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2.
Ugeskr Laeger ; 184(29)2022 Jul 18.
Article in Danish | MEDLINE | ID: mdl-35959819

ABSTRACT

Benign skin tumours are commonly seen by general practitioners. They are important to differentiate from skin malignancies. Most benign skin lesions are diagnosed based on the history and clinical features. However, if the clinical diagnosis is uncertain, a skin biopsy, e.g. excisional or punch for histopathological examination is necessary to rule out malignancy. Seborrheic keratoses are the most common benign skin tumours with an increasing incidence with age. Other common benign skin lesions include melanocytic naevi, acrochordons and dermatofibromas, which may resemble malignant neoplasms.


Subject(s)
Nevus, Pigmented , Skin Diseases , Skin Neoplasms , Biopsy , Humans , Nevus, Pigmented/diagnosis , Nevus, Pigmented/pathology , Nevus, Pigmented/surgery , Skin/pathology , Skin Diseases/pathology , Skin Neoplasms/diagnosis , Skin Neoplasms/epidemiology , Skin Neoplasms/surgery
3.
Cancer Causes Control ; 33(9): 1161-1172, 2022 Sep.
Article in English | MEDLINE | ID: mdl-35799033

ABSTRACT

PURPOSE: To quantitatively evaluate contributions of trends in incidence, relative survival, and stage at diagnosis to the dynamics in the prevalence of major cancers (lung, prostate, colon, breast, urinary bladder, ovaries, stomach, pancreas, esophagus, kidney, liver, and skin melanoma) among older U.S. adults age 65 +. METHODS: Trend partitioning was applied to the Surveillance, Epidemiology, and End Results Program data for 1973-2016. RESULTS: Growth of cancer prevalence in older adults decelerated or even decreased over time for all studied cancers due to decreasing incidence and improving survival for most of cancers, with a smaller contribution of the stage at cancer diagnosis. Changes in the prevalence of cancers of the lung, colon, stomach, and breast were predominantly due to decreasing incidence, increasing survival and more frequent diagnoses at earlier stages. Changes in prevalence of some other cancers demonstrated adverse trends such as decreasing survival in localized and regional stages (urinary bladder and ovarian) and growing impact of late-stage diagnoses (esophageal cancer). CONCLUSION: While decelerating or decreasing prevalence of many cancers were due to a beneficial combination of decreasing incidence and increasing survival, there are cancers for which decelerating prevalence is due to lack of improvement in their stage-specific survival and/or increasing frequency of diagnosis at advanced stages. Overall, if the observed trends persist, it is likely that the burden associated with cancer prevalence in older U.S. adults will be lower  comparing to projections based on constant increasing prevalence have previously estimated.


Subject(s)
Esophageal Neoplasms , Melanoma , Neoplasms , Skin Neoplasms , Adult , Aged , Humans , Incidence , Male , Melanoma/epidemiology , Middle Aged , Prevalence , Registries , Skin Neoplasms/epidemiology
4.
BMC Cancer ; 22(1): 836, 2022 Jul 30.
Article in English | MEDLINE | ID: mdl-35907848

ABSTRACT

BACKGROUND: The disease burden of non-melanoma skin cancer (NMSC) has become a significant public health threat. We aimed to conduct a comprehensive analysis to mitigate the health hazards of NMSC. METHODS: This study had three objectives. First, we reported the NMSC-related disease burden globally and for different subgroups (sex, socio-demographic index (SDI), etiology, and countries) in 2019. Second, we examined the temporal trend of the disease burden from 1990 to 2019. Finally, we used the Bayesian age-period-cohort (BAPC) model integrated nested Laplacian approximation to predict the disease burden in the coming 25 years. The Norpred age-period-cohort (APC) model and the Autoregressive Integrated Moving Average (ARIMA) model were used for sensitivity analysis. RESULTS: The disease burden was significantly higher in males than in females in 2019. The results showed significant differences in disease burden in different SDI regions. The better the socio-economic development, the heavier the disease burden of NMSC. The number of new cases and the ASIR of basal cell carcinoma (BCC) were higher than that of squamous cell carcinoma (SCC) in 2019 globally. However, the number of DALYs and the age-standardized DALYs rate were the opposite. There were statistically significant differences among different countries. The age-standardized incidence rate (ASIR) of NMSC increased from 54.08/100,000 (95% uncertainty interval (UI): 46.97, 62.08) in 1990 to 79.10/100,000 (95% UI: 72.29, 86.63) in 2019, with an estimated annual percentage change (EAPC) of 1.78. Other indicators (the number of new cases, the number of deaths, the number of disability-adjusted life years (DALYs), the age-standardized mortality rate (ASMR), and the age-standardized DALYs rate) showed the same trend. Our predictions suggested that the number of new cases, deaths, and DALYs attributable to NMSC would increase by at least 1.5 times from 2020 to 2044. CONCLUSIONS: The disease burden attributable to NMSC will continue to increase or remain stable at high levels. Therefore, relevant policies should be developed to manage NMSC, and measures should be taken to target risk factors and high-risk groups.


