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Epidemiology and Risk Factors of Skin Cancer

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A special issue of Current Oncology (ISSN 1718-7729). This special issue belongs to the section "Dermato-Oncology".

Deadline for manuscript submissions: 30 June 2024 | Viewed by 30321

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Special Issue Editor

Prof. Dr. Leslie K. Dennis

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Department of Epidemiology & Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA
Interests: cancer epidemiology; cancer control; melanoma; infectious causes of cancer; melanoma etiology and prevention

Special Issue Information

Dear Colleagues,

Skin cancer altogether accounts for more cancers than other cancers combined. We are well aware of the importance of ultraviolet radiation via sun exposure in the development of skin cancer. Despite this, certain aspects of specific types of sun exposure in different populations need further clarification, particularly for non-melanoma skin cancers. Published reports on surveillance for non-melanoma skin cancers are infrequent. Few studies have reported non-UVR risk factors for BCC, SCC, nevi and melanoma.

This Special Issue aims to expand our knowledge on the risk factors for skin cancer, including specific types of sun exposure beyond sun exposure when data are available.

Current Oncology is an international, peer-reviewed open access journal on oncology. This Special Issue invites a range of papers from original research articles to comprehensive reviews on risk factors and surveillance for non-melanoma skin cancers (BCC, SCC and others), nevi and melanoma.

We welcome manuscripts in the following formats:

Original research;
Review articles;
Short communications;

I look forward to receiving your contributions.

Prof. Dr. Leslie K. Dennis
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Current Oncology is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

epidemiology
etiology
risk factors
BCC
SCC
melanoma
nevi
ultraviolet radiation (UVR)

Published Papers (12 papers)

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Research

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14 pages, 434 KiB

Open AccessArticle

Molecular Markers in Melanoma Progression: A Study on the Expression of miRNA Gene Subtypes in Tumoral vs. Benign Nevi

by Mihaela Prodan, Sergiu Costescu, Ahmed Elagez, Sorina Maria Denisa Laitin, Vlad Bloanca, Zorin Crainiceanu, Edward Seclaman, Ana-Olivia Toma, Roxana Manuela Fericean, George Puenea and Gabriel Veniamin Cozma

Curr. Oncol. 2024, 31(5), 2881-2894; https://doi.org/10.3390/curroncol31050220 (registering DOI) - 17 May 2024

Viewed by 257

Abstract

This study investigates the differential expression of miRNA gene subtypes in tumoral versus benign nevi in individuals with melanoma, aiming to identify clinically significant correlations that could serve as reliable markers for assessing tumor stage and progression. Conducted between 2019 and 2022, this descriptive, quantitative observational research analyzed 90 formalin-fixed paraffin-embedded (FFPE) samples from the Pius Brinzeu County Emergency Clinical Hospital, Timisoara, including 45 samples of advanced-stage melanoma and 45 samples of pigmented nevi. miRNA purification and analysis were performed using the miRNeasy Kit and the Human Cancer PathwayFinder miScript miRNA PCR Array, with statistical analysis (including logistic regression) to determine associations with cancer staging, such as high Breslow index risk, number of mitoses, and vascular invasion. After the analysis and comparison of 180 miRNA gene subtypes, we selected 10 of the most upregulated and 10 most downregulated genes. The results revealed that hsa-miR-133b, hsa-miR-335-5p, hsa-miR-200a-3p, and hsa-miR-885-5p were significantly upregulated in melanoma samples, with fold changes ranging from 1.09 to 1.12. Conversely, hsa-miR-451a and hsa-miR-29b-3p showed notable downregulation in melanoma, with fold changes of 0.90 and 0.92, respectively. Additionally, logistic regression analysis identified hsa-miR-29b-3p (OR = 2.51) and hsa-miR-200a-3p (OR = 2.10) as significantly associated with an increased risk of a high Breslow index, while hsa-miR-127-3p and hsa-miR-451a were associated with a reduced risk. Conclusively, this study underscores the significant alterations in miRNA expression in melanoma compared to benign nevi and highlights the potential of specific miRNAs as biomarkers for melanoma progression. The identification of miRNAs with significant associations to melanoma characteristics suggests their utility in developing non-invasive, cost-effective diagnostic tools and in guiding therapeutic decisions, potentially improving patient outcomes in melanoma management. Full article

(This article belongs to the Special Issue Epidemiology and Risk Factors of Skin Cancer)

