Plasma Carotenoids and Biomarkers of Oxidative Stress in Patients with prior Head and Neck Cancer

Diets high in fruits and vegetables are generally believed protective against several chronic diseases. One suggested mechanism is a reduction in oxidative stress. The carotenoids, nutrients found in colored fruits and vegetables, possess antioxidant properties in vitro, but their role in humans is less well documented. The aim of this cross-sectional study was to explore the relationships between the most abundant plasma carotenoids (alpha-carotene, beta-carotene, lycopene, lutein, zeaxanthin and beta-cryptoxanthin), as well as grouped carotenoids (total xanthophylls, carotenes and carotenoids), and urinary excretion of the F2-isoprostanes (F2-IsoPs), stable and specific biomarkers of oxidative damage to lipids. Two F2-IsoP measures were utilized: total F2-IsoPs and 8-iso-PGF2α. The study population (N = 52) was drawn from a study among patients curatively treated for early-stage head and neck cancer. Unadjusted linear regression analyses revealed significant inverse associations between plasma lutein, total xanthophylls and both F2-IsoP measures at baseline. After control for potential confounders, all individual and grouped xanthophylls remained inversely associated with the F2-IsoP measures, but none of these associations achieved significance. The carotenes were not inversely associated with total F2-IsoPs or 8-iso-PGF2a concentrations. The finding of consistent inverse associations between individual and grouped xanthophylls, but not individual and grouped carotenes, and F2-IsoPs is intriguing and warrants further investigation

Host phenotype characteristics and MC1R in relation to early-onset basal cell carcinoma.

Basal cell carcinoma (BCC) incidence is increasing, particularly among adults under the age of 40 years. Pigment-related characteristics are associated with BCC in older populations, but epidemiologic studies among younger individuals and analyses of phenotype-genotype interactions are limited. We examined self-reported phenotypes and melanocortin 1 receptor gene (MC1R) variants in relation to early-onset BCC. BCC cases (n=377) and controls with benign skin conditions (n=390) under the age of 40 years were identified through Yale's Dermatopathology database. Factors most strongly associated with early-onset BCC were skin reaction to first summer sun for 1 hour (severe sunburn vs. tan odds ratio (OR)=12.27, 95% confidence interval (CI)=4.08-36.94) and skin color (very fair vs. olive OR=11.06, 95% CI=5.90-20.74). Individuals with two or more MC1R non-synonymous variants were 3.59 times (95% CI=2.37-5.43) more likely to have BCC than those without non-synonymous variants. All host characteristics and MC1R were more strongly associated with multiple BCC case status (37% of cases) than a single BCC case status. MC1R, number of moles, skin reaction to first summer sun for 1 hour, and hair and skin color were independently associated with BCC. BCC risk conferred by MC1R tended to be stronger among those with darker pigment phenotypes, traditionally considered to be at low risk of skin cancer

Lifetime history of indoor tanning in young people: a retrospective assessment of initiation, persistence, and correlates

<p>Abstract</p> <p>Background</p> <p>Despite educational and public health campaigns to convey the risks of indoor tanning, many individuals around the world continue to engage in this behavior. Few descriptive studies of indoor tanning have collected information pertaining to the lifetime history of indoor tanning, thereby limiting our ability to understand indoor tanning patterns and potentially target interventions for individuals who not only initiate, but continue to persistently engage in indoor tanning.</p> <p>Methods</p> <p>In-person interviews elicited detailed retrospective information on lifetime history of indoor tanning among white individuals (n = 401) under age 40 seen by a dermatologist for a minor benign skin condition. These individuals were controls in a case-control study of early-onset basal cell carcinoma. Outcomes of interest included ever indoor tanning in both males and females, as well as persistent indoor tanning in females - defined as females over age 31 who tanned indoors at least once in the last three or all four of four specified age periods (ages 11-15, 16-20, 21-30 and 31 or older). Multivariate logistic regression was used to identify sociodemographic and lifestyle correlates of ever and persistent indoor tanning in females.</p> <p>Results</p> <p>Approximately three-quarters (73.3%) of females and 38.3% of males ever tanned indoors, with a median age of initiation of 17.0 and 21.5, respectively. Among indoor tanners, 39.3% of females and 21.7% of males reported being burned while indoor tanning. Female ever indoor tanners were younger, had darker color eyes, and sunbathed more frequently than females who never tanned indoors. Using unique lifetime exposure data, 24.7% of female indoor tanners 31 and older persistently tanned indoors starting as teenagers. Female persistent indoor tanners drank significantly more alcohol, were less educated, had skin that tanned with prolonged sun exposure, and sunbathed outdoors more frequently than non-persistent tanners.</p> <p>Conclusions</p> <p>Indoor tanning was strikingly common in this population, especially among females. Persistent indoor tanners had other high-risk behaviors (alcohol, sunbathing), suggesting that multi-faceted behavioral interventions aimed at health promotion/disease prevention may be needed in this population.</p