Subject(s)
Global Burden of Disease , Skin Neoplasms , Adult , Bayes Theorem , Cost of Illness , Female , Global Health , Humans , Incidence , Male , Quality-Adjusted Life Years , Risk Factors , Skin Neoplasms/epidemiology
5.
BMC Public Health ; 22(1): 1282, 2022 07 02.
Article in English | MEDLINE | ID: mdl-35780087

ABSTRACT

BACKGROUND: Keratinocyte cancer (KC) rates are increasing in the U.S., particularly in older age groups. Use of hydrochlorothiazide (HCTZ), due to its photosensitizing properties, and high sun exposure are two known NMSC risk factors, but their synergistic effects are undetermined. The purpose of this study was to examine the development of NMSC between adults who did and did not use HCTZ, as well as those with high and low sun exposure. METHODS: A retrospective case-control sample was assembled from adult patients in north-central Wisconsin (USA). Duration of HCTZ use and occupational sun exposure were extracted from electronic health records, along with a linked survey of lifetime sun exposure. RESULTS: There were 333 cases and 666 controls in the analytical sample. A significant main effect was observed for HCTZ duration in the full sample. Under low sun exposure, the odds of NMSC was 14% greater for each additional year of HCTZ use (aOR = 1.14 [1.11, 1.18], p < 0.001). In a sensitivity analysis of participants age 70 years and over, there was a borderline significant (p = 0.086) HCTZ use by high sun exposure interaction, suggesting modestly increased HCTZ risk in older, high sun exposure adults. CONCLUSIONS: Consistent with prior studies, longer duration of HCTZ use was a predictor of NMSC in north-central Wisconsin adults. NMSC may be accelerated in HCTZ users with outdoor lifestyles, but future studies should attempt to further disaggregate specific effects of sun exposure time, HCTZ duration, and age on NMSC development.


Subject(s)
Hydrochlorothiazide , Skin Neoplasms , Adult , Aged , Humans , Hydrochlorothiazide/adverse effects , Keratinocytes , Retrospective Studies , Skin Neoplasms/epidemiology , Skin Neoplasms/etiology , Sunlight/adverse effects , United States
6.
Cutis ; 109(5): 272-276, 2022 May.
Article in English | MEDLINE | ID: mdl-35856762

ABSTRACT

The COVID-19 pandemic has impacted the practice of Mohs micrographic surgery (MMS). We sought to determine the characteristics of skin cancers treated by MMS during the pandemic compared with prepandemic controls. A retrospective chart review was conducted. Tumors included were all treated in accordance with best practice guidelines set forth by state- and national-level professional governing bodies. Bivariate and multivariate analyses were performed to compare outcome variables. Changes in tumor characteristics during the pandemic are of clinical significance, potentially affecting extent of reconstructive surgery, cost, operating time, and future tumor characteristics.


Subject(s)
COVID-19 , Skin Neoplasms , COVID-19/epidemiology , Humans , Mohs Surgery , Pandemics , Retrospective Studies , Skin Neoplasms/epidemiology , Skin Neoplasms/pathology , Skin Neoplasms/surgery
7.
Article in English | MEDLINE | ID: mdl-35886215