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12 pages, 944 KiB

Open AccessArticle

The Level of Agreement between Self-Assessments and Examiner Assessments of Melanocytic Nevus Counts: Findings from an Evaluation of 4548 Double Assessments

by Olaf Gefeller, Isabelle Kaiser, Emily M. Brockmann, Wolfgang Uter and Annette B. Pfahlberg

Curr. Oncol. 2024, 31(4), 2221-2232; https://doi.org/10.3390/curroncol31040164 - 13 Apr 2024

Viewed by 567

Abstract

Cutaneous melanoma (CM) is a candidate for screening programs because its prognosis is excellent when diagnosed at an early disease stage. Targeted screening of those at high risk for developing CM, a cost-effective alternative to population-wide screening, requires valid procedures to identify the high-risk group. Self-assessment of the number of nevi has been suggested as a component of such procedures, but its validity has not yet been established. We analyzed the level of agreement between self-assessments and examiner assessments of the number of melanocytic nevi in the area between the wrist and the shoulder of both arms based on 4548 study subjects in whom mutually blinded double counting of nevi was performed. Nevus counting followed the IARC protocol. Study subjects received written instructions, photographs, a mirror, and a “nevometer” to support self-assessment of nevi larger than 2 mm. Nevus counts were categorized based on the quintiles of the distribution into five levels, defining a nevus score. Cohen’s weighted kappa coefficient (κ) was estimated to measure the level of agreement. In the total sample, the agreement between self-assessments and examiner assessments was moderate (weighted κ = 0.596). Self-assessed nevus counts were higher than those determined by trained examiners (mean difference: 3.33 nevi). The level of agreement was independent of sociodemographic and cutaneous factors; however, participants’ eye color had a significant impact on the level of agreement. Our findings show that even with comprehensive guidance, only a moderate level of agreement between self-assessed and examiner-assessed nevus counts can be achieved. Self-assessed nevus information does not appear to be reliable enough to be used in individual risk assessment to target screening activities. Full article

(This article belongs to the Special Issue Epidemiology and Risk Factors of Skin Cancer)

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10 pages, 625 KiB

Open AccessArticle

Prioritizing Melanoma Surgeries to Prevent Wait Time Delays and Upstaging of Melanoma during the COVID-19 Pandemic

by Katherine Aw, Rebecca Lau and Carolyn Nessim

Curr. Oncol. 2023, 30(9), 8328-8337; https://doi.org/10.3390/curroncol30090604 - 9 Sep 2023

Cited by 1 | Viewed by 1175

Abstract

Prompt diagnosis and surgical management of melanoma strongly impact prognosis. Considering the limited resources, emergency closures, and staffing shortages during the COVID-19 pandemic in Canada, our institution implemented a dedicated care pathway to prioritize cancer surgeries. We aim to assess whether this strategy was effective at preventing surgical wait time delays and upstaging of melanoma. We retrospectively collected data of patients aged ≥18 years with biopsy-proven primary melanoma who underwent wide local excision (WLE) ± sentinel lymph node biopsy (SLNB) between 1 March 2018–29 February 2020 (pre-pandemic) and 1 March 2020–22 March 2022 (pandemic). Patients with distant metastasis, recurrence, in situ disease, and unknown primary were excluded. Wait time from consult to surgery, tumour (T) and nodal (N) stage, and overall stage were collected. Results: We included 419 patients [pre-pandemic (n = 204) and pandemic (n = 215)]. Median wait time (days) [interquartile range] to surgery was 36 [22–48] pre-pandemic and 35 [24–49] during the pandemic (p = 0.888). There were no differences found in T stage (p = 0.060), N stage (p = 0.214), or overall melanoma stage (p = 0.192). We highlight the importance of streamlining melanoma surgery during a pandemic. As the need arises to meet surgical backlogs including benign surgery, dedicated cancer surgery should maintain a priority to not negatively affect cancer outcomes. Full article

(This article belongs to the Special Issue Epidemiology and Risk Factors of Skin Cancer)

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15 pages, 2524 KiB

Open AccessArticle

Comparison of Prognostic Factors for Merkel Cell Carcinoma, Mucosal Melanoma and Cutaneous Malignant Melanoma: Insights into Their Etiologies

by Leslie K. Dennis, Heidi E. Brown and Amanda K. Arrington

Curr. Oncol. 2023, 30(4), 3974-3988; https://doi.org/10.3390/curroncol30040301 - 31 Mar 2023

