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1.
Adv Clin Exp Med ; 29(10): 1221-1230, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33064381

RESUMO

The increasing number of hematopoietic stem cell transplantation (HSCT) procedures and lower transplant-related mortality has led to a growing population of survivors facing long-term increased risk of secondary malignancy, including cutaneous neoplasms. In this review, we aim to discuss the incidence, risk factors and preventive strategies for secondary skin neoplasms after autologous and allogeneic HSCT. Cutaneous neoplasms, such as basal cell carcinoma, squamous cell carcinoma and melanoma, are among the most common solid cancers arising in patients after HSCT. Besides risk factors established in the general population, primary disease, chronic graft-versus-host disease (CGvHD), prolonged immunosuppression, especially with the use of cyclosporine and azathioprine, radiation exposure, light skin color, male sex, and young age at transplantation play a role in the development of cutaneous neoplasms in HSCT recipients. Skin cancer development after HSCT may be explained by cumulative effects of chemotherapy and radiotherapy-induced DNA damage, prolonged immunosuppressive conditions and chronic mucosal inflammation, particularly after allogeneic HSCT. Delayed immune recovery and persistent immunodeficiency in patients with graft-versus-host disease (GvHD) may also contribute to carcinogenesis. Regular dermatological surveillance and prompt recognition of precancerous and cancerous lesions is crucial for patient's prognosis and management.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Neoplasias Cutâneas , Ciclosporina , Doença Enxerto-Hospedeiro/etiologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/etiologia , Transplante Homólogo
2.
Adv Exp Med Biol ; 1268: 115-122, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32918215

RESUMO

Increasing sun exposure is related to lower prevalence of death in cardiovascular disease (CVD), type 2 diabetes, and other noncancer non-CVD. In this chapter we aim to make a short update on the knowledge regarding sun exposure and all-cause mortality. Data support the hypothesis that low sun exposure habits are a major risk factor for all-cause mortality. Low sun exposure is related to an increased risk of death due to CVD and noncancer/non-CVD, and a minor reduction in risk of cancer. Active sun exposure habits have a dual effect; it increases the incidence of skin cancer, but also improves the prognosis in terms of all-cause mortality. In a low solar intensity region, we should carefully assess both risk and benefits of sun exposure in order to obtain balanced recommendations.


Assuntos
Causas de Morte , Luz Solar , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/prevenção & controle , Humanos , Fatores de Risco , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/etiologia
3.
Adv Exp Med Biol ; 1268: 123-139, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32918216

RESUMO

Melanoma and keratinocyte skin cancer (KSC) are the most common types of cancer in White-skinned populations. Both tumor entities showed increasing incidence rates worldwide but stable or decreasing mortality rates. Rising incidence rates of cutaneous melanoma (CM) and KSC are largely attributed to increasing exposure to ultraviolet (UV) radiation, the main causal risk factor for skin cancer.Incidence rates of KSC, comprising of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are much higher than that of melanoma. BCC development is mainly the cause of an intensive UV exposure in childhood and adolescence, while SCC development is related to chronic, cumulative UV exposure over decades. Although mortality is relatively low, KSC is an increasing problem for health care services causing significant morbidity.Cutaneous melanoma is rapidly increasing in White populations, with an estimated annual increase of around 3-7% over the past decades. In contrast to SCC, melanoma risk is associated with intermittent and chronic exposure to sunlight. The frequency of its occurrence is closely associated with the constitutive color of the skin and the geographical zone. Changes in outdoor activities and exposure to sunlight during the past 70 years are an important factor for the increasing incidence of melanoma. Mortality rates of melanoma show stabilization in the USA, Australia, and in European countries. In the USA even dropping numbers of death cases were recently reported, probably reflecting efficacy of the new systemic treatments.Among younger cohorts in some populations (e.g., Australia and New Zealand,), stabilizing or declining incidence rates of CM are observed, potentially caused by primary prevention campaigns aimed at reducing UV exposure. In contrast, incidence rates of CM are still rising in most European countries and in the USA. Ongoing trends towards thinner melanoma are largely ascribed to earlier detection.