ABSTRACT

The global incidence of skin cancer has steadily increased in recent years, and malignant melanoma still has one of the fastest-growing incidence rates among all malignant tumors in the western world. Thus, newly diagnosed patients have an increased need for health information concerning their disease. Using a standardized questionnaire, our study aims to investigate our patients' primary sources of health-related information as well as their self-proclaimed eHealth literacy. We received 714 questionnaires. Regardless of age, the primary source of information was the treating dermato-oncologist, followed by the treating general practitioner and the Internet. However, with increasing age, the usage of the Internet decreased. Hence, younger participants were better equipped to find health-related information while using the Internet. Additionally, comprehending health-related information and gaining medical knowledge was significantly increased in better-educated participants. Overall, our study shows that with increased use of eHealth services, accessing web-based information increased, correlating with a better eHealth literacy of our patients. eHealth technologies are increasingly becoming more prevalent as a primary source of information in our modern health care system. Thus, it is crucial to educate cancer patients in eHealth literacy to make autonomous, informed decisions and gain more confidence in dealing with their disease.


Subject(s)
Health Literacy , Melanoma , Skin Neoplasms , Telemedicine , Humans , Internet , Melanoma/epidemiology , Skin Neoplasms/epidemiology , Surveys and Questionnaires
8.
BMC Med ; 20(1): 228, 2022 07 07.
Article in English | MEDLINE | ID: mdl-35794547

ABSTRACT

BACKGROUND: Previous findings on the associations of thiazide use with skin cancers were conflicting. This study aimed to examine the associations of individual thiazide use with skin cancer risk, differentiated by subtypes of skin cancers, geographic regions, and cumulative doses of individual thiazides. METHODS: We searched PubMed, Embase, and Cochrane Central Register of Controlled Trials for relevant studies on January 5, 2022, scanned the references of included studies, and consulted experts. We included case-control and cohort studies or randomized trials reporting the associations of individual thiazide or thiazide-like diuretics use with skin cancers. Non-melanoma skin cancer (NMSC) and melanoma were analysed separately. A random-effects model meta-analysis was conducted for pooled odds ratio (OR) and hazard ratio (HR) for skin cancers related to individual thiazide use. RESULTS: We included 15, 5, and 5 case-control or cohort studies reporting the risk for skin cancers associated with hydrochlorothiazide, bendroflumethiazide, and indapamide use, respectively, with 17,848,313 participants. The meta-analysis showed associations of hydrochlorothiazide use with increased risk of NMSC (OR 1.16, 95% CI 1.08-1.24; HR 1.26, 95% CI 1.04-1.54), squamous cell carcinoma (SCC) (OR 1.32, 95% CI 1.06-1.65; HR 1.61, 95% CI 0.97-2.67), and melanoma (OR 1.11, 95% CI 1.02-1.20; HR 1.03, 95% CI 0.93-1.14). The increased risks for SCC were associated with high cumulative doses of hydrochlorothiazide (OR 2.56, 95% CI 1.43-4.57; HR 1.20, 95% CI 1.00-1.45). Hydrochlorothiazide use was associated with different subtypes of melanoma including superficial spreading (OR 1.18, 95% CI 1.05-1.33), nodular (OR 1.23, 95% CI 1.08-1.39), and lentigo maligna melanoma (OR 1.33, 95% CI 1.08-1.65). Various cumulative doses of hydrochlorothiazide were associated with increased odds for melanoma. However, the associations of hydrochlorothiazide use with increased risk of NMSC and melanoma only appeared in non-Asian countries. No meaningful increase in the risk for skin cancers was associated with bendroflumethiazide and indapamide. CONCLUSIONS: Hydrochlorothiazide is associated with an increased risk for NMSC (especially SCC) and melanoma in non-Asian countries, whereas bendroflumethiazide and indapamide are not associated with a meaningful risk for skin cancers. Healthcare professionals and patients should be informed of the different risk profiles of skin cancers associated with different thiazides, cumulative doses, and regions. TRIAL REGISTRATION: PROSPERO CRD42021234317 .


