This thesis presents studies on different aspects of the epidemiology of melanoma:

variations in disease frequency in time and place, determinants of melanoma incidence

and variation in prognostic factor

Vries, E. (Esther) de

Erasmus University Digital Repository

Stellingen behorend bij het proefschrift 'Trends and risk factors of cutaneous melanoma in Europe' 1. The fact that melanoma mortality trends stabilise while incidence trends keep rising in North-western Europe is not due to better treatment of melanoma. (this thesis) 2. Trends in melanoma incidence, particularly by body site, suggest increases in intermittent instead of chronic exposure to ultraviolet radiation. (this thesis) 3. Future increases in the numbers of new basal cell carcinoma and melanoma patients will be mainly due to increases in incidence, rather than to demographic changes towards ageing of the population. (this thesis) 4. Awareness of risk factors for melanoma in the general population can improve early detection and (primary) prevention, but hampers case"control studies which use self-reported measures of sun-exposure. (this thesis) 5. The aetiological, pathological and clinical observations made in 1933 by Dr Wassink in Dutch and Indonesian Dutch patients were a nice foreshadowing of the current knowledge regarding the causes of skin cancer. (Wassink, Ned Tijdschr Geneeskd 1933 : 77(3): 4064-4069) ... de carcinomen van het verhoornende plaveisecelepitheeltype ontstaan in den regel via praecarcinomateuse voorstadia, die zelve zich ohtwikkelen op een gewoonlijk reeds sinds Iangen tijd ziekelijk veranderende huid. ... De basocellulaire · carcinomen · vormen in menig opzicht een tegenstelling ... zij ontstaan ook op een overigens gezonde, onbeschadigde huid. In de voorgeschiedenis mist men dan ook de chronische beschadigingen, waaraan de huid, die een plaveiselcelepitheel carcinoom vormen zal, in den regel blootgesteld is geweest. Terwijl de plaveiselcelepitheel-kankers zeer vee! menigvuldiger bij den man dan bij de vrouw worden gezien, vonden wij dit onderscheid niet bij de basaalcelcarcinomen .... mijn theorie, dat in onze streken een groot dee! der kankers van aangezicht en oor, namelijk die van het epidermoidtype, althans bij de weinig of niet gepigmenteerde bevolking, practisch gesproken aleen aan klimatologische oorzaken, met als voomaamste het zonlicht, te wijten Zijn ... ' 6. Secondary prevention campaigns should take into account possible shortages of involved care suppliers when they also lead to an increased workload. 7. Observational research should be restricted to questions that can meet the underlying assumption that the exposure allocation is unrelated to outcome. (Vandenbroucke, Lancet 2004: 363: 1728-1731) 8. History followed different courses for different peoples because of differences among peoples' environments, not because of biological differences among peoples themselves. (J. Diamond 'Guns, Germs, and Steel: The Fates of Human Societies. New York: W. W. Norton & Company, Inc.) 9. No matter the languages we speak or the colour of our skin, we share ancestors with those who planted rice on the banks of the Yangtze, who first domesticated horses on the steppes of the Ukraine, who hunted giant sloths in the forests of North and South America, and who laboured to build the Great Pyramid of Khufu. (Rohde D. L. T, Olson S. & Chang J. T. Nature, 431, 562- 565. (2004). 10. George Orwell could not have improved upon the following statement posed on the website of the Dutch Immigration and Naturalisation Services (IND): 'IND employees are inspired, resourceful, responsible and knowledgeable'. (http:lfwww.ind.nl/en/inbedrijf/overdeind/werkenbijdeind(index.asp) 11. Everyone can walk on water if the water is cold enough. Esther de Vries, 2004 

Trends and risk factors of cutaneous melanoma in Europe

http://repub.eur.nl/pub/51703/stellingen-De-Vries.pdf

Trends and risk factors of cutaneous melanoma in Europe

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