Assuntos
Neoplasias Cutâneas/epidemiologia , Austrália/epidemiologia , Europa (Continente)/epidemiologia , Humanos , Incidência , Melanoma/epidemiologia , Neoplasias Induzidas por Radiação/epidemiologia , Nova Zelândia/epidemiologia , Estados Unidos/epidemiologia
4.
Adv Exp Med Biol ; 1268: 155-170, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32918218

RESUMO

To shed further light on the ongoing debate whether sunbed use may increase melanoma risk, we have critically assessed the scientific literature that is at present available, focussing on a meta-analysis that we published recently. Our literature search identified several meta-analyses that report a weak association for ever-exposure to UV radiation from a solarium with melanoma risk. However, the quality of studies included in these meta-analyses and the resulting evidence levels and grades of recommendation were very low due to the lack of interventional trials and because of severe limitations of many of the observational studies. The results of cohort and case-control studies published until today do not prove causality, not even by the Hill criteria. The overall quality of these observational studies and the resulting evidence levels are low due to severe limitations (including unobserved or unrecorded confounding), which leads to bias. It must be recognized that in the majority of studies, published to date, many of the confounding factors, including sun exposure, sunburns and skin type, have not been adequately and systematically recorded and adjusted for. We conclude that the many limitations of the individual studies and the resulting low levels of evidence and grades of recommendation do at present not allow postulation of a causal relationship between solarium use and melanoma risk. At present, there is no convincing evidence that moderate/responsible solarium use increases melanoma risk.


Assuntos
Melanoma/epidemiologia , Neoplasias Cutâneas/epidemiologia , Banho de Sol , Humanos , Neoplasias Induzidas por Radiação/epidemiologia , Medição de Risco , Queimadura Solar/epidemiologia
5.
Adv Exp Med Biol ; 1268: 335-353, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32918227

RESUMO

Although great progress has been achieved during the last decades, the clinical management of organ transplant recipients (OTRs) remains a challenge. OTRs need in general lifelong immunosuppressive therapy that is associated with an increased risk to develop skin cancer and with an unfavorable clinical outcome of these malignancies. Skin cancer prevention measures, including regular full-body examinations, are therefore necessary in OTRs to detect and treat suspicious lesions at an early stage. The frequency of aftercare depends on the individual risk factors of the patient. Patients should apply consistent sun protection with sunscreens and clothing, as well as a monthly self-examination. On the other hand, the need of UVR avoidance increases the risk of vitamin D deficiency, which itself is associated with an increased risk for many diseases, including malignancies. OTRs should therefore be monitored for 25(OH)D status and/or should take vitamin D supplements. It has to be emphasized that an interdisciplinary approach, coordinated by the transplant center, that includes regular skin examinations by a dermatologist, is needed to ensure the best care for the OTRs.


Assuntos
Neoplasias Cutâneas/diagnóstico , Transplantados , Raios Ultravioleta , Vitamina D , Humanos , Imunossupressão/efeitos adversos , Neoplasias Induzidas por Radiação/diagnóstico , Neoplasias Induzidas por Radiação/epidemiologia , Neoplasias Cutâneas/epidemiologia , Transplantados/estatística & dados numéricos , Vitamina D/administração & dosagem , Vitamina D/sangue , Vitaminas/administração & dosagem , Vitaminas/sangue
6.
Adv Exp Med Biol ; 1268: 355-379, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32918228