Cited by 1 | Viewed by 1763

Abstract

Little is known about the epidemiology of Merkel cell carcinoma (MCC) and mucosal melanoma (MM). Using the United States (US) National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program data, we compared MCC and MM with cutaneous malignant melanoma (CMM) with respect to incidence rates and prognostic factors to better understand disease etiologies. We describe the proportional incidences of the three cancers along with their survival rates based on 20 years of national data. The incidence rates in 2000–2019 were 203.7 per 1,000,000 people for CMM, 5.9 per 1,000,000 people for MCC and 0.1 per 1,000,000 people for MM. The rates of these cancers increased over time, with the rate of MM tripling between 2000–2009 and 2010–2019. The incidences of these cancers increased with age and rates were highest among non-Hispanic Whites. Fewer MCCs and MMS were diagnosed at the local stage compared with CMM. The cases in the 22 SEER registries in California were not proportional to the 2020 population census but instead were higher than expected for CMM and MCC and lower than expected for MM. Conversely, MM rates were higher than expected in Texas and New York. These analyses highlight similarities in the incidence rates of CMM and MCC—and differences between them and MM rates—by state. Understanding more about MCC and MM is important because of their higher potential for late diagnosis and metastasis, which lead to poor survival. Full article

(This article belongs to the Special Issue Epidemiology and Risk Factors of Skin Cancer)

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12 pages, 4250 KiB

Open AccessEditor’s ChoiceArticle

Validity of a Self-Assessment Skin Tone Palette Compared to a Colorimeter for Characterizing Skin Color for Skin Cancer Research

by Michelle K. Martin, Tanzida Zaman, Amanda M. Okello and Leslie K. Dennis

Curr. Oncol. 2023, 30(3), 3189-3200; https://doi.org/10.3390/curroncol30030241 - 8 Mar 2023

Cited by 2 | Viewed by 6818

Abstract

Our goal is to determine whether our objective 9-point Self-Assessment Skin Tone Palette (SASTP) is correlated with a colorimeter’s assessment of a melanin index, so that Hispanic and Black people can be included in skin cancer research where scales were developed for White populations. Subjects were asked to self-identify their skin tones using the SASTP. This study assessed the criterion validity of the SASTP by measuring a range of skin colors compared to a melanin index reported from a colorimeter for the upper-inner arm (non-sun-exposed skin color), and the outer forearm (sun-exposed). Among 188 non-artificial tanners, 50% were White, 30% were Hispanic or White-Hispanic, and 20% were other racial categories. Meanwhile, 70% were female (30% male) and 81% were age 18–29 (19% age 30+). The mean melanin of the upper-inner arm decreased with lighter skin color and stronger tendency to burn. The SASTP in comparison to melanin index values was correlated for both the upper-inner arm (r = 0.81, p < 0.001) and the outer forearm (r = 0.77, p < 0.001). The SASTP provides a 9-point scale that can be considered as an alternative, less expensive method that is comparable to the objective colorimeter melanin index, which may be useful in studies on skin cancer among White, non-White, and Hispanic peoples. Full article

(This article belongs to the Special Issue Epidemiology and Risk Factors of Skin Cancer)

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10 pages, 243 KiB

Open AccessArticle

Association of Sun Safety Behaviors and Barriers with Sunburn History in College Students in a Region with High UV Exposure

by Dylan T. Miller, Zoe Baccam and Robin B. Harris

Curr. Oncol. 2022, 29(12), 9671-9680; https://doi.org/10.3390/curroncol29120759 - 8 Dec 2022

Cited by 1 | Viewed by 1668

Abstract

Over five million cases of skin cancer are diagnosed each year in the United States with melanoma the third most common cancer in young adults. While publications have shown that sunburns increase the risk of developing melanoma throughout the lifetime including in adolescence and adulthood showing the importance of altering sun exposing behaviors throughout the lifetime, use of sun protection in college students remails low. In Fall 2019, an online survey of undergraduate students living on campus at a large southwestern university was conducted to determine the frequency of recent sunburns as well as sun protective behaviors and perceived knowledge of and barriers to sun protection. Associations between knowledge, behaviors, and barriers with self-reported sunburn were evaluated using logistic regression. Over 46% of 458 students reported at least one sunburn in the past three months and 21% reported having multiple sunburns in that period. Furthermore, 53% reported that they intentionally tanned their skin outdoors occasionally or more frequently, while 6.4% reported using an indoor tanning bed occasionally or more. Adjusted for skin sensitivity, recent sunburn history was associated with higher tanning activity scores and with high agreement that tanning was attractive (p < 0.01). This information can inform a more targeted series of intervention programming on the university campus. Full article