Compliance with indoor tanning laws for minors among salons and business in the United States

Indoor tanning is an established risk factor for skin cancer, yet indoor tanning is quite common among adolescents. Laws exists in some states to limit access to indoor tanning by minors, but there is limited research on industry compliance with these laws.We conducted a telephone survey with a random sample of businesses (n=412) offering indoor tanning in the 14 states with indoor tanning bans for minors as of May 2015. Female research assistants posing as minors conducted telephone interviews with employees using a standardized script.The majority of businesses (73.5%) told the minor caller that she could not use the tanning facilities. However, 12.6% told her she could tan and 13.9% gave other inaccurate information related to parental permission. Among the businesses (n=368) that completed the full interview, when asked about dangers from indoor tanning 52.2% identified burning and 20.1% mentioned skin cancer. However, 21.7% said dangers were no worse than the sun, 11.4% said the booths in their business were safer than others, and 10.3% said there were no dangers. Many businesses stated benefits when asked, including vitamin D (27.7%), social/cosmetic (27.2%), and treatment of skin diseases (26.4%), with only 4.9% indicating no health benefits.While three-quarters of businesses followed the indoor tanning bans when a minor called, one- quarter were noncompliant. Many of the businesses made inaccurate health claims about indoor tanning. Additional enforcement may be necessary to increase compliance and other regulations are needed to penalize businesses from stating health benefits and presenting false risk information

Compliance with indoor tanning laws for minors among salons and business in the United States

Indoor tanning is an established risk factor for skin cancer, yet indoor tanning is quite common among adolescents. Laws exists in some states to limit access to indoor tanning by minors, but there is limited research on industry compliance with these laws.We conducted a telephone survey with a random sample of businesses (n=412) offering indoor tanning in the 14 states with indoor tanning bans for minors as of May 2015. Female research assistants posing as minors conducted telephone interviews with employees using a standardized script.The majority of businesses (73.5%) told the minor caller that she could not use the tanning facilities. However, 12.6% told her she could tan and 13.9% gave other inaccurate information related to parental permission. Among the businesses (n=368) that completed the full interview, when asked about dangers from indoor tanning 52.2% identified burning and 20.1% mentioned skin cancer. However, 21.7% said dangers were no worse than the sun, 11.4% said the booths in their business were safer than others, and 10.3% said there were no dangers. Many businesses stated benefits when asked, including vitamin D (27.7%), social/cosmetic (27.2%), and treatment of skin diseases (26.4%), with only 4.9% indicating no health benefits.While three-quarters of businesses followed the indoor tanning bans when a minor called, one- quarter were noncompliant. Many of the businesses made inaccurate health claims about indoor tanning. Additional enforcement may be necessary to increase compliance and other regulations are needed to penalize businesses from stating health benefits and presenting false risk information

Attitudes and predictors of sunless tanning in a sample of young adults

Given the popularity of a tan appearance, sunless tanning may play a role in skin cancer prevention as a substitute for ultraviolet (UV) tanning. Few studies have comprehensively assessed attitudes toward sunless tanning or predictors of use.Demographic, phenotypic, and lifestyle characteristics were ascertained during in-person interviews of 385 non-Hispanic whites (75 sessions vs no indoor tanning OR=3.30, 95% CI=1.52-7.16), a tendency to burn with first summer sun exposure (OR=1.89, 95% CI=1.03-3.47), higher public body consciousness (OR=1.09, 95%CI=1.02-1.18), and believing sunless tanning was useful for tanning when weather is not optimal for sunbathing (OR=5.08, 95% CI=2.11-12.22).Results suggest young adults find sunless tanning to be an acceptable method of achieving a tanned appearance. Sunless tanning may prove useful in reducing UV exposure, particularly among females who engage in sunbathing or indoor tanning

Alcohol and tobacco use prediagnosis and postdiagnosis, and survival in a cohort of patients with early stage cancers of the oral cavity, pharynx, and larynx

