Sun protection for preventing basal cell and squamous cell skin cancers

Background'Keratinocyte cancer' is now the preferred term for the most commonly identified skin cancers basal cell carcinoma (BCC) and cutaneoussquamous cell carcinoma (cSCC), which were previously commonly categorised as non-melanoma skin cancers (NMSC). Keratinocytecancer (KC) represents about 95% of malignant skin tumours. Lifestyle changes have led to increased exposure to the sun, which has,in turn, led to a significant increase of new cases of KC, with a worldwide annual incidence of between 3% and 8%. The successful useof preventive measures could mean a significant reduction in the resources used by health systems, compared with the high cost of thetreatment of these conditions. At present, there is no information about the quality of the evidence for the use of these sun protectionstrategies with an assessment of their benefits and risks.ObjectivesTo assess the effects of sun protection strategies (i.e. sunscreen and barrier methods) for preventing keratinocyte cancer (that is, basal cellcarcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) of the skin) in the general population.Search methodsWe searched the following databases up to May 2016: the Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase, andLILACS. We also searched five trial registries and the bibliographies of included studies for further references to relevant trials.Selection criteriaWe included randomised controlled clinical trials (RCTs) of preventive strategies for keratinocyte cancer, such as physical barriers andsunscreens, in the general population (children and adults), which may provide information about benefits and adverse events related tothe use of solar protection measures. We did not include trials focused on educational strategies to prevent KC or preventive strategiesin high-risk groups. Our prespecified primary outcomes were BCC or cSCC confirmed clinically or by histopathology at any follow-up andadverse events

Effectiveness of topical sunscreen use to prevent skin cancers: systematic review

Topical sunscreen is a potential modality to prevent skin cancer development in vulnerable people although few study has evaluated its effectiveness in clinical setting. This study is aimed to review most recently available evidence on the clinical effectiveness of topical sunscreen in preventing skin cancers. We identified literature from online databases including Pubmed and Google Scholar and included population-based study evaluating the effect of sunscreen usage and risk of skin cancers, including melanoma, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC) either as primary objective or as a confounder in multivariate analysis. Data form included articles was harvested and analyzed with thematic analysis. Final analysis included 11 articles. Of these, 6 reported results on melanoma, 4 reported on BCC, and 3 on SCC. Overall, there was conflicting evidence on the effectiveness of topical sunscreen in preventing skin cancer. Available evidence found that topical sunscreen was most effective in preventing melanoma and SCC. However, there was considerable heterogenicity in study design and definition of sunscreen treatment between included articles that may affect the results. There are no consensus among included articles, including among RCTs, on the ideal topical sunscreen regiment to prevent skin cancer. There are conflicting evidence on the clinical effectiveness of topical sunscreen to prevent skin cancer although evidence suggest that it would be effective in preventing melanoma and SCC. More clinical studies should be conducted with special emphasis on ensuring subject apply the sunscreen correctly and consistently

Reduction in squamous cell carcinomas in mouse skin by dietary zinc supplementation.

Inadequate dietary Zn consumption increases susceptibility to esophageal and other cancers in humans and model organisms. Since Zn supplementation can prevent cancers in rodent squamous cell carcinoma (SCC) models, we were interested in determining if it could have a preventive effect in a rodent skin cancer model, as a preclinical basis for considering a role for Zn in prevention of human nonmelanoma skin cancers, the most frequent cancers in humans. We used the 7,12-dimethyl benzanthracene carcinogen/phorbol myristate acetate tumor promoter treatment method to induce skin tumors in Zn-sufficient wild-type and Fhit (human or mouse protein) knockout mice. Fhit protein expression is lost in \u3e50% of human cancers, including skin SCCs, and Fhit-deficient mice show increased sensitivity to carcinogen induction of tumors. We hypothesized that: (1) the skin cancer burdens would be reduced by Zn supplementation; (2) Fhit(-/-) (Fhit, murine fragile histidine triad gene) mice would show increased susceptibility to skin tumor induction versus wild-type mice. 30 weeks after initiating treatment, the tumor burden was increased ~2-fold in Fhit(-/-) versus wild-type mice (16.2 versus 7.6 tumors, P \u3c 0.001); Zn supplementation significantly reduced tumor burdens in Fhit(-/-) mice (males and females combined, 16.2 unsupplemented versus 10.3 supplemented, P = 0.001). Most importantly, the SCC burden was reduced after Zn supplementation in both strains and genders of mice, most significantly in the wild-type males (P = 0.035). Although the mechanism(s) of action of Zn supplementation in skin tumor prevention is not known in detail, the Zn-supplemented tumors showed evidence of reduced DNA damage and some cohorts showed reduced inflammation scores. The results suggest that mild Zn supplementation should be tested for prevention of skin cancer in high-risk human cohorts