RESUMO

Incidence rates of nonmelanoma skin cancer and melanoma have been on the rise in the USA for the past 25 years. UV radiation (UVR) exposure remains the most preventable environmental risk factor for these cancers. Aside from sun avoidance, sunscreens continue to provide the best alternative protection. UVR directly damages DNA and causes indirect cellular damage through the creation of reactive oxygen species, the sum of which leads to cutaneous immunosuppression and a tumorigenic milieu. The current generation of sunscreens protect from UVR through two main mechanisms: absorption and deflection. In the USA, the Food and Drug Association (FDA) regulates sunscreen products which are considered over-the-counter drugs. With the release of new FDA testing and labeling requirements in 2011 and the enactment of the Sunscreen Innovation Act in 2014, sunscreen manufacturers are now required to evaluate their products not only on the sun protection factor (SPF) but also on broad-spectrum UVA protection. The American Academy of Dermatology Association and the American Academy of Pediatrics have provided specific recommendations for proper sun protection and sunscreen usage with the continual goal of increasing public awareness and compliance with appropriate sun protective measures. Antioxidants, photolyases, and plant polyphenols remain an interesting avenue of research as additives to sunscreens or stand-alone topical or oral products that appear to modulate the immunosuppressive effects of UVR on the skin. Additionally, although UVR induces endogenous cutaneous production of vitamin D, its damaging effects overshadow this positive benefit, especially in light of the ease of achieving recommended amounts of vitamin D through diet and supplementation.


Assuntos
Protetores Solares/normas , Humanos , Incidência , Melanoma/epidemiologia , Melanoma/prevenção & controle , Medição de Risco , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/prevenção & controle , Protetores Solares/química , Raios Ultravioleta/efeitos adversos , Estados Unidos/epidemiologia , Vitamina D/administração & dosagem
7.
Saudi Med J ; 41(7): 709-714, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32601638

RESUMO

OBJECTIVES: To assess the prevalence of melanoma and non-melanoma skin cancer for patients attended King Khalid University Hospital, Riyadh, Saudi Arabia. We are also assessing the most common category of skin cancer to be encountered among those patients. Methods: The authors conducted a retrospective study including all patients (Saudi and non-Saudi) who attended King Khalid University Hospital (KKUH) at the period of (2007-2018). Data were collected from archives of Pathology Department at KKUH and categorized into: melanoma skin cancer (MSC), non-melanoma skin cancer (NMSC), which included: basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), pre-neoplastic lesions, and non-neoplastic skin lesions. Results: A total of 111 patients were reported to have skin cancer out of 9828 cases, which had other skin pathology. Majority of cases were basal cell carcinoma with a total number of 76 (68.5%) of all cases. 18 patients (16.2%) were diagnosed with MSC. The remaining 17 patients (15.3%) were diagnosed with squamous cell carcinoma. Conclusion: Skin cancer prevalence and incidence is increasing worldwide. In our study, BCC was the most common type of skin cancer to be reported in our institute, which is similar to the majority of other international studies.


Assuntos
Carcinoma Basocelular/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Melanoma/epidemiologia , Neoplasias Cutâneas/epidemiologia , Adulto , Idoso , Feminino , Hospitais Universitários/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Arábia Saudita/epidemiologia , Fatores de Tempo
8.
Eur J Cancer ; 133: 120-130, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32502876

RESUMO

BACKGROUND: Brentuximab vedotin was approved for adult patients with CD30-expressing cutaneous T-cell lymphoma treated with prior systemic therapy based on improved response rates and progression-free survival with brentuximab vedotin (1.8 mg/kg once every 3 weeks; ≤16 cycles) versus physician's choice (methotrexate/bexarotene; ≤48 weeks) in the phase III ALCANZA study. Quality of life (QoL) in ALCANZA patients was also examined. METHODS: QoL measures in ALCANZA were based on the Skindex-29, Functional Assessment of Cancer Therapy-General (FACT-G) and European QoL 5-dimension (EQ-5D) questionnaires. RESULTS: Mean maximum reduction from the baseline Skindex-29 symptom domain score (key secondary end-point) was greater with brentuximab vedotin than physician's choice (-27.96 versus -8.62); the difference, -18.9 (95% confidence interval -26.6, -11.2; adjusted p < 0.001), exceeded the study-defined minimally important difference (9.0-12.3). Mean changes from baseline to end-of-treatment visit total FACT-G scores were similar with brentuximab vedotin and physician's choice (0.15 versus -2.29). EQ-5D changes were also comparable between arms. Among brentuximab vedotin-treated patients with peripheral neuropathy (PN), mean maximum reduction in Skindex-29 symptom domain was -35.54 versus -11.11 in patients without PN. PN had no meaningful effect on FACT-G and EQ-5D QoL scores. CONCLUSIONS: In summary, brentuximab vedotin produced superior reductions in symptom burden compared with physician's choice, without adversely impacting QoL. QoL was unaffected by the presence of PN in brentuximab vedotin-treated patients. CLINICAL TRIAL REGISTRATION: NCT01578499.


