long-term follow-up of skin cancer events and toxicity. Cancer Prev Res (Phila) 2012; 5:1368-74. [PMID: 23060038 DOI: 10.1158/1940-6207.capr-12-0233] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Decreasing the incidence of nonmelanoma skin cancer (NMSC) is of great importance in regards to future healthcare services. Given the previously reported preventive effects of α-difluoromethylornithine (DFMO) in skin and colon cancer trials, we determined appropriate cause to update the clinical data on the subjects from the recently reported randomized, double-blind, placebo-controlled phase III skin cancer prevention study of DFMO. Our intention was to retrospectively assess the further incidence of skin cancer, other malignancies, and adverse events of patients accrued to our phase III skin cancer prevention study of DFMO. Clinical records of 209 University of Wisconsin (UW) Health subjects were reviewed, and 2,092.7 person years of on study (884.3 person years) and poststudy (1,208.4 person years) follow-up for these patients were assessed for new NMSC events and recurrence rates from the on study period, the poststudy period, and the two study periods combined. No evidence of increased significant diagnoses or serious adverse events was observed in the DFMO participants. The initially observed, marginally significant reduction (P = 0.069) in NMSC rates for DFMO subjects relative to placebo continued without evidence of rebound. Event rates after discontinuation from study for total NMSCs (DFMO 0.236 NMSC/person/year, placebo 0.297, P = 0.48) or the subtypes of basal cell carcinomas (BCC; DFMO 0.179 BCC/person/year, placebo 0.190, P = 0.77) and squamous cell carcinomas (SCC; DFMO 0.057 SCC/person/year, placebo 0.107, P = 0.43) are listed. Follow-up data revealed a persistent but insignificant reduction in new NMSCs occurring in DFMO subjects without evidence of latent or cumulative toxicity relative to placebo subjects.
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Affiliation(s)
- Sarah M Kreul
- University of Wisconsin Carbone Cancer Center, Madison, Wisconsin, USA
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Abstract
OBJECTIVE To synthesise the literature on indoor tanning and non-melanoma skin cancer. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed (1966 to present), Embase (1974 to present), and Web of Science (1898 to present). STUDY SELECTION All articles that reported an original effect statistic for indoor tanning and non-melanoma skin cancer were included. Articles that presented no data, such as review articles and editorials, were excluded, as were articles in languages other than English. DATA EXTRACTION Two investigators independently extracted data. Random effects meta-analysis was used to summarise the relative risk of ever use versus never use of indoor tanning. Dose-response effects and exposure to indoor tanning during early life were also examined. The population attributable risk fraction for the United States population was calculated. RESULTS 12 studies with 9328 cases of non-melanoma skin cancer were included. Among people who reported ever using indoor tanning compared with those who never used indoor tanning, the summary relative risk for squamous cell carcinoma was 1.67 (95% confidence interval 1.29 to 2.17) and that for basal cell carcinoma was 1.29 (1.08 to 1.53). No significant heterogeneity existed between studies. The population attributable risk fraction for the United States was estimated to be 8.2% for squamous cell carcinoma and 3.7% for basal cell carcinoma. This corresponds to more than 170 000 cases of non-melanoma skin cancer each year attributable to indoor tanning. On the basis of data from three studies, use of indoor tanning before age 25 was more strongly associated with both squamous cell carcinoma (relative risk 2.02, 0.70 to 5.86) and basal cell carcinoma (1.40, 1.29 to 1.52). CONCLUSIONS Indoor tanning is associated with a significantly increased risk of both basal and squamous cell skin cancer. The risk is higher with use in early life (<25 years). This modifiable risk factor may account for hundreds of thousands of cases of non-melanoma skin cancer each year in the United States alone and many more worldwide. These findings contribute to the growing body of evidence on the harms of indoor tanning and support public health campaigns and regulation to reduce exposure to this carcinogen.