Promotion of Skin Protection in Children in Waterbury, VT

Background: Vermont has among the highest rates of skin cancer in the nation. Between 2001 and 2005, Vermont had the highest incidence of melanoma of any state, 63% higher than the national average. It is also estimated that if children under 18 regularly used sunscreen of at least SPF 15, the incidence of squamous and basal cell carcinomas would decrease by 78%. Modeling by the EPA and CDC suggests that recommended sun protection measures could prevent 11,000 cases of skin cancer, 50 deaths, and $30 million in cancer treatment costs nationwide. Intervention: To create an information sheet on skin protection and skin cancer prevention to be included in well-child visits at the Waterbury Health Center. Method: I integrated state-specific data, national data, and epidemiologic facts about the risks of sun exposure and other risks for skin cancer with recommendations made by the UVM Dermatology residents who I interviewed, in order to create a brief yet fairly comprehensive fact sheet on skin protection in children.https://scholarworks.uvm.edu/fmclerk/1281/thumbnail.jp

Modifiable risk-factors for keratinocyte cancers in Australia: a case-control study

Keratinocyte cancer is the most common malignancy in Caucasians. The aim of this study was to investigate risk-factors responsible for development of keratinocyte cancer in Australia. A case-control study was conducted, including 112 cases of squamous cell carcinoma (SCC), 95 cases of basal cell carcinoma (BCC) and 122 controls. Freckling during adolescence (SCC: odds ratio (OR) 1.04, p < 0.01; BCC: OR 1.05, p < 0.01), propensity to sunburn (SCC: OR 2.75, p = 0.01, BCC: OR 2.68 p = 0.01) and high cumulative sun-exposure (SCC: OR 2.43, p = 0.04; BCC: OR 2.36 p = 0.04) were independent risk-factors for both SCC and BCC. This study provides further evidence that a sun-sensitive phenotype and excessive sun-exposure during adulthood contribute to the risk of developing keratinocyte cancer. Wearing a hat, long-sleeved shirts, and sunscreen did not significantly reduce the risk of keratinocyte cancer in this study

Bill to Restrict Indoor Tanning for Minors in The State of Maine

Background: Melanoma is the deadliest and the most common type of cancer in individuals age 15 to 29. Evidence has shown that ultraviolet radiation overexposure at younger ages significantly increases the risk of developing non-melanoma and melanoma skin cancer in later years. Despite these concerns, approximately 1.6 million minors under the age of 18 participate in the use of indoor tanning devices annually. The high prevalence of skin cancer in the United States continues to be a public health issue that warrants continued preventative and regulatory action. In spite of the health risks associated with indoor tanning, the state of Maine does not restrict the use of tanning devices for minors, as 18 states now do. Therefore, the aim of this DNP project was to implement a health policy change initiative with the goal of restricting access to commercial indoor tanning devices for minors. Methods:The policy process framework and population health framework were used as models for implementing the health policy initiative. The population health framework was used to develop an argument for the public health implications of excessive ultraviolet (UV) radiation and provides rationale for restricting UV exposure among minors. The policy process framework was used to guide and evaluate the legislative work of this project. The legislative work was accomplished in collaboration with Maine Representative Anne Perry and other stakeholders. Purpose/Implementation Plan: The purpose of this DNP project was to implement a substantive health policy change, that being the restriction of minors under the age of 18 from the use of commercial indoor tanning devices. The health policy change process included the following steps: 1. Create awareness of long-term health risks of indoor tanning devices among key legislators, constituents, and interest groups, 2. Work with legislators to bring a bill forward to restrict access to indoor tanning devices, 3. Evaluate the process and develop a proposal for sustainable action, if the legislation fails. The overall objective of this initiative was to decrease the risk of skin cancer among Maine’s youth. Results:A proposal for the policy change was presented to stakeholders and was developed in support of the initiative. LD #1297, An Act to Reduce Youth Cancer Risk was introduced through the efforts of the coalition. The first public hearing for LD #1297 was held on April 3, 2019 with the Health and Human Services Committee (HHS) in Augusta, Maine with support from the stakeholders. A work session was held on April 16, 2019 where the bill was voted “ought to pass” 7 to 3 by members of the HHS committee. Conclusion:The population health framework and application of the policy process framework to guide legislative efforts, resulted in greater support for LD #1297 by the HHS committee. Policy engagement to address the upstream causes of disease such as skin cancer is a professional responsibility of doctorally prepared nurse practitioners. This can be achieved by engaging in coalition building and enacting legislative initiatives for public health challenges such as the serious public health threat of indoor tanning by minors. Key Words: skin neoplasms, skin cancer, ultraviolet radiation, indoor tanning, artificial tanning, basal cell carcinoma, squamous cell carcinoma, melanom

Skin cancer among young adults : an overview : an honors thesis (HONRS 499)

Skin cancer is a serious disease that is caused primarily by damage to the skin through exposure to the sun's Ultra-Violet rays. Because skin cancerHonors CollegeBall State UniversityMuncie, IN 47306Honors CollegeThesis (B.?.