Subject(s)
Carcinoma, Squamous Cell , Indapamide , Melanoma , Skin Neoplasms , Bendroflumethiazide , Humans , Hydrochlorothiazide , Melanoma/chemically induced , Melanoma/epidemiology , Skin Neoplasms/chemically induced , Skin Neoplasms/epidemiology , Thiazides
9.
Magy Onkol ; 66(2): 94-99, 2022 Jun 20.
Article in Hungarian | MEDLINE | ID: mdl-35724385

ABSTRACT

Skin melanoma is not among malignancies with the highest incidences and mortalities worldwide; however, the observed constant increase in newly diagnosed cases is troublesome. According to the database of the Hungarian Cancer Registry, the number of newly reported cases doubled between 2001 and 2019, which is consistent with international data. Notwithstanding, within the same interval, Hungarian mortality did not change significantly according to the database of the Hungarian Statistical Office, which is in contrast to international trends. The increasing incidence together with unchanging mortality resulted in better survival rates and hence more favorable follow-up data in our country. Advancements in secondary prevention programs and better efficacy of modern therapeutic interventions in the last decade may have contributed to the observed improvement in the survival rates of Hungarian melanoma patients.


Subject(s)
Melanoma , Skin Neoplasms , Humans , Hungary/epidemiology , Incidence , Melanoma/epidemiology , Skin Neoplasms/epidemiology , Skin Neoplasms/pathology , Survival Rate
10.
J Evid Based Dent Pract ; 22(2): 101717, 2022 06.
Article in English | MEDLINE | ID: mdl-35718442

ABSTRACT

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: González-Moles MÁ, Ramos-García P, Warnakulasuriya S. An appraisal of highest quality studies reporting malignant transformation of oral lichen planus based on a systematic review. Oral Dis. 2021 Nov;27(8):1908-1918. doi: 10.1111/odi.13741. Epub 2020 Dec 24. PMID: 33274561. SOURCE OF FUNDING: The Royal College of Physicians and Surgeons (RCPSG) provided logistic support for holding the expert symposium. Henry Schein Cares provided an educational grant for travel expenses for some of the invited experts. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis.


Subject(s)
Cell Transformation, Neoplastic , Lichen Planus, Oral/pathology , Skin Neoplasms/pathology , Cell Transformation, Neoplastic/pathology , Humans , Lichen Planus, Oral/epidemiology , Skin Neoplasms/epidemiology
11.
West Afr J Med ; 39(6): 623-627, 2022 Jun 24.
Article in English | MEDLINE | ID: mdl-35752963

ABSTRACT

BACKGROUND: Malignant melanoma (MM) is the most lethal of all cutaneous malignancies, accounting for about 79% of skin cancer related deaths. In blacks, it is associated with greater morbidity and mortality compared to Caucasians. Breslow thickness and ulceration status are two of the most important histopathologic prognostic factors in MM. No study on MM in Nigeria has however examined these factors. METHODS: Formalin-fixed paraffin-embedded (FFPE) tissue blocks and corresponding Haematoxylin and Eosin (H&E) stained slides of all confirmed cases of MM from January 2005 to December 2014 in the AMP Department of Lagos University Teaching Hospital (LUTH) were retrieved. RESULTS: Fifty-two MM cases were histologically diagnosed in LUTH during the study period which represented 1.0% of total solid malignancies. Forty-three of these occurred in the skin accounting for 19.7% of all skin malignancies and making MM the 3rd commonest skin malignancy after squamous cell carcinoma (SCC) and kaposi sarcoma (KS). Eighty eight percent (88%) of the tumour were in Clark's stage IV and V while 84% had Breslow thickness >4mm. Ulceration was present in 67%. The Clark's level and Breslow thickness were correlated with the ulceration status of the tumour. There is significant correlation between the Breslow thickness and ulceration with p-value < 0.05 while there is no significant association between the Clark's level and ulceration. CONCLUSION: MM constituted a significant proportion of skin malignancy in LUTH and majority of the cases present at an advanced stage. Breslow thickness and ulceration statuses of the tumour are important histopathologic parameters that should be reported in all MM biopsies.


