[Illness, health and sunlight]. / Ziekte, gezondheid en zonlicht.

New scientific insights show that the influence of sunlight on health is profound. Recent data suggest that our skin is well adapted to the Dutch climate, but changes in the exposure pattern cause a steady increase in skin cancer. These changes mainly consist of a decrease in daily exposure and a shift from a regular to an intermittent exposure. In the Netherlands, probably the best advice is for moderate, frequent exposure to the sun. Evidence is accumulating that frequent exposure to sunlight is a protective factor against colorectal, prostate, and breast cancer and non-Hodgkin lymphoma, multiple sclerosis and metabolic syndrome. The circadian rhythm is affected by light. Too low levels of exposure to light in daytime and too high levels of exposure to light in the evening and at night can weaken and disrupt the circadian rhythm. This disruption most probably is a risk factor for some types of cancer and metabolic syndrome.

[Improved compliance with the 'Melanoma' treatment guideline]. / Betere navolging van de richtlijn 'Melanoom'.

OBJECTIVE: To evaluate the level of compliance with the revised treatment guideline for melanoma (2005) and the extent to which the points of concern from the previous guideline evaluation in 2001 had been implemented. DESIGN: Retrospective observational cohort study. METHOD: The evaluation was performed using data from the pathology reports of patients diagnosed with melanoma of the skin between 1 April and 30 September 2007 at hospitals that fall under the Comprehensive Cancer Centres for the South and West of the Netherlands. RESULTS: In 85% of the patients the melanoma was treated according to the guideline in two sessions: a diagnostic excision followed by a therapeutic re-excision. These figures were 69% for melanoma in situ, and 87% for invasive melanoma. The other patients were treated in one session. In the pathology reports of the patients with an invasive melanoma the rates of pathological documentation were: margin of the diagnostic excision: 64%, Breslow thickness: 97%, presence or absence of ulceration: 77%. In the Comprehensive Cancer Care Centre West Netherlands region, the margin of re-excision was determined: this margin satisfied the guideline in 86% of patients with an invasive melanoma. CONCLUSION: Compared to the previous guideline evaluation in 2001, the excision policy had improved. In the pathology report, the excision margin and the presence or absence of ulceration should be better documented.