Skin cancer mortality in Spain: adjusted mortality rates by province and related risk factors

Background:Ultraviolet radiation is the main environmental risk factor responsible for thedevelopment of skin cancer. Other occupational, socioeconomic, and environmental factorsappear to be related to the risk of skin cancer. Furthermore, the factors appear to differ formelanoma and non-melanoma skin cancer (NMSC). The purpose of this study is toanalyze mortality rates of skin cancer in the different provinces of Spain and to determinethe influence of socioeconomic conditions and other environmental and demographicfactors in rates.MethodsDeaths from melanoma and NMSC in the period 2000–2019 were obtained aswell as socioeconomic and environmental variables. Annual standardized mortality rates(SMR) were calculated for all Spanish provinces. The Pearson correlation coefficient wascalculated.ResultsThe SMR of melanoma was 2.10/100,000 inhabitants, while that of NMSC was1.28/100,000. At the provincial level, a great variability is confirmed. Gross domesticproduct showed a positive correlation with melanoma mortality but a negative correlationwith NMSC. Other environmental and socioeconomic variables also showed correlation, asa positive correlation between tobacco sales and melanoma and between agriculturaldevelopment and the NMSC.ConclusionsThere are still important differences between each province that must betaken into account when planning health care and resource distribution. This ecologicaland province-wise study helps to elucidate the relationship between social and ambientexposure determinants and skin cancer mortality in Spain

Hidradenitis suppurativa and suicide risk: a multivariate analysis in a disease with a high psychological burden.

Hidradenitis suppurativa (HS) is a disorder that can lead to serious sequelae and important comorbidities. It has been associated with different mental health conditions, such as depression, anxiety or completed suicide. The objective is to analyze the suicide risk (SR) among patients in a monographic HS consultation, as well as to establish individual association factors. Patients older than 18 years seen in our specific HS unit were consecutively included and invited to respond to the self-administered Beck hopelessness scale. Those patients with significant intellectual disabilities or severe mental health conditions, including a history of psychosis, were excluded. In addition, data related to the skin process were collected. Subsequently, it was studied whether there were significant differences between patients with absent-mild SR and those with moderate-severe SR and a logistic regression analysis was performed to determine the relationship of these variables with SR. A total of 136 patients were included in the study, 51.5% men. Of them, 21.3% presented a moderate or severe SR (score ≥ 9 in the Beck test). This risk was significantly related to having a previous or concomitant psychiatric disorder (OR = 2.586, 95% CI 1.044-6.409, p = 0.040) followed by the history of biological treatment (OR = 2.867, 95% CI 1.004-8.182, p = 0.049). The existence of other affected relatives was confirmed as a protective factor (OR = 0.377, 95% CI 0.150-0.951, p = 0.039). The prevalence of SR in patients with HS is higher than that of the general Spanish population. The presence of a psychiatric disorder and the need for biological treatment are established as factors that increase SR, both of which can be interpreted as a more advanced disease. As a protective factor, the presence of other cases in the family is established, which suggests a greater normalization of the disease