Author