CONTEXTE: Le mélanome malin (MM) est la plus meurtrière de toutes les affections malignes cutanées, représentant environ 79 % des décès liés au cancer de la peau. Chez les Noirs, il est associé à une plus grande morbidité et de mortalité plus élevées que chez les Caucasiens. L'épaisseur de Breslow et le statut d'ulcération sont deux des facteurs pronostiques histopathologiques les plus importants du MM. Aucune étude sur le MM au Nigeria n'a cependant examiné ces facteurs. MÉTHODES: Nous avons récupéré des blocs de tissus fixés au formol et incorporés en paraffine (FFPE) ainsi que les lames correspondantes colorées à l'hématoxyline et à l'éosine (H&E) de tous les cas confirmés de MM entre janvier 2005 et décembre 2014 dans le département AMP du Lagos University Teaching Hospital (LUTH). RÉSULTATS: Cinquante-deux cas de MM ont été diagnostiqués histologiquement au LUTH pendant la période d'étude, ce qui représente 1,0 % du total des tumeurs malignes solides. Quarantetrois de ces cas sont survenus dans la peau, ce qui représente 19,7% de toutes les tumeurs cutanées et fait du MM la troisième tumeur cutanée la plus fréquente après le carcinome épidermoïde (SCC) et le sarcome de Kaposi (KS). Quatre-vingt huit pour cent (88%) de la tumeur étaient au stade IV et V de Clark tandis que 84% avaient une épaisseur de Breslow e"4mm. Une ulcération était présente dans 67% des cas. Le niveau de Clark et l'épaisseur de Breslow étaient corrélés avec le statut d'ulcération de la tumeur. Il existe une corrélation significative entre l'épaisseur de Breslow et l'ulcération avec une valeur p < 0,05 alors qu'il n'y a pas d'association significative entre le niveau de Clark et l'ulcération. CONCLUSION: Le MM constitue une proportion significative des tumeurs cutanées malignes à l'hôpital LUTH et la majorité des cas sont à un stade avancé. L'épaisseur de Breslow et les statuts d'ulcération de la tumeur sont des paramètres histopathologiques importants qui devraient être rapportés dans toutes les biopsies de MM. Mots clés: Mélanome malin, épaisseur de Breslow, niveau de Clark, ulcération, facteurs pronostiques.


Subject(s)
Melanoma , Skin Neoplasms , Humans , Melanoma/epidemiology , Melanoma/pathology , Neoplasm Staging , Nigeria/epidemiology , Prognosis , Skin Neoplasms/epidemiology , Skin Neoplasms/pathology
12.
Surg Oncol Clin N Am ; 31(3): 511-525, 2022 07.
Article in English | MEDLINE | ID: mdl-35715147

ABSTRACT

Skin sarcomas are tumors that are superficial and small in size in comparison with other sarcomas arising in intramuscular or intrabdominal sites. Skin sarcomas are often underrecognized and misdiagnosed. A high level of suspicion is needed, as early recognition and appropriate management including initial surgery is important for oncologic outcomes. Here, the epidemiology, clinical presentation, management, and surveillance of 4 common cutaneous sarcomas are reviewed.


Subject(s)
Sarcoma , Skin Neoplasms , Soft Tissue Neoplasms , Humans , Sarcoma/diagnosis , Sarcoma/epidemiology , Sarcoma/therapy , Skin Neoplasms/diagnosis , Skin Neoplasms/epidemiology , Skin Neoplasms/therapy
13.
Ann Palliat Med ; 11(5): 1736-1751, 2022 May.
Article in English | MEDLINE | ID: mdl-35672891

ABSTRACT

BACKGROUND: Melanoma is a malignant tumor with poor prognosis and increasing global incidence. Little is known about the burden of melanoma in eastern Chinese cities, as the results of previous studies are inconsistent or unclear. METHODS: In this study, we collected incidence rate data from the Ningbo National Health Information Platform, diagnostic data from the Ningbo Clinicopathological Diagnosis Center, and other relevant data from the Ningbo Bureau of Statistics to evaluate temporal trends and geographic variation in melanoma incidence and to analyze the relationship between melanoma incidence and medical resource availability. RESULTS: The incidence of melanoma in Ningbo has increased significantly in the past 8 years. In 2018, melanoma incidence in Ningbo was 521.67% higher than that in 2011, which was higher than the increase in the national rate. This may be a result of our study including early melanoma, which has a faster increase rate than invasive melanoma. The incidence rate of melanoma in urban areas was significantly higher than that in rural districts. From 2011 to 2018, the incidence rate in rural districts increased by 794.15%, which was significantly higher than the incidence rate increase in urban areas (245.03%). CONCLUSIONS: All indicators relating to medical resources had a significant positive impact on melanoma incidence, indicating that the low incidence of melanoma is partly due to a lack of medical resources, which can lead to delayed treatment and increased disability-adjusted life years (DALYs). Therefore, it is necessary to continue to strengthen investment in medical resources, especially in China's rural areas and western regions where medical resources are less available.


