Non-melanoma Skin Cancer in Canada Chapter 1: Introduction to the Guidelines

Guenther, Lyn; Barber, Kirk; Searles, Gordon; Lynde, Charles; Janiszewski, Peter M.; Ashkenas, John

doi:10.1177/1203475415588652

Cited by 9 publications

(6 citation statements)

References 79 publications

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“…(See chapter I for general methods. 86 ) bStrength of recommendation is evaluated as strong or weak, depending on the confidence that the treatment is more helpful than the alternative(s), including nontreatment. Hence, therapies with a high level of evidence regarding efficacy may receive a weak recommendation if the risk of adverse response is high or if this risk is not well known.…”

Section: Resultsmentioning

confidence: 99%

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Non-melanoma Skin Cancer in Canada Chapter 5: Management of Squamous Cell Carcinoma

et al. 2015

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Background Squamous cell carcinoma (SCC) is the second-most common form of non-melanoma skin cancer (NMSC). Objective To provide guidance to Canadian health care practitioners regarding management of SCCs. Methods Literature searches and development of graded recommendations were carried out as discussed in the accompanying introduction (chapter 1 of the NMSC guidelines). Results SCCs are sometimes confined to the epidermis, but they can also invade nearby tissues and, in some cases, metastasize to neighbouring lymph nodes or other organs. This chapter discusses the natural history, staging, prognosis, and management of SCC—a tumour type that is less common but typically more aggressive than BCC. For this reason, margin control is strongly preferred in treating SCCs. Conclusions Although approaches such as cryosurgery and radiation therapy may be considered for some patients, surgical excision—sometimes coupled with radiation—remains the cornerstone of SCC management. Patients with high-risk SCC may also be considered for referral to an appropriate multidisciplinary clinic.

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Section: Resultsmentioning

confidence: 99%

“…Literature searches and development of graded recommendations were carried out as discussed in the accompanying introduction (chapter 1 of the Canadian NMSC guidelines). 86…”

Section: Methodsmentioning

confidence: 99%

Non-melanoma Skin Cancer in Canada Chapter 5: Management of Squamous Cell Carcinoma

et al. 2015

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“…The quality of the papers reviewed were scored, where appropriate, using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, as discussed in Chapter 1. 104…”

Section: Methodsmentioning

confidence: 99%

Non-melanoma Skin Cancer in Canada Chapter 2: Primary Prevention of Non-melanoma Skin Cancer

Barber

Searles

Vender³

et al. 2015

J Cutan Med Surg

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Background: Non-melanoma skin cancer (NMSC), including basal and squamous cell carcinoma (BCC and SCC), represents the most common malignancy. Objective: To provide guidance to Canadian health care practitioners regarding primary prevention of NMSC. Methods: Structured literature searches were conducted, using search terms including prevention, sunscreen, and sun prevention factor. All recommendations concern guidance that physicians should regularly discuss with their patients to help establish photoprotection habits. The GRADE system was used to assign strength to each recommendation. Results: Ultraviolet exposure is the major modifiable risk factor for NMSC. Aspects of photoprotection, including effective sunscreen use and avoidance of both the midday sun and artificial tanning, are discussed. Several widespread misunderstandings that undermine responsible public health measures related to sun safety are addressed. Conclusions: Photoprotection represents both an individual priority and a public health imperative. By providing accurate information during routine patient visits, physicians reinforce the need for ongoing skin cancer prevention. RésuméContexte : De tous les cancers, le carcinome cutané (non-mélanome), y compris le carcinome basocellulaire et le carcinome spinocellulaire, est le plus fréquent. Objectif : Fournir des conseils aux professionnels canadiens de la santé au sujet de la prévention du carcinome cutané. Méthodologie : On a effectué des recherches documentaires structurées à l'aide de divers mots clés, dont « prévention », « écran solaire » et « facteur de protection solaire ». Toutes les recommandations que nous avons repérées portent sur des conseils dont les médecins devraient régulièrement discuter avec leurs patients pour les aider à adopter des habitudes de photoprotection. On a utilisé l'échelle GRADE pour évaluer la pertinence de chacune des recommandations. Résultats : L'exposition aux rayons UV est le plus important facteur de risque modifiable du carcinome cutané. Certains aspects de la photoprotection, entre autres l'utilisation efficace d'un écran solaire, l'évitement du soleil de mi-journée et l'évitement du bronzage artificiel, sont examinés. Plusieurs croyances erronées répandues nuisent aux mesures de santé publique en matière de protection contre le soleil. Conclusions : La photoprotection constitue autant une priorité personnelle qu'un impératif de santé publique. En fournissant des renseignements précis aux patients lors des visites de routine, les médecins insistent sur la nécessité d'une prévention continue du cancer de la peau.