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Connolly SM, Baker DR, Coldiron BM, Fazio MJ, Storrs PA, Vidimos AT, Zalla MJ, Brewer JD, Smith Begolka W, Berger TG, Bigby M, Bolognia JL, Brodland DG, Collins S, Cronin TA, Dahl MV, Grant-Kels JM, Hanke CW, Hruza GJ, James WD, Lober CW, McBurney EI, Norton SA, Roenigk RK, Wheeland RG, Wisco OJ. AAD/ACMS/ASDSA/ASMS 2012 appropriate use criteria for Mohs micrographic surgery: A report of the American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery Association, and the American Society for Mohs Surgery. J Am Acad Dermatol 2012; 67:531-50. [DOI: 10.1016/j.jaad.2012.06.009] [Citation(s) in RCA: 224] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 06/07/2012] [Accepted: 06/12/2012] [Indexed: 10/27/2022]
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Briesacher BA, Tjia J, Doubeni CA, Chen Y, Rao SR. Methodological issues in using multiple years of the Medicare current beneficiary survey. Medicare Medicaid Res Rev 2012; 2:mmrr2012-002-01-a04. [PMID: 24800135 PMCID: PMC4006385 DOI: 10.5600/mmrr.002.01.a04] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
BACKGROUND The analysis presented in this paper examines the multi-year capacity of the Medicare Current Beneficiary Survey (MCBS). METHODS We systematically reviewed the literature for methodological approaches in research using multiple years of the MCBS and categorized the studies by study design, use of survey sampling weights, and variance adjustments. We then replicated the approaches in an empirical demonstration using functional status (activities of daily living (ADL) and 2005-2007 MCBS data. RESULTS In the systematic review, we identified 22 pooled, 17 repeated cross-sectional, and 17 longitudinal studies. Less than half of these studies explicitly described the weighting approach or variance estimation. In the empirical demonstration, we showed that different study designs and weighting approaches will yield statistically different estimates. CONCLUSION There is a variety of methodological approaches when using multiple years of the MCBS, and some of them provide biased results. Research needs to improve in describing the methods and preferred approaches for using these complex data.
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Affiliation(s)
- Becky A Briesacher
- University of Massachusetts Medical School, Meyers Primary Care Institute, HealthCore Inc., and Bedford VA Medical Center
| | - Jennifer Tjia
- University of Massachusetts Medical School, Meyers Primary Care Institute, HealthCore Inc., and Bedford VA Medical Center
| | - Chyke A Doubeni
- University of Massachusetts Medical School, Meyers Primary Care Institute, HealthCore Inc., and Bedford VA Medical Center
| | - Yong Chen
- University of Massachusetts Medical School, Meyers Primary Care Institute, HealthCore Inc., and Bedford VA Medical Center
| | - Sowmya R Rao
- University of Massachusetts Medical School, Meyers Primary Care Institute, HealthCore Inc., and Bedford VA Medical Center
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Matteucci P, Pinder R, Magdum A, Stanley P. Accuracy in skin lesion diagnosis and the exclusion of malignancy. J Plast Reconstr Aesthet Surg 2011; 64:1460-5. [DOI: 10.1016/j.bjps.2011.06.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2011] [Revised: 06/01/2011] [Accepted: 06/14/2011] [Indexed: 10/18/2022]
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Abstract
Novel strategies are urgently needed to address the millions of nonmelanoma skin cancers treated in the United States annually. The need is greatest for those patients who are poor surgical candidates or those prone to numerous nonmelanoma skin cancers and therefore at risk for marked disfigurement. Traditional treatment strategies include electrosurgery with curettage, radiation therapy, cryotherapy, excision, and Mohs micrographic surgery. Alternatives to traditional treatment, including topical medications and light or laser therapies, are becoming popular; however, there are various degrees of efficacy among these alternative tactics. These alternatives include topical retinoids, peels, 5-fluorouracil, imiquimod, photodynamic therapy, and lasers. The purpose of this paper is to review the available data regarding these alternative strategies and permit the reader to have a sense of which therapies are reasonable options for care.
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Affiliation(s)
- Lori Brightman
- Laser & Skin Surgery Center of New York, 317 East 34th Street New York, NY 10016, USA.
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Lesiak A, Norval M, Wodz-Naskiewicz K, Pawliczak R, Rogowski-Tylman M, Sysa-Jedrzejowska A, Sobjanek M, Wlodarkiewicz A, Narbutt J. An enhanced risk of basal cell carcinoma is associated with particular polymorphisms in the VDR and MTHFR genes. Exp Dermatol 2011; 20:800-4. [DOI: 10.1111/j.1600-0625.2011.01328.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Tang JY, Fu T, Leblanc E, Manson JE, Feldman D, Linos E, Vitolins MZ, Zeitouni NC, Larson J, Stefanick ML. Calcium plus vitamin D supplementation and the risk of nonmelanoma and melanoma skin cancer: post hoc analyses of the women's health initiative randomized controlled trial. J Clin Oncol 2011; 29:3078-84. [PMID: 21709199 DOI: 10.1200/jco.2011.34.5967] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE In light of inverse relationships reported in observational studies of vitamin D intake and serum 25-hydroxyvitamin D levels with risk of nonmelanoma skin cancer (NMSC) and melanoma, we evaluated the effects of vitamin D combined with calcium supplementation on skin cancer in a randomized placebo-controlled trial. METHODS Postmenopausal women age 50 to 79 years (N = 36,282) enrolled onto the Women's Health Initiative (WHI) calcium/vitamin D clinical trial were randomly assigned to receive 1,000 mg of elemental calcium plus 400 IU of vitamin D3 (CaD) daily or placebo for a mean follow-up period of 7.0 years. NMSC and melanoma skin cancers were ascertained by annual self-report; melanoma skin cancers underwent physician adjudication. RESULTS Neither incident NMSC nor melanoma rates differed between treatment (hazard ratio [HR], 1.02; 95% CI, 0.95 to 1.07) and placebo groups (HR, 0.86; 95% CI, 0.64 to 1.16). In subgroup analyses, women with history of NMSC assigned to CaD had a reduced risk of melanoma versus those receiving placebo (HR, 0.43; 95% CI, 0.21 to 0.90; P(interaction) = .038), which was not observed in women without history of NMSC. CONCLUSION Vitamin D supplementation at a relatively low dose plus calcium did not reduce the overall incidence of NMSC or melanoma. However, in women with history of NMSC, CaD supplementation reduced melanoma risk, suggesting a potential role for calcium and vitamin D supplements in this high-risk group. Results from this post hoc subgroup analysis should be interpreted with caution but warrant additional investigation.