(This article belongs to the Special Issue Epidemiology and Risk Factors of Skin Cancer)

11 pages, 569 KiB

Open AccessArticle

Prognostic Relevance of Type 2 Diabetes and Metformin Treatment in Head and Neck Melanoma: Results from a Population-Based Cohort Study

by Steffen Spoerl, Michael Gerken, Susanne Schimnitz, Juergen Taxis, René Fischer, Sophia R. Lindner, Tobias Ettl, Nils Ludwig, Silvia Spoerl, Torsten E. Reichert and Gerrit Spanier

Curr. Oncol. 2022, 29(12), 9660-9670; https://doi.org/10.3390/curroncol29120758 - 7 Dec 2022

Cited by 3 | Viewed by 1589

Abstract

Background: Type 2 Diabetes (DM2) and the consecutively daily use of antidiabetic medication are characterized by a frequent prevalence worldwide and were shown to impact the initiation and progression of malignant diseases. While these effects were observed in a variety of malignancies, comprehensive data about the role of DM2 and antidiabetic drugs in the outcome of head and neck melanoma (HNM) patients are missing. Methods: This retrospective population-based cohort study included 382 HNM patients from Eastern Bavaria having received tumor resection to negative margins between 2010 and 2017. Recurrence-free survival (RFS) was evaluated with regard to DM2 and routine metformin intake. Statistical analysis was performed by uni- and multivariate analyses. The median follow-up time was 5.6 years. Results: DM2 was diagnosed in 68 patients (17.8%), routine metformin intake was found in 39 cases (10.2%). The univariate survival analysis revealed impaired 5-year RFS in HNM patients with DM2 compared to non-diabetic controls (p = 0.016; 64.0% and 74.5%, respectively). The multivariate Cox regression substantiated this effect (HR = 1.980, 95% CI = 1.108–3.538, p = 0.021). In detail, the cumulative locoregional recurrence rate displayed the most far-reaching negative effect on the RFS of diabetic HNM patients (HR = 4.173, 95% CI = 1.628–10.697, p = 0.003). For metformin intake, a profound positive effect on the RFS in multivariate statistics was observed, both in the complete cohort (HR = 0.396, 95% CI = 0.177–0.884, p = 0.024) as well as in the cohort of diabetic HNM patients (HR = 0.352, 95% CI = 0.135–0.913, p = 0.032). Conclusions: This study emphasizes that DM2 is a relevant comorbid condition in HNM patients, impairing patient survival. Metformin intake was associated with a favorable outcome in HNM patients, providing possible therapeutic implications for future adjuvant treatment regimes. Full article

(This article belongs to the Special Issue Epidemiology and Risk Factors of Skin Cancer)

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16 pages, 2999 KiB

Open AccessArticle

A Regional Survey on Merkel Cell Carcinoma: A Plea for Uniform Patient Journey Modeling and Diagnostic–Therapeutic Pathway

by Michela Roberto, Andrea Botticelli, Alessio Caggiati, Alberto Chiriatti, Carlo Della Rocca, Virginia Ferraresi, Felice Musicco, Giovanni Pellacani and Paolo Marchetti

Curr. Oncol. 2022, 29(10), 7229-7244; https://doi.org/10.3390/curroncol29100570 - 30 Sep 2022

Cited by 2 | Viewed by 1739

Abstract

Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous neuroendocrine cancer that usually affects the elderly and immunosuppressed in sun-exposed areas. Due to its rarity, it is frequently unrecognized, and its management is not standardized across medical centers, despite the more recent availability of immunotherapy, with avelumab as first-line treatment improving the prognosis even in advanced stages of disease. We conducted a purpose-designed survey of a selected sample of physicians working in the Lazio region, in Italy, to assess their awareness and knowledge of MCC as well as their perspective on assisted diagnostic and therapeutic pathways. The Lazio region, and in particular Rome, is one of the most important academic and non- academic center in Italy dedicated to the diagnosis and treatment of skin cancer. A total of 368 doctors (including 100 general practitioners, 72 oncologists, 87 dermatologists, 59 surgeons, and 50 anatomopathologists) agreed to be part of this survey. Surgeons, oncologists, and dermatologists thought themselves significantly more updated on MCC than primary care physicians, but more than half of the interviewees are interested in CCM training courses and training with clearer and more standardized care pathways. Significant differences have been reported from survey participants in terms of multidisciplinary team set up for MCC management. The identification of specialized centers and the improvement of communication pathways among different specialties, as well as between patients and physicians, could be very beneficial in improving patients’ journey modeling and starting a uniform diagnostic and therapeutic pathway for MCC patients in the new era of immunotherapies. Full article