As more people begin to survive first cancers, there is an increased need for science-based recommendations to improve survivorship. For survivors of head and neck cancer, use of tobacco and alcohol before diagnosis predicts poorer survival; however, the role of continuing these behaviors after diagnosis on mortality is less clear, especially for more moderate alcohol consumption. Patients (n = 264) who were recent survivors of early stage head and neck cancer were asked to retrospectively report their tobacco and alcohol histories (before diagnosis), with information prospectively updated annually thereafter. Patients were followed for an average of 4.2 years, with 62 deaths observed. Smoking history before diagnosis dose-dependently increased the risk of dying; risks reached 5.4 [95% confidence interval (95% CI), 0.7-40.1] among those with >60 pack-years of smoking. Likewise, alcohol history before diagnosis dose-dependently increased mortality risk; risks reached 4.9 (95% CI, 1.5-16.3) for persons who drank >5 drinks/d, an effect explained by beer and liquor consumption. After adjusting for prediagnosis exposures, continued drinking (average of 2.3 drinks/d) postdiagnosis significantly increased risk (relative risk for continued drinking versus no drinking, 2.7; 95% CI, 1.2-6.1), whereas continued smoking was associated with nonsignificantly higher risk (relative risk for continued smoking versus no smoking, 1.8; 95% CI, 0.9-3.9). Continued drinking of alcoholic beverages after an initial diagnosis of head and neck cancer adversely affects survival; cessation efforts should be incorporated into survivorship care of these patients

Low Plasma Lycopene Concentration is Associated with Increased Mortality in a Cohort of Patients with Prior Oral, Pharynx or Larynx Cancers

Objective: This analysis was conducted to evaluate the association between plasma beta-carotene, alpha-carotene, lycopene, lutein/zeaxanthin, total carotenoids, retinol, alpha-tocopherol and subsequent mortality. Methods: Blood samples collected longitudinally from 259 participants in a chemoprevention trial aimed at the prevention of second cancers of the oral cavity, pharynx, or larynx were analyzed by high performance liquid chromatography for selected micronutrients. All-cause mortality (primary outcome) and cause-specific mortality (secondary outcomes) were evaluated in relation to plasma micronutrient concentrations at baseline and longitudinally. Results: A total of 61 deaths occurred over a follow-up time of up to 90 months. Cox proportional hazards models with time-dependent covariates were used for data analyses. In models adjusted for age, plasma cholesterol, time-dependent smoking, treatment arm, study site and gender, only plasma lycopene was significantly inversely associated with total mortality [hazard ratio (HR) above versus below median = 0.53, 95% confidence interval (CI) 0.30-0.93]. Plasma alpha-carotene was inversely associated (HR 0.24, 95% CI 0.08-0.75) while plasma retinol was positively associated (HR 5.12, 95% CI 1.54-17.05) with cardiovascular death. Smoking status modified plasma nutrient associations with total mortality. Lycopene (HR 0.08, 95% CI 0.02-0.36), alpha-carotene (HR 0.25, 95% CI 0.09-0.73) and total carotenoids (HR 0.22, 95% CI 0.07-0.70) were inversely associated with mortality in non-smokers, while plasma retinol (HR = 3.56, 95% CI 1.40-9.09) and alpha-tocopherol (HR = 2.47, 95% CI 1.02-5.98) were positively associated with mortality in smokers. Conclusions: Only plasma lycopene was significantly associated (inversely) with total mortality in the full study population. Smoking modifies associations between nutrients and mortality

Supplemental beta-carotene, smoking, and urinary F2-isoprostane excretion in patients with prior early stage head and neck cancer

Supplemental beta-carotene has been shown to increase lung cancer risk in recent chemoprevention trials, especially in current smokers. Several possible mechanisms for this effect have been suggested based upon in vitro and animal studies, but mechanistic data from human studies to explain the excess risk are lacking. beta-Carotene has both antioxidant and prooxidant effects in vitro; therefore, we evaluated whether or not high-dose supplemental beta-carotene might have prooxidant effects in vivo, especially in current smokers taking high-dose supplemental beta-carotene for several years (median 4.0 yr). Urine samples (n = 55 total) were collected from both smokers and nonsmokers participating in a multiyear randomized chemoprevention trial of supplemental beta-carotene (50 mg/day) versus placebo. Samples were analyzed by GC/MS for total isoprostanes and for 8-iso-prostaglandin F2 (8-iso-PGF2), stable end products of lipid peroxidation in vivo. Smokers had higher levels of both total isoprostanes and 8-iso-PGF2. Smokers and nonsmokers randomized to beta-carotene had nonsignificantly lower concentrations of total isoprostanes and of 8-iso-PGF2 [mean +- SD 8-iso-PGF2/ml = 2.00 +- 1.72 (placebo smoker); 1.72 +- 1.66 (beta-carotene smoker); 1.22 +- 0.68 (placebo nonsmoker); 0.97 +- 0.62 (beta-carotene nonsmoker)]. These results indicate that supplemental beta-carotene, even when given at high doses for many years, does not have prooxidant effects in either smokers or nonsmokers, as measured by urinary excretion of F2-isoprostanes