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Affiliation(s)
- Jean Y Tang
- Department of Dermatology, Stanford University School of Medicine, 450 Broadway, Pavilion C, MC 5334, Redwood City, CA, USA.
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Renzi C, Mastroeni S, Mannooranparampil TJ, Passarelli F, Potenza C, Pasquini P. Reliability of self-reported information on skin cancer among elderly patients with squamous cell carcinoma. Ann Epidemiol 2011; 21:551-4. [PMID: 21524593 DOI: 10.1016/j.annepidem.2011.02.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2010] [Revised: 02/02/2011] [Accepted: 02/24/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE We aimed to evaluate reliability of self-reported information on skin cancer among individuals aged > 65 years with cutaneous squamous cell carcinoma (SCC). METHODS A test-retest was performed with patients completing two questionnaires one month apart. RESULTS Among 102 recruited patients the response rate was 97.1% (mean age 80.9 years, 74.8% men). The majority of items showed substantial agreement: history of skin cancer screening (k = 0.88), past skin cancer in general (k = 0.92), basal cell carcinoma (k = 0.75), patient delay (k = 0.64) and total delay (k = 0.86). Agreement was high also for ages > 80 years. Recall of past SCCs (k = 0.48) and sunscreen use (k = 0.38) was less accurate. CONCLUSIONS Our study provided evidence on the reliability of patient reported skin cancer information among elderly individuals, who represent the majority of affected cases.
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Affiliation(s)
- Cristina Renzi
- Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata, Rome, Italy
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Efird JT, Toland AE, Lea CS, Phillips CJ. The combined influence of oral contraceptives and human papillomavirus virus on cutaneous squamous cell carcinoma. Clin Med Insights Oncol 2011; 5:55-75. [PMID: 21499554 PMCID: PMC3076039 DOI: 10.4137/cmo.s6905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The vast majority of cutaneous squamous cell carcinoma (CSCC) will occur in those with fair complexion, tendency to burn, and high ultraviolet radiation (UVR) exposure. Organ transplant recipients also are an important population at great risk for CSCC. An association has been reported between oral contraceptive (OC) use, human papillomavirus virus (HPV) and cervical cancer, and there could be a similar association for CSCC. The cutaneous HPV β-E6 protein, a close cousin of the transformative E6 protein underlying anogenital cancers, has been shown to inhibit apoptosis in response to UVR damage and stimulate morphologic transformation in rodent fibroblast cell lines. Furthermore, OC use has been shown to enhance HPV transcription and may contribute to CSCC risk through this pathway.
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Affiliation(s)
- Jimmy T. Efird
- Center for Health Disparities Research, Brody School of Medicine, East Carolina University, 1800 W. 5th Street (Medical Pavilon), Greenville, NC 27834 USA
- Department of Public Health, 1709 W. 6th Street, Mail Stop 660, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA
| | - Amanda E. Toland
- Department of Molecular Virology, Immunology and Medical Genetics, 998 Biomedical Research Tower, 460 W. 12th Avenue, The Ohio State University, Columbus, OH 43210, USA
| | - C. Suzanne Lea
- Department of Public Health, 1709 W. 6th Street, Mail Stop 660, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA
| | - Christopher J. Phillips
- Department of Defence Center for Deployment Health Research, Naval Health Research Center, Dept. 164, 140 Sylvester Rd., San Diego, CA 92106, USA
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Abstract
IMPORTANCE OF THE FIELD In the United States, the annual incidence of basal cell carcinoma (BCC) is close to 1 million. Ultraviolet radiation exposure is the main risk factor; however, the availability of ever more potent sunscreens and education have not prevented the rise in BCC incidence. Therefore, concerted effects to identify novel preventive and therapeutic strategies are necessary. AREAS COVERED IN THIS REVIEW This article summarizes our current understanding of the etiology and molecular mechanisms of BCC tumorigenesis and discusses the preclinical and clinical studies to identify agents with anti-BCC efficacy. WHAT THE READER WILL GAIN The discovery that hyperactive Hh pathway signaling causes several cancers, including BCC, has spawned the development of many pharmacologic inhibitors of Hh signaling. Early clinical testing of the most advanced, GDC-0449, demonstrated impressive efficacy in patients with advanced BCC. Other promising anti-BCC chemopreventive strategies include drugs that are already FDA-approved for treating other diseases. TAKE HOME MESSAGE Preclinical and clinical trials with pre-existing FDA-approved drugs suggest novel uses for BCC chemoprevention and treatment. Also, new chemical entities that inhibit the Hh pathway show promise, and in combination with other drugs may provide a nonsurgical cure for this most common cancer.