(This article belongs to the Special Issue Epidemiology and Risk Factors of Skin Cancer)

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14 pages, 1364 KiB

Open AccessArticle

Treatment of Basal Cell Carcinoma with Electrochemotherapy: Insights from the InspECT Registry (2008–2019)

by Giulia Bertino, Tobian Muir, Joy Odili, Ales Groselj, Roberto Marconato, Pietro Curatolo, Erika Kis, Camilla Kjaer Lonkvist, James Clover, Pietro Quaglino, Christian Kunte, Romina Spina, Veronica Seccia, Francesca de Terlizzi, Luca Giovanni Campana and the InspECT BCC Working Group

Curr. Oncol. 2022, 29(8), 5324-5337; https://doi.org/10.3390/curroncol29080423 - 28 Jul 2022

Cited by 6 | Viewed by 2758

Abstract

This prospective registry-based study aims to describe electrochemotherapy (ECT) modalities in basal cell carcinoma (BCC) patients and evaluate its efficacy, safety, and predictive factors. The International Network for Sharing Practices of Electrochemotherapy (InspECT) multicentre database was queried for BCC cases treated with bleomycin-ECT between 2008 and 2019 (n = 330 patients from seven countries, with 623 BCCs [median number: 1/patient; range: 1–7; size: 13 mm, range: 5–350; 85% were primary, and 80% located in the head and neck]). The procedure was carried out under local anaesthesia in 68% of cases, with the adjunct of mild sedation in the remaining 32%. Of 300 evaluable patients, 242 (81%) achieved a complete response (CR) after a single ECT course. Treatment naïvety (odds ratio [OR] 0.35, 95% confidence interval [C.I.] 0.19–0.67, p = 0.001) and coverage of deep tumour margin with electric pulses (O.R. 5.55, 95% C.I. 1.37–21.69, p = 0.016) predicted CR, whereas previous radiation was inversely correlated (O.R. 0.25, p = 0.0051). Toxicity included skin ulceration (overall, 16%; G3, 1%) and hyperpigmentation (overall, 8.1%; G3, 2.5%). At a 17-month follow-up, 28 (9.3%) patients experienced local recurrence/progression. Despite no convincing evidence that ECT confers improved outcomes compared with standard surgical excision, it can still be considered an opportunity to avoid major resection in patients unsuitable for more demanding treatment. Treatment naïvety and coverage of the deep margin predict tumour clearance and may inform current patient selection and management. Full article

(This article belongs to the Special Issue Epidemiology and Risk Factors of Skin Cancer)

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9 pages, 565 KiB

Open AccessArticle

Cutaneous Melanoma in Alpine Population: Incidence Trends and Clinicopathological Profile

by Alessandra Buja, Massimo Rugge, Giuseppe De Luca, Emanuela Bovo, Manuel Zorzi, Chiara De Toni, Claudia Cozzolino, Antonella Vecchiato, Paolo Del Fiore, Romina Spina, Sandro Cinquetti, Vincenzo Baldo, Carlo Riccardo Rossi and Simone Mocellin

Curr. Oncol. 2022, 29(3), 2165-2173; https://doi.org/10.3390/curroncol29030175 - 21 Mar 2022

Cited by 8 | Viewed by 2685

Abstract

Previous studies associated high-level exposure to ultraviolet radiation with a greater risk of cutaneous malignant melanoma (CMM). This study focuses on the changing incidence of CMM over time (from 1990 to 2017) in the Veneto region of Northeast Italy, and its Alpine area (the province of Belluno). The clinicopathological profile of CMM by residence is also considered. A joinpoint regression analysis was performed to identify significant changes in the yearly incidence of CMM by sex and age. For each trend, the average annual percent change (AAPC) was also calculated. In the 2017 CMM cohort, the study includes a descriptive analysis of the disease’s categorical clinicopathological variables. In the population investigated, the incidence of CMM has increased significantly over the last 30 years. The AAPC in the incidence of CMM was significantly higher among Alpine residents aged 0–49 than for the rest of the region’s population (males: 6.9 versus 2.4; females 7.7 versus 2.7, respectively). Among the Alpine residents, the AAPC was 3.35 times greater for females aged 0–49 than for people aged 50+. The clinicopathological profile of CMM was significantly associated with the place of residence. Over three decades, the Veneto population has observed a significant increase in the incidence of CMM, and its AAPC. Both trends have been markedly more pronounced among Alpine residents, particularly younger females. While epidemiology and clinicopathological profiles support the role of UV radiation in CMM, the young age of this CMM-affected female population points to other possible host-related etiological factors. These findings also confirm the importance of primary and secondary prevention strategies. Full article