Interventions for preventing non-melanoma skin cancers in high-risk groups

Background Some groups of people have a greater risk of developing common non‐melanoma skin cancers (NMSC). Objectives To evaluate interventions for preventing NMSC in people at high risk of developing NMSC. Search methods We searched the Cochrane Skin Group Specialised Register (March 2007), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2007, MEDLINE (from 2003 to March 2007), EMBASE (from 2005 to March 2007), the metaRegister of Controlled Trials (February 2007). References from trials and reviews were also searched. Pharmaceutical companies were contacted for unpublished trials. Selection criteria Randomised controlled trials of adults and children at high risk of developing NMSC. Data collection and analysis Two review authors independently selected studies and assessed their methodological quality. Main results We identified 10 trials (7,229 participants) that assessed a variety of interventions. One trial found T4N5 liposome lotion significantly reduced the rate of appearance of new BCCs in people with xeroderma pigmentosum. One of three trials of renal transplant recipients showed a significantly reduced risk of new NMSCs when acitretin was compared to placebo (relative risk (RR) 0.22 95% confidence interval (CI) 0.06 to 0.90) and no significant difference in risk of adverse events in two trials (RR 1.80, 95% CI 0.70 to 4.61). In three trials conducted in people with a history of NMSC, the evidence was inconclusive for the development of BCCs for retinol or isoretinoin. However the risk of a new SCC in one trial (HR 1.79, 95% CI 1.16 to 2.76) and adverse events in another trial (RR 1.76, 95% CI 1.57 to 1.97) were significantly increased in the isotretinoin group compared with placebo. In one trial selenium showed a reduced risk of other types of cancer compared with placebo (RR 0.65, 95% CI 0.50 to 0.85) but also a significantly elevated risk of a new NMSC (HR 1.17, 95% CI 1.02 to 1.34). The evidence for one trial of beta‐carotene was inconclusive; and there was a trend towards fewer new NMSC in a trial of a reduced fat diet (RR 0.16, 95% CI 0.02 to 1.31), p = 0.09. Authors' conclusions Some preventative treatments may benefit people at high risk of developing NMSC, but the ability to draw firm conclusions is limited by small numbers of trials, often with one trial per intervention or with inconsistent results between studies

Zachorowalność na raka kolczystokomórkowego skóry w Polsce Centralnej — analiza dostępnych danych

Introduction: In recent years, the incidence of non-melanoma skin cancers has increased rapidly all over the world. Squamous cell carcinoma (SCC) is the second most common malignant neoplasm in humans after basal cell carcinoma. Unfortunately, the cancer registry in Poland does not record SCC individually. Thus, the incidence of this neoplasm in a defined population is unknown.Methods and materials: We have reviewed the clinical records of patients from the Dermatology and Venereology Department, Medical University of Lodz who were diagnosed with SCC by histopathology during the sixteen-year period from 1999 to 2015.Results: The incidence of SCC was slightly increasing between 1999 and 2008, but levelled off in next years. The largest relative increase in cancers was observed for patients above 74 years. Anatomical site distribution differs according to age of patients. In older patients, most prevalent were face lesions, while clothed areas were more commonly involved in patients below 45 years. The study revealed characteristics of SCC regarding age, gender and localization.Conclusions: SCC is quite common in our society. In recent years, the incidence rate has been levelling off. Nevertheless, the effective treatment is still very expensive. Moreover, the consistent international registration of this cancer should be applied worldwide.Wprowadzenie: W ostatnich latach zachorowalność na nieczerniakowate nowotwory skóry gwałtownie wzrosła na całym świecie. Rak kolczystokomórkowy skóry jest drugim co do częstości występowania najczęstszym nowotworem złośliwym skóry, zaraz po raku podstawnokomórkowym skóry. Niestety, Krajowy Rejestr Nowotworów w Polsce nie wyróżnia w swojej klasyfikacji osobno raka kolczystokomórkowego skóry. W związku z tym dokładne dane dotyczące zachorowalności w danej populacji pozostają nieznane.Materiały i metody: Przeanalizowano retrospektywnie dane kliniczne pacjentów leczonych z powodu raka kolczystokomórkowego w Klinice Dermatologii i Wenerologii Uniwersytetu Medycznego w Łodzi, pochodzące z lat 1999–2015.Wyniki: Zachorowalność na raka kolczystokomórkowego nieznacznie wzrastała między 1999 a 2008 rokiem. W ostatnich 4 latach zaobserwowano jednak tendencję stabilizującą. Najwięcej przypadków zachorowań stwierdzono w grupie pacjentów powyżej 74 rż. Rozmieszczenie anatomiczne zmian różni się w zależności od wieku pacjentów. U starszych pacjentów zaobserwowano większość zmian w obrębie twarzy, podczas gdy u pacjentów młodszych (poniżej 45 rż.) częściej występowały zmiany w obrębie części ciała na ogół zakrytych. W badaniu scharakteryzowano raka kolczystokomórkowego w zależności od wieku, płci oraz lokalizacji zmian.Wnioski: Rak kolczystokomórkowy skóry często występuje w naszym społeczeństwie. W ostatnich latach jego zachorowalność się ustabilizowała. Niemniej jednak, efektywne leczenie jest wciąż bardzo kosztowne. Co więcej, należy podjąć działania, aby stworzyć spójne międzynarodowe rejestry, umożliwiające zebranie wiarygodnych danych epidemiologicznych, które naświetliłyby skalę problemu, z jakim mamy do czynienia niemal na całym świecie