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Affiliation(s)
- Po-Lin So
- Children's Hospital Oakland Research Institute, Cancer Division, 5700 Martin Luther King Jr Way, Oakland, CA 94609, USA.
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48
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Abstract
BACKGROUND Based on empirical evidence, a personal history of nonmelanoma skin cancer (NMSC) has been hypothesized to be a risk factor for other cancers. Others hypothesize that NMSC may be a marker of high cutaneous vitamin D synthesis and therefore inversely associated with risk of other malignancies. To reconcile these divergent views, we carried out a systematic review to determine the association between NMSC and subsequent risk of other cancers. METHODS Bibliographic databases were searched through March 2009. Studies were included if sufficient information was presented to estimate the risk of developing other cancers following NMSC. Studies were reviewed and data were abstracted independently in duplicate with disagreements resolved by consensus. RESULTS Of the 21 included studies, 15 reported the association between NMSC and risk of all other cancers combined. NMSC was significantly associated with increased risk of another malignancy among cohort studies based on cancer registries summary random-effects relative risk (SRR), 1.12; 95% confidence interval (CI), 1.07-1.17; n = 12 studies) and those with individual-level data (SRR, 1.49; 95% CI, 1.12-1.98; n = 3). In stratified analyses of registry studies, this association held true for both squamous (SRR, 1.17; 95% CI, 1.12-1.23; n = 7) and basal cell carcinoma (SRR, 1.09; 95% CI, 1.01-1.17; n = 7), and both men (SRR, 1.14; 95% CI, 1.09-1.20; n = 12) and women (SRR, 1.10; 95% CI, 1.04-1.15; n = 12). CONCLUSIONS Strong, consistent evidence indicates that a personal history of NMSC is associated with increased risk of developing other malignancies. IMPACT For unknown reasons, NMSC may be a risk factor for other cancers.
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Affiliation(s)
- Lee Wheless
- Division of Biostatistics and Epidemiology, Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
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Tang JY, Parimi N, Wu A, Boscardin WJ, Shikany JM, Chren MM, Cummings SR, Epstein EH, Bauer DC. Inverse association between serum 25(OH) vitamin D levels and non-melanoma skin cancer in elderly men. Cancer Causes Control 2010; 21:387-91. [PMID: 19921445 PMCID: PMC2835729 DOI: 10.1007/s10552-009-9470-4] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Accepted: 11/03/2009] [Indexed: 01/09/2023]
Abstract
To determine the relationship between 25(OH) vitamin D levels and non-melanoma skin cancer (NMSC), we performed a nested case–control study in ambulatory, elderly men enrolled in the Osteoporotic Fractures in Men (MrOS) Study. Health habit and medical history, including self-reported history of NMSC were recorded and 25(OH)D levels were measured on serum collected at baseline from a random sample of Caucasian MrOS subjects. Mean age (73 ± 5), BMI, daily vitamin D and calcium intake were similar in the men with (n = 178) and without NMSC (n = 930), but higher levels of 25(OH)D were associated with a decreased risk of having a history of NMSC (Ptrend = 0.04). Men in the highest quintile of 25(OH)D (>30 ng/mL) had 47% lower odds of NMSC (95% CI: 0.30–0.93, p = 0.026) compared to those in the lowest quintile. Our results suggest that a diagnosis of NMSC is not a surrogate for adequate 25(OH)D levels or increased UV exposure, and high 25(OH)D levels may be associated with a reduced risk of NMSC.
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Affiliation(s)
- Jean Y Tang
- Children's Hospital of Oakland Research Institute, USA.
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Kravitz M. Indoor Tanning, Skin Cancer, and Tanorexia: Development of U.S. Indoor Tanning Policy. Journal of the Dermatology Nurses' Association 2010; 2:110-5. [DOI: 10.1097/jdn.0b013e3181e1adab] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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