Subject(s)
Melanoma , Skin Neoplasms , China/epidemiology , Cities , Humans , Incidence , Melanoma/epidemiology , Skin Neoplasms/epidemiology
14.
J Eur Acad Dermatol Venereol ; 36 Suppl 6: 5-11, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35738812

ABSTRACT

Euromelanoma is a Europe-wide, dermatologist-led organization that campaigns to have a public, scientific, and political impact on raising awareness of the prevention, early diagnosis, and treatment of skin cancer. The organization raises public awareness of skin cancer by providing practical support to participating countries for the roll out of yearly screening campaigns, and then builds on these campaigns by providing resources via its website to educate the general public on key skin cancer prevention measures, risk factors, and the importance of recognizing abnormal lesions through self-examination. Euromelanoma also provides a valuable platform for the scientific community, facilitating collaborations between countries and coordinating the collection of standardized data on the epidemiology, demographic and clinical characteristics, and risk factors for all forms of skin cancer. As our scientific understanding of skin cancer advances, Euromelanoma plays a key role in ensuring that the importance of skin cancer prevention, treatment, and diagnosis remains at the forefront of European and national healthcare policies. Since its creation in 1999, Euromelanoma has continued to evolve, adapt, and expand its approach to achieve these public, scientific, and political goals: the organization now has networks of dermatologists working in over 30 countries and has screened and gathered skin cancer data from around 420 000 subjects. This review highlights these achievements by providing an outline of the history of Euromelanoma and the benefits of the first decade of action and by describing the evolving approach over the past 20 years. Future Euromelanoma projects, which aim to evaluate skin cancer risk in specific populations (outdoor workers, organ transplant recipients, etc.) are also introduced, and current challenges for the Euromelanoma campaign are discussed, including the need to improve reporting of non-melanoma skin cancer cases and to raise awareness of melanoma subtypes, particularly the more difficult to diagnose nodular melanoma form.


Subject(s)
Melanoma , Skin Neoplasms , Europe/epidemiology , Humans , Mass Screening , Melanoma/diagnosis , Melanoma/epidemiology , Melanoma/prevention & control , Self-Examination , Skin Neoplasms/diagnosis , Skin Neoplasms/epidemiology , Skin Neoplasms/prevention & control
16.
Transl Vis Sci Technol ; 11(6): 3, 2022 06 01.
Article in English | MEDLINE | ID: mdl-35653147

ABSTRACT

Purpose: To investigate the association between outdoor time and the risk of cataract surgery in a large Australian population. Methods: This was a population-based prospective cohort study with 137,133 participants 45 to 65 years of age and without prior history of cataract surgery from the 45 and Up Study. Outdoor hours per day on weekdays and weekends, as well as tanning with repeated sun exposure, were assessed by a self-administered baseline questionnaire. Cataract surgery events were confirmed by the Medicare Benefits Schedule from baseline until the end of follow-up in 2016. Results: During a mean follow-up of 9 years, 14,338 participants received cataract surgery with a corresponding incidence of 10.5%. Multiple Cox regression analysis showed that more outdoor hours on weekends (P trend < 0.001) and the ability to get tanned by repeated sun exposure (P trend = 0.041) were significantly associated with a lower risk of cataract surgery, whereas more outdoor hours on weekdays were nominally significantly associated (P trend = 0.055). Participants who spent 10+ hours outdoors on weekends had 9% decreased risk compared with those who spent ≤2 hours outdoors. In addition, compared to participants who got very tanned by repeated sun exposure, those less likely to get tanned had a 5% to 7% increased risk of cataract surgery. Conclusions: In this large Australian cohort 45 to 65 years of age, more outdoor time and ease of tanning with sun exposure were associated with a lower incidence of cataract surgery. Translational Relevance: With proper sun protection, more outdoor time may lead to a lower risk of severe cataracts requiring surgery.