Assuntos
Brentuximab Vedotin/uso terapêutico , Linfoma Cutâneo de Células T/tratamento farmacológico , Qualidade de Vida , Neoplasias Cutâneas/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Feminino , Humanos , Linfoma Cutâneo de Células T/epidemiologia , Linfoma Cutâneo de Células T/patologia , Linfoma Cutâneo de Células T/psicologia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/psicologia , Medidas de Resultados Relatados pelo Paciente , Psicometria/métodos , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/psicologia , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
9.
PLoS One ; 15(6): e0232800, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32497148

RESUMO

Second primary breast cancer (SPBC) is becoming one of the major obstacles to breast cancer (BC) control. This study was aimed to determine the trend of SPBC incidence over time and the risk of developing SPBC in site-specific primary cancer survivors in the United States. The Surveillance, Epidemiology, and End Results (SEER) 13 registry (1992-2015) was used to identify SPBC patients with previous malignancies. Standardized incidence ratio (SIR) was computed to compare the incidence rates of the observed cases of SPBC in cancer survivors over the expected cases in the general population. Elevated risk of SPBC was observed in women with previous BC (SIR = 1.74) or thyroid cancer (SIR = 1.17). Women with initial skin melanoma in older age (≥50 years) (SIR = 1.11), or White race (SIR = 1.11) presented an elevated incidence of SPBC than the general female population. Besides, Asian/Pacific Islander (API) women with cancer of corpus uteri, ovary, bladder, or kidney were prone to developing SPBC when compared with the general population, with SIRs of 1.61, 1.35, 1.48, and 1.70, respectively. Male BC patients showed profound risk of developing SPBC (SIR = 34.86). Male leukemia patients also presented elevated risk of developing SPBC (SIR = 2.06). Our study suggests significant increase of SPBC in both sexes in the United States. Elevated risk of SPBC exists in survivors with primary BC, female thyroid cancer, male leukemia, and API female cancer patients with primary genitourinary cancer. Our study is helpful in developing strategies for BC control and prevention on specific first primary cancer survivors with an elevated risk of SPBC.


Assuntos
Neoplasias da Mama Masculina/epidemiologia , Neoplasias da Mama/epidemiologia , Sobreviventes de Câncer , Segunda Neoplasia Primária/epidemiologia , Adulto , Fatores Etários , Idoso , Grupos de Populações Continentais/estatística & dados numéricos , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Leucemia/epidemiologia , Masculino , Melanoma/epidemiologia , Pessoa de Meia-Idade , Neoplasias Hormônio-Dependentes/epidemiologia , Especificidade de Órgãos , Programa de SEER , Neoplasias Cutâneas/epidemiologia , Neoplasias da Glândula Tireoide/epidemiologia , Estados Unidos/epidemiologia , Neoplasias Urogenitais/epidemiologia
10.
Anticancer Res ; 40(6): 3411-3415, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32487638