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“…Skin cancer is the most common cancer worldwide, and comprises almost 40% of incident cancers in Canada ( 4 ). Of these, almost all are NMSCs, and are largely preventable with effective sun protection ( 5 ). Recent estimates found that over 6% of NMSC cases in Canada were attributable to sun exposure at work, with the majority of these cases occurring among those in the agricultural or construction industries ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Strategic Task and Break Timing to Reduce Ultraviolet Radiation Exposure in Outdoor Workers

Peters

Tenkate

Heer

et al. 2020

Front. Public Health

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Objectives: Public health messaging about sun avoidance strategies is often not practical for outdoor workers. The objective of this study was to use personal monitoring data to determine when peak UVR exposure occurs for outdoor workers, estimate how much UVR could be reduced by altering the timing of shady tasks or breaks during peak exposure times, and descriptively compare these to peak periods of ambient UVR. Ultimately, we aim to provide evidence-based sun avoidance recommendations for outdoor workers in British Columbia, Canada. Methods: UVR exposure data [standard erythemal dose (SED)] were collected during the 2013 summer months in Vancouver, using personal electronic dosimeters that sampled once per minute for an average of 4.4 working days (range: 1–7 days). Mixed-effect models were used to estimate the 60-, 30-, and 15-min time intervals at which maximum exposure occurred for the months of July and August. Using these time intervals, UVR exposure during peak periods was summarized as SED and as a percentage of the total daily exposure. Ambient UVR was also collected using data from the nearest Brewer spectrophotometer station and parallel analyses were conducted. Results: There were 73 workers and 321 participant-days available for analysis. Models indicated that periods of maximum exposure for 15-, 30-, and 60-min intervals began at 12:28, 12:17 pm, and 11:52 am, respectively, for sunny days in July. These periods were similar in August. The median exposure during these time periods and the potential for reducing UVR was 0.03 SED (2.8% potential daily exposure reduction), 0.09 SED (7.1%), and 0.18 SED (15.9%), respectively. However, there was a large range in exposure estimates as some workers experienced up to 84.8% of their exposure in the peak 60-min interval. Conclusion: Skin cancer prevention messaging does not include practical messages for outdoor workers and providing times of peak UVR help to identify times when the greatest reductions in exposure can occur. Prevention measures including shady breaks, increased sun protection, and task reorganization during these peak times are recommended during these peak times to reduce UVR exposure among those at highest risk.

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Non-melanoma Skin Cancer in Canada Chapter 1: Introduction to the Guidelines

Abstract: This introduction describes the need for primary prevention and offers an overview of treatment options that are discussed in later chapters of the guidelines.

Cited by 9 publications

References 79 publications

Non-melanoma Skin Cancer in Canada Chapter 5: Management of Squamous Cell Carcinoma

Non-melanoma Skin Cancer in Canada Chapter 5: Management of Squamous Cell Carcinoma

Non-melanoma Skin Cancer in Canada Chapter 2: Primary Prevention of Non-melanoma Skin Cancer

Strategic Task and Break Timing to Reduce Ultraviolet Radiation Exposure in Outdoor Workers

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