(This article belongs to the Special Issue Epidemiology and Risk Factors of Skin Cancer)

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Review

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18 pages, 2014 KiB

Open AccessFeature PaperReview

An Epidemiological Update on Indoor Tanning and the Risk of Skin Cancers

by Clio Dessinioti and Alexander J. Stratigos

Curr. Oncol. 2022, 29(11), 8886-8903; https://doi.org/10.3390/curroncol29110699 - 17 Nov 2022

Cited by 15 | Viewed by 5732

Abstract

Indoor tanning (sunbeds, solarium) uses artificial ultraviolet radiation (UVR) to stimulate cosmetic tanning of the skin. Indoor tanning has been officially classified as a human carcinogen in 2009 by the International Agency for Research on Cancer of the World Health Organization (WHO). The differences in the prevalence of sunbed use across countries and over the years highlight underlying legislative, climatic, and cultural differences. Indoor tanning-seeking behaviors may be driven by motivations for an appealing appearance, largely influenced by gender and age, and several misconceptions that a prevacation tan safeguards the skin, that sunbeds can be used to treat acne or to increase vitamin D, or that tanning is a healthy habit. This review provides an epidemiological update on the prevalence of sunbed use, who tends to use sunbeds and why, and details the current evidence on the association of sunbeds with skin cancers, including cutaneous melanoma, basal cell carcinoma (BCC), and cutaneous squamous cell carcinoma (cSCC). A statistically significant higher risk of cutaneous melanoma, BCC and cSCC with the use of sunbeds has been consistently demonstrated. This risk of skin cancer is even higher with the more frequent use of sunbeds, underscoring a dose–response relationship, and in those first exposed to sunbeds at a younger age. Preventive measures against sunbed use include legislation restricting sunbed use, educational campaigns to inform and discourage from indoor tanning, as well as using the internet, online advertising messages and the social media to reach larger audiences and to promote an untanned appearance. Full article

(This article belongs to the Special Issue Epidemiology and Risk Factors of Skin Cancer)

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Other

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11 pages, 2027 KiB

Open AccessSystematic Review

Systematic Review of Calcineurin Inhibitors and Incidence of Skin Malignancies after Kidney Transplantation in Adult Patients: A Study of 309,551 Cases

by Aleksandra Kulbat, Karolina Richter, Tomasz Stefura, Marta Kołodziej-Rzepa, Michał Kisielewski, Tomasz Wojewoda and Wojciech M. Wysocki

Curr. Oncol. 2023, 30(6), 5727-5737; https://doi.org/10.3390/curroncol30060430 - 13 Jun 2023

Cited by 2 | Viewed by 1949

Abstract

The purpose of this systematic review and meta-analysis was to compare the risk of non-melanoma skin cancer (NMSC) and melanoma development in renal transplant recipients who receive calcineurin inhibitors to that of patients treated with other immunosuppressive agents, and investigate the possible association between the type of maintenance immunosuppression and the incidence of NSMC and melanoma in this group of patients. The authors searched databases such as PubMed, Scopus, and Web of Science for articles that would help establish the influence of calcineurin inhibitors on skin cancer development. The inclusion criteria for the study consisted of randomized clinical trials, cohort studies, and case-control studies that compared patients who received kidney transplants and were treated with a calcineurin inhibitor (CNI), such as cyclosporine A (CsA) or tacrolimus (Tac), to those who received alternative immunosuppressants and did not receive a CNI. Seven articles were analyzed overall. The results revealed a correlation between CNI treatment in renal transplant recipients and increased total skin cancer risk (OR 1.28; 95% CI: 0.10–16.28; p < 0.01), melanoma risk (OR 1.09; 95% CI: 0.25–4.74; p < 0.01), and NMSC risk (OR 1.16; 95% CI: 0.41–3.26; p < 0.01). In conclusion, the calcineurin inhibitors used after kidney transplantation are associated with a higher risk of skin cancer—both non-melanoma and melanoma—when compared with other immunosuppressive therapies. This finding suggests that careful monitoring for skin lesions in post-transplant patients must be conducted. However, the decision on the kind of immunotherapy used should always be considered on an individual basis for each renal transplant recipient. Full article

(This article belongs to the Special Issue Epidemiology and Risk Factors of Skin Cancer)

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