Analysis of the Melanoma Epidemic, Both Apparent and Real

Dennis, Leslie K.

doi:10.1001/archderm.135.3.275

Cited by 165 publications

(63 citation statements)

References 18 publications

(25 reference statements)

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“…The lowest score of 5 was assigned to women with the lowest relative risk (RR ¼ 1.0) for all factors; the highest risk scores were 11.9 in NHS and 14.3 in NHS II. Categories of low, middle, and high risk were defined to ensure Table 1 Age-standardised characteristics a within the low and high categories of vitamin C, vitamin E, retinol, and b-carotene intakes from foods plus supplements among the women in the NHS (n=73 432) and NHS II (n=88 541) study populations Values are means or percentages of the population within categories of nutrient intakes and are standardised to the age distribution of the study populations over follow-up (NHS 1984(NHS -1998NHS II 1991-1999. b mg of a-tocopherol equivalents.…”

Section: Resultsmentioning

confidence: 99%

“…c 95% confidence interval. (1984-1998) and NHS II (1991-1999 were pooled to obtain risk estimates for the combined cohorts. b Relative risks were adjusted for the covariates listed in Table 2 footnote c plus total energy intake, multivitamin use, and use of vitamin C, vitamin E, and b-carotene supplements.…”

Section: Discussionmentioning

confidence: 99%

“…Certain foods, such as orange juice, may be associated with an increased risk of melanoma, but further research is needed to confirm this finding and to identify the responsible constituents in these foods. (1984-1998) and NHS II (1991-1999 were pooled to obtain risk estimates for the combined cohorts. All P-values were 40.05 in tests for heterogeneity.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of melanoma in the US is increasing at a greater rate than that of any other cancer site (Rigel, 1997), and this is considered real and not because of earlier detection or changes in diagnostic criteria (Dennis, 1999). Excessive exposure to sunlight is the primary environmental risk factor for melanoma (Elwood and Jopson, 1997;Osterlind et al, 1988).…”

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confidence: 99%

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Dietary intakes of vitamins A, C, and E and risk of melanoma in two cohorts of women

et al. 2003

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Within the two Nurses' Health Study cohorts of US women, we examined whether higher intakes of vitamin C, vitamin E, retinol, or individual tocopherols or carotenoids are associated with a lower risk of melanoma. We confirmed 414 cases of invasive melanoma among over 162 000 Caucasian women aged 25 -77 years during more than 1.6 million person-years of follow-up. Diet was measured every 4 years with a food frequency questionnaire and supplement use was reported every 2 years. Several measures of sun sensitivity were assessed and included in proportional hazards models. We found that vitamins A, C, E and their individual components were not associated with a lower risk of melanoma. Only retinol intake from foods plus supplements appeared protective within a subgroup of women who were otherwise at low risk based on nondietary factors (relative risk (RR) ¼ 0.39, 95% confidence interval (CI) 0.22 -0.71 for X1800 vs o400 mg day À1 , P for linear trend ¼ 0.01). Contrary to expectation, we observed higher risks of melanoma with greater intakes of vitamin C from food only (RR ¼ 1.43, 95% CI 1.01 -2.00 for X175 vs o90 mg day À1 , P for linear trend ¼ 0.05) and a significant positive dose -response with frequency of orange juice consumption (P ¼ 0.008). Further research is needed to determine whether another component in foods such as orange juice may contribute to an increase in risk.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Dietary intakes of vitamins A, C, and E and risk of melanoma in two cohorts of women

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“…2 Between 1980 and 1989, the incidence of melanoma in American men and women increased 76% and 59%, respectively. 4 Twenty percent of the patients with melanoma die of the disease. Early identification and surgical removal is currently the only proven therapy for melanoma.…”

Section: Skin Cancer Epidemicmentioning

confidence: 99%

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2000

Liver Transpl

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Skin cancer is the most common malignancy arising in the posttransplantation setting. Multiple factors contribute to the high risk for cutaneous carcinoma in immunosuppressed organ-transplant recipients. We review the phenomenon of skin cancer in solid-organ transplant recipients and further delineate the problem in the context of liver transplantation. Skin cancer is a significant medical and surgical problem for organ-transplant recipients. With prolonged allograft function and patient survival, the majority of solid-organ transplant recipients will eventually develop skin cancer. Although squamous cell carcinoma is the most common cutaneous malignancy in this population, basal cell carcinoma, melanoma, and Kaposi's sarcoma, as well as uncommon skin malignancies, may occur. Highly susceptible patients may develop hundreds of squamous cell carcinomas, which may be life threatening. Management strategies focus on regular full-skin and nodal examination, aggressive treatment of established malignancies, and prophylactic measures to reduce the risk for additional photodamage and malignant transformation. Skin cancer is a substantial cause of morbidity and even mortality among solid-organ transplant recipients. As a byproduct of immunosuppression, liver transplant recipients experience a high incidence of skin cancer and should be educated and managed accordingly. (Liver Transpl 2000;6:253-262.) S kin cancer is the most common malignancy occurring in the setting of solid-organ transplantation and immunosuppression. The incidence of skin cancer increases substantially with extended survival after organ transplantation. Although for many patients, the cutaneous malignancies that arise are easily managed, there is a distinct subset of patients for whom major morbidity and even mortality may occur.Fortunately, skin cancer is a potentially preventable malignancy, and efforts increasingly are being directed to primary prevention in addition to treatment of skin cancers. Because the majority of organ-transplant recipients eventually develop skin cancer, it behooves the transplant physician and team to be knowledgeable about the early recognition of these lesions. Prompt referral to a dermatologist expert in the management of these patients is essential to minimize morbidity and occasional mortality.This review summarizes the skin cancer epidemic, the phenomenon of skin cancer in the setting of solid-organ transplantation, etiologic factors, and the recognition, management, and prevention of this substantial complication of transplantation-associated immunosuppression.

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Melanoma and the Dermatologist in the Third Millennium

MacKie¹

2000

Arch Dermatol

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Analysis of the Melanoma Epidemic, Both Apparent and Real

Cited by 165 publications

References 18 publications

Dietary intakes of vitamins A, C, and E and risk of melanoma in two cohorts of women

Dietary intakes of vitamins A, C, and E and risk of melanoma in two cohorts of women

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Melanoma and the Dermatologist in the Third Millennium

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