RESUMO

BACKGROUND/AIM: Acral lentiginous melanoma (ALM) is the least common subtype of cutaneous melanoma and typically occurs on the palms, soles, and nails. Tumor characteristics and disease severity in the US population are not well understood. Our aim was to analyze the characteristics of ALM of the extremities. PATIENTS AND METHODS: We queried the National Cancer Database to identify patients with the diagnosis of ALM and common malignant melanoma located in the extremities (CMME). We compared demographic, tumor, and treatment characteristics between patients with ALM and those with CMME. Statistical analysis was performed with chi-squared test and multivariate logistic regression models. RESULTS: We identified 5,203 patients with ALM and 118,485 with CMME. When compared with patients with CMME, those with ALM were more likely to be older than 80. years at diagnosis [odds ratio (OR)=2.85, 95% confidence intervaI (CI)=2.12-3.82; p<0.001], have stage III disease (OR=4.22, 95% CI=1.47-12.16; p=0.01), and have ulceration (OR=1.52, 95% CI=1.33-1.74; p<0.001). Moreover, patients with ALM were less likely to have a mitotic count of 1/mm2 or greater (OR=0.57, 95% CI=0.48-0.67; p<0.001). No statistical difference was found for sex, lymph node involvement, regression, and use of surgery, radiotherapy, and immunotherapy between groups. CONCLUSION: Age, disease stage, ulceration, and mitotic count are independent factors associated with ALM. Knowledge of the disease characteristics may allow for better diagnosis and understanding of disease pathophysiology.


Assuntos
Pé/patologia , Mãos/patologia , Melanoma/diagnóstico , Melanoma/epidemiologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Bases de Dados Factuais , Feminino , Humanos , Masculino , Melanoma/terapia , Pessoa de Meia-Idade , Metástase Neoplásica , Estadiamento de Neoplasias , Razão de Chances , Estudos Retrospectivos , Neoplasias Cutâneas/terapia , Resultado do Tratamento , Adulto Jovem
11.
Cancer ; 126(17): 3900-3906, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32478867

RESUMO

During the coronavirus disease 2019 (COVID-19) pandemic, providers and patients must engage in shared decision making regarding the pros and cons of early versus delayed interventions for localized skin cancer. Patients at highest risk of COVID-19 complications are older; are immunosuppressed; and have diabetes, cancer, or cardiopulmonary disease, with multiple comorbidities associated with worse outcomes. Physicians must weigh the patient's risk of COVID-19 complications in the event of exposure against the risk of worse oncologic outcomes from delaying cancer therapy. Herein, the authors have summarized current data regarding the risk of COVID-19 complications and mortality based on age and comorbidities and have reviewed the literature assessing how treatment delays affect oncologic outcomes. They also have provided multidisciplinary recommendations regarding the timing of local therapy for early-stage skin cancers during this pandemic with input from experts at 11 different institutions. For patients with Merkel cell carcinoma, the authors recommend prioritizing treatment, but a short delay can be considered for patients with favorable T1 disease who are at higher risk of COVID-19 complications. For patients with melanoma, the authors recommend delaying the treatment of patients with T0 to T1 disease for 3 months if there is no macroscopic residual disease at the time of biopsy. Treatment of tumors ≥T2 can be delayed for 3 months if the biopsy margins are negative. For patients with cutaneous squamous cell carcinoma, those with Brigham and Women's Hospital T1 to T2a disease can have their treatment delayed for 2 to 3 months unless there is rapid growth, symptomatic lesions, or the patient is immunocompromised. The treatment of tumors ≥T2b should be prioritized, but a 1-month to 2-month delay is unlikely to worsen disease-specific mortality. For patients with squamous cell carcinoma in situ and basal cell carcinoma, treatment can be deferred for 3 months unless the individual is highly symptomatic.


Assuntos
Betacoronavirus , Tomada de Decisão Clínica/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Médicos/psicologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/terapia , Comorbidade , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/virologia , Humanos , Hospedeiro Imunocomprometido , Morbidade , Pandemias , Pneumonia Viral/mortalidade , Pneumonia Viral/virologia , Tempo para o Tratamento
13.
Medicentro (Villa Clara) ; 24(2): 305-319, abr.-jun. 2020. tab
Artigo em Espanhol | LILACS | ID: biblio-1124994