Subject(s)
Cataract , Skin Neoplasms , Aged , Australia/epidemiology , Cataract/complications , Cataract/etiology , Humans , National Health Programs , Prospective Studies , Skin Neoplasms/epidemiology , Skin Neoplasms/etiology , Skin Neoplasms/prevention & control
17.
BMC Health Serv Res ; 22(1): 771, 2022 Jun 11.
Article in English | MEDLINE | ID: mdl-35690746

ABSTRACT

BACKGROUND: Routine skin cancer screening (SCS) is covered by the German statutory health insurance (SHI) since 2008. The objective of this study was to compare direct healthcare costs between patients in whom skin cancer was detected by routine SCS and patients in whom skin cancer was not detected by routine SCS. METHODS: A retrospective observational study of administrative claims data from a large German SHI was performed. Patients with a diagnosis of malignant melanoma (MM) or non-melanoma skin cancer (NMSC) diagnosed in 2014 or 2015 were included. Costs were obtained for one year before and one year after diagnosis and analyzed in a difference-in-differences approach using regression models. Frequency matching was applied and risk adjustment was performed. Additional analyses were conducted, separately for specific age groups, excluding persons who died during the observation period and without taking costs for screening into consideration. RESULTS: A total of 131,801 patients were included, of whom 13,633 (10.3%) had a diagnosis of MM and 118,168 (89.7%) had a diagnosis of NMSC. The description of total costs (without risk adjustment) shows lower mean total costs among patients whose skin cancer was detected via routine SCS compared to patients in whom skin cancer was not detected by routine SCS (MM: €5,326 (95% confidence interval (CI) €5,073; €5,579) vs. €9,038 (95% CI €8,629; €9,448); NMSC: €4,660 (95% CI €4,573; €4,745) vs. €5,890 (95% CI €5,813; €5,967)). Results of the regression analysis show cost savings of 18.8% (95% CI -23.1; -8.4) through routine SCS for patients with a diagnosis of MM. These cost savings in MM patients were more pronounced in patients younger than 65 years of age. For patients with a diagnosis of NMSC, the analysis yields a non-substantial increase in costs (2.5% (95% CI -0.1; 5.2)). CONCLUSION: Cost savings were detected for persons with an MM diagnosed by routine SCS. However, the study could not detect lower costs due to routine SCS in the large fraction of persons with a diagnosis of NMSC. These results offer important insights into the cost structure of the routine SCS and provide opportunities for refinements.


Subject(s)
Data Analysis , Skin Neoplasms , Follow-Up Studies , Germany/epidemiology , Health Care Costs , Humans , Melanoma , Retrospective Studies , Skin Neoplasms/diagnosis , Skin Neoplasms/epidemiology
18.
World J Surg ; 46(8): 1820-1825, 2022 Aug.
Article in English | MEDLINE | ID: mdl-35691970

ABSTRACT

BACKGROUND: For melanoma patients, timely identification and tumor thickness are directly correlated with outcomes. COVID-19 impacted both patients' ability and desire to see physicians. We sought to identify whether the pandemic correlated with changes in melanoma thickness at presentation and subsequent treatment timeline. METHODS: Retrospective chart review was performed on patients who underwent surgery for melanoma in an academic center surgical oncology practice from May 2019 to September 2021. Patients were split into two cohorts: "pre-pandemic" from May 2019 to May 2020 and "pandemic," after May 2020, representing when these patients received their initial diagnostic biopsy. Demographic and melanoma-specific variables were recorded and analyzed. RESULTS: A total of 112 patients were identified: 51 patients from the "pre-pandemic" and 61 from the "pandemic" time period. The pandemic cohort more frequently presented with lesions greater than 1 mm thickness compared to pre-pandemic (68.8% v 49%, p = 0.033) and were found to have significantly more advanced T stage (p = 0.02) and overall stage disease (p = 0.022). Additionally, trends show that for pandemic patients more time passed from patient-reported lesion appearance/change to diagnostic biopsy (5.7 ± 2.0 v 7.1 ± 1.5 months, p = 0.581), but less time from biopsy to operation (42.9 ± 2.4 v 52.9 ± 5.0 days, p = 0.06). CONCLUSIONS: "Pandemic" patients presented with thicker melanoma lesions and more advanced-stage disease. These results may portend a dangerous trend toward later stage at presentation, for melanoma and other cancers with rapid growth patterns, that will emerge as the prolonged effects of the pandemic continue to impact patients' presentation for medical care.