RESUMO

RESUMEN Introducción: el cáncer de piel es una afección común en las zonas expuestas a la luz solar; es la neoplasia maligna más frecuente a nivel mundial y su incidencia ha aumentado en las últimas décadas. Objetivo: describir las características clínico-epidemiológicas en pacientes con lesiones malignas en la piel. Métodos: se realizó un estudio descriptivo-transversal en los pacientes atendidos en la consulta de Dermatología del Policlínico Docente «Octavio de la Concepción y la Pedraja, Camajuaní, Villa Clara, año 2016. La muestra estuvo conformada por el total de pacientes diagnosticados clínicamente y por biopsia (160). La información se recopiló a través de un cuestionario y se procesó estadísticamente. Resultados: en las lesiones malignas de la piel: el 52,50 % perteneció al sexo masculino y se incrementó con la edad en ambos sexos. Se observó que la mayoría de los pacientes recibían exposición solar prolongada (61,40 %), durante cuatro o más horas diarias, principalmente los hombres obreros agrícolas (28,75 %), con predominio del fototipo cutáneo III (48,75 %). Las sombrillas son uno de los medios de protección solar más utilizados (16,87 %); mientras que el 32,50 % de los pacientes no utilizaban ninguno. Se constató que la mayoría de estas lesiones estaban localizadas en la región de la nariz (21,25 %). Conclusiones: las lesiones malignas de la piel se incrementan con la edad en ambos sexos. Están relacionadas con la exposición solar prolongada, principalmente en los hombres. Se evidenció un predominio del fototipo cutáneo III en los trabajadores agrícolas.


ABSTRACT Introduction: skin cancer is a common condition in areas exposed to sunlight; it is the most common malignancy worldwide and its incidence has increased in recent decades. Objective: to describe the clinical and epidemiological characteristics in patients with malignant skin lesions. Methods: a descriptive, cross-sectional study was conducted in patients seen in the Dermatology consultation at "Octavio de la Concepción y la Pedraja" Teaching Polyclinic, Camajuaní, Villa Clara during 2016. The total number of patients diagnosed clinically and by biopsy (160) constituted the sample. The information was collected through a questionnaire and processed statistically. Results: in malignant skin lesions: 52.50% belonged to male gender and increased with age in both genders. It was observed that most patients received prolonged sun exposure (61.40%), for four or more hours a day, mainly male agricultural workers (28.75%), with predominance of skin phototype III (48.75%). Umbrellas are one of the most used means of sun protection (16.87%); while 32.50% of the patients did not use any. It was found that most of these lesions were located in the region of the nose (21.25%). Conclusions: malignant skin lesions increase with age in both genders. They are related to prolonged sun exposure, mainly in men. A predominance of skin phototype III was evidenced in agricultural workers.


Assuntos
Atenção Primária à Saúde , Neoplasias Cutâneas/epidemiologia
15.
J Surg Res ; 254: 147-153, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32445930

RESUMO

BACKGROUND: For the past 30 y, the incidence rate of malignant melanoma has risen steadily. Ultraviolet radiation exposure has been identified as the most prevalent modifiable risk factor for melanoma. Here, next-generation sequencing was used to analyze the relationship between multiple sun exposure factors and select cancer-related genes to determine the relationship of sun exposure on the molecular profiles of melanomas. METHODS: The collection and analysis of study samples were approved by the institutional review board. The patient cohort consisted of 173 patients whose melanoma tissue samples underwent next-generation sequencing analysis for somatic mutations of 50 cancer-related genes. Univariate and multivariate analyses were conducted. RESULTS: Patients with a history of blistering sunburn had an absolute mutation incidence of 1.67 mutations per patient, compared with patients without a history of blistering sunburn, who had an absolute mutation incidence of 1.16 mutations per patient (P = 0.028). A BRAF mutation was found in more tumors of patients who reported visiting a tanning salon (57.14%), compared with those who had not (18.75%; P = 0.0463). Patients with a previous history of skin cancer were more likely to have a CDKN2A mutation (20.83%), compared with those without a previous history of skin cancer (7.76%; P = 0.0292). CONCLUSIONS: The trends seen in the molecular profiles of melanomas with respect to various sun exposure factors suggest that sun exposure impacts genetic makeup. Considering the increase in absolute mutation incidence in patients with a history of blistering sunburn suggests that additional genes may contribute to the pathology of malignancy. Future studies will use the unique molecular profiles of melanomas to personalize patient treatments.


Assuntos
Sequenciamento de Nucleotídeos em Larga Escala , Melanoma/genética , Mutação/genética , Neoplasias Cutâneas/genética , Luz Solar/efeitos adversos , Raios Ultravioleta/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Inibidor p16 de Quinase Dependente de Ciclina/genética , Feminino , Humanos , Masculino , Melanoma/epidemiologia , Pessoa de Meia-Idade , Proteínas Proto-Oncogênicas B-raf/genética , Neoplasias Cutâneas/epidemiologia , Banho de Sol/estatística & dados numéricos , Queimadura Solar/genética , Curtume , Proteína Supressora de Tumor p53/genética
16.
Am J Gastroenterol ; 115(8): 1246-1252, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32453047

RESUMO

INTRODUCTION: There are limited data on repeated basal cell cancer (BCC) occurrences among patients with inflammatory bowel disease (IBD), especially the impact of continuing immunosuppressive medications. METHODS: We conducted a retrospective cohort study of 54,919 patients with IBD followed in the Veterans Affairs Healthcare System. We identified patients who had an incident BCC after their IBD diagnosis. We defined patients' exposure based on their IBD medications use as follows: (i) only aminosalicylate (5-ASA) use, (ii) only active thiopurine (TP) use, (iii) past TP use (discontinued >6 months ago) and no antitumor necrosis factor (TNF) use, (iv) anti-TNF use after previous TP use, (v) only anti-TNF use, and (vi) active anti-TNF and TP use. The outcome of interest was the repeated occurrence of BCC. Adjusted and unadjusted hazard ratios with 95% confidence intervals were used to estimate the risk of repeated BCC occurrence. RESULTS: A total of 518 patients developed BCC after their IBD diagnosis. The numbers of repeated BCC occurrences per 100 person-years were 12.8 (5-ASA use only), 34.5 (active TP use), 19.3 (past TP use and no anti-TNF use), 25.4 (anti-TNF use after previous TP use), 17.8 (only anti-TNF use), and 22.4 (active anti-TNF and TP use). Compared with 5-ASA use alone, only active TP use was associated with an increased risk for repeated BCC occurrence (adjusted hazard ratio 1.65, 95% confidence interval 1.24-2.19; P = 0.0005). However, the increased risk was no longer present for other exposure categories. DISCUSSION: Among IBD patients who developed an incident BCC while taking a TP and continued it, there was an increased risk of repeated BCC occurrences.


Assuntos
Imunossupressores/administração & dosagem , Doenças Inflamatórias Intestinais/tratamento farmacológico , Neoplasia de Células Basais/epidemiologia , Neoplasias Cutâneas/epidemiologia , Idoso , Estudos de Coortes , Feminino , Humanos , Imunossupressores/efeitos adversos , Doenças Inflamatórias Intestinais/complicações , Masculino , Neoplasia de Células Basais/etiologia , Sistema de Registros , Estudos Retrospectivos , Fatores de Risco , Neoplasias Cutâneas/etiologia , Estados Unidos/epidemiologia , United States Department of Veterans Affairs , Veteranos
17.
Cancer Causes Control ; 31(8): 787-794, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32458137

RESUMO

PURPOSE: The association between smoking and the risk of skin cancers has been studied without reaching consistent findings. This study aims to assess this association through an updated meta-analysis of cohort studies. METHODS: We retrieved cohort studies that investigated the temporal association between smoking and the risk of basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma (MM). Pooled relative risks (RRs) and confidence intervals (CIs) of the included articles were calculated for current, former, and heavy smoking compared with never smoking. Publication bias was detected using the Egger's regression. RESULTS: A total of 15 studies, published between 1990 and 2018, were included. Current smoking was associated with a higher risk of SCC (pooled RR = 1.32, 95% CI 1.15, 1.52) but with a lower risk of BCC (pooled RR = 0.85, 95% CI 0.75, 0.96) and MM (pooled RR = 0.72, 95% CI 0.64, 0.82). No publication bias was detected, and no single study had a substantial impact on the pooled results. Similar results were detected for heavy smoking, while former smoking was not associated with the risk of skin cancer. CONCLUSION: Current smoking and heavy smoking were associated with a higher risk of SCC but a decreased risk of BCC and MM, while former smoking was not associated with skin cancer risk.