Subject(s)
COVID-19 , Melanoma , Skin Neoplasms , Animals , COVID-19/epidemiology , Canaries , Coal , Humans , Melanoma/epidemiology , Melanoma/surgery , Pandemics , Retrospective Studies , Skin Neoplasms/epidemiology , Skin Neoplasms/pathology , Skin Neoplasms/surgery
19.
Immun Inflamm Dis ; 10(7): e623, 2022 07.
Article in English | MEDLINE | ID: mdl-35759242

ABSTRACT

BACKGROUND: The Black population has lower skin cancer incidence compared to White, Indian/Asian, and Mixed-race populations in South Africa; however, skin cancer still exists in the Black population. The aim of this study is to identify risk factors associated with skin cancer among Black South Africans. MATERIALS AND METHODS: A case-control study was conducted. Cases were patients with keratinocyte cancers (KCs) and/or melanoma skin cancers (MSCs) and controls were cardiovascular patients. Sociodemographic exposures, environmental health variables, smoking, and HIV status were assessed. Stepwise logistic regression was used to identify risk factors associated with KCs and MSCs. RESULTS: The KCs histological subtypes showed that there were more squamous cell carcinomas (SCCs) (78/160 in females, and 72/160 in males) than basal cell carcinomas (BCCs). The SCC lesions were mostly found on the skin of the head and neck in males (51%, 38/72) and on the trunk in females (46%, 36/78). MSC was shown to affect the skin of the lower limbs in both males (68%, 27/40) and females (59%, 36/61). Using females as a reference group, when age, current place of residency, type of cooking fuel used, smoking, and HIV status were adjusted for, males had an odds ratio (OR) of 2.04 for developing KCs (confidence interval [CI]: 1.08-3.84, p = .028). Similarly, when age, current place of residency, and place of cooking (indoors or outdoors) were adjusted for, males had an OR of 2.26 for developing MSC (CI: 1.19-4.29, p = .012). CONCLUSIONS: Differences in the anatomical distribution of KCs by sex suggest different risk factors between sexes. There is a positive association between being male, smoking, rural dwelling, and a positive HIV status with KCs and being male and rural dwelling with MSC. The rural dwelling was a newly found association with skin cancer and warrants further investigation.


Subject(s)
HIV Infections , Skin Neoplasms , Case-Control Studies , Female , HIV Infections/epidemiology , Humans , Male , Melanoma , Risk Factors , Skin Neoplasms/epidemiology , South Africa/epidemiology
20.
Article in English | MEDLINE | ID: mdl-35682459

ABSTRACT

The association between skin cancer and ultraviolet radiation (UVR) is well established, and sun protection behavior represents an important preventative measure. In children, caregivers play a key role in this regard. The subject of this study was threefold: whether caregivers of 1 to 11 year-old children are more likely to use sun protection measures compared to non-caregivers, whether considering oneself a role model is associated with sun protection behaviors, and whether their sun protection and risk behaviors are related to children's behaviors. We used data from the 2020 wave of the National Cancer Aid Monitoring (NCAM) comprised of 4000 individuals (including 554 caregivers of at least one child aged 1-10 years) aged 16 to 65 years and living in Germany. Data were collected through telephone interviews between October and December 2020. No significant differences between caregivers and non-caregivers regarding sun protection and risk behaviors were identified (except tanning on vacation). In both groups, sun protection behaviors were deficient. Caregivers who considered themselves role models concerning sun safety were more likely to use sun protection measures (e.g., using sunscreen on the face: OR = 5.08, p < 0.001). In addition, caregivers' sun protection behaviors were positively associated with children's behaviors. Caregivers being highly protected against UVR were more likely to report the use of different measures by/in the child (mean = 4.03), compared to caregivers with medium (3.41) and low (2.97, p < 0.001) protection levels. However, we also found that caregivers' risk behavior was associated with children's reported risk behavior. For future prevention, it might be worth focusing on the aspect of caregivers serving as role models. A comprehensive public-health strategy is needed, including key figures such as pediatricians to prevent today's children from developing skin cancer in later life.


Subject(s)
Skin Neoplasms , Sunburn , Caregivers , Child , Child, Preschool , Health Behavior , Humans , Infant , Prevalence , Skin Neoplasms/epidemiology , Skin Neoplasms/prevention & control , Sunburn/prevention & control , Sunscreening Agents/therapeutic use , Ultraviolet Rays/adverse effects
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