Assuntos
Carcinoma Basocelular/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Melanoma/epidemiologia , Neoplasias Cutâneas/epidemiologia , Fumar/epidemiologia , Estudos de Coortes , Humanos , Fatores de Risco
19.
Eur J Epidemiol ; 35(6): 537-547, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32350689

RESUMO

We consider disease mapping of early- and late-stage cancer, in order to identify and monitor inequalities in early detection. Our method is demonstrated by mapping cancer incidence at high geographical resolution using data on 10,302 cutaneous malignant melanoma (CMM) cases within the 3.7 million population of South-West Sweden. The cases were geocoded into small-areas, each with a population size between 600 and 2600 and accessible socio-demographic data. Using the disease mapping application Rapid Inquiry Facility (RIF) 4.0, we produced regional maps to visualise spatial variations in stage I, II and III-IV CMM incidences, complemented by local maps to explore the variations within two urban areas. Pronounced spatial disparities in stage I CMM incidence were revealed by the regional and local maps. Stage I CMM incidence was markedly higher in wealthier small-areas, in particular within each urban area. A twofold higher stage I incidence was observed, on average, in the wealthiest small-areas (upper quintile) than in the poorest small-areas (lower quintile). We identified in the regional map of stage III-IV CMM two clusters of higher or lower than expected late-stage incidences which were quite distinct from those identified for stage I. In conclusion, our analysis of CMM incidences supported the use of this method of cancer stage incidence mapping for revealing geographical and socio-demographic disparities in cancer detection.


Assuntos
Detecção Precoce de Câncer , Melanoma/diagnóstico , Neoplasias Cutâneas/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Monitoramento Epidemiológico , Feminino , Humanos , Incidência , Masculino , Melanoma/epidemiologia , Melanoma/patologia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Sistema de Registros/estatística & dados numéricos , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/patologia , Classe Social , Fatores Socioeconômicos , Suécia/epidemiologia
20.
Invest Ophthalmol Vis Sci ; 61(5): 48, 2020 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-32460312

RESUMO

Purpose: Ultraviolet radiation from sunlight contributes to age-related cataract and skin cancer. The EPHA2 gene is implicated in both these diseases. The purpose of this study was to determine whether age-related cataract and skin cancer are associated in a cohort of older Australians. Methods: A cross-sectional study was performed using the Historical Cohort of the Registry of Senior Australians. Individuals aged ≥65 years or aged ≥50 years and of Aboriginal or Torres Strait Islander descent, who had an aged care eligibility assessment between July 2005 and June 2015, and had a history of cataract surgery and/or skin cancer according to the Australian Government Medicare Benefits Schedule dataset, during the 3-year period prior, were evaluated (N = 599,316). A multivariable logistic regression model was used to determine association and multiple hypothesis correction was employed. Results: Of the evaluated individuals, 87,097 (14.5%) had a history of cataract and 170,251 (28.4%) a history of skin cancer. Among those with a history of cataract, 20,497 (23.5%), 1127 (1.3%), and 14,730 (16.9%) individuals had a concurrent history of keratinocyte, melanoma, and premalignant/solar keratosis, respectively. Those with a history of cataract were 19% more likely to have a history of skin cancer (odds ratio [OR], 1.19; 95% confidence interval [CI], (1.17-1.21). Co-occurrence of keratinocyte skin cancer was 16% (OR, 1.16; 95% CI, 1.14-1.18), melanoma 21% (OR, 1.21; 95% CI, 1.13-1.29), and premalignant/solar keratosis 19% (OR, 1.19; 95% CI, 1.17-1.22) more in the presence than absence of history of cataract. Conclusions: Age-related cataract is positively associated with skin cancer and its subtypes, including premalignant lesions in an older Australian population.


Assuntos
Catarata/complicações , Catarata/epidemiologia , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/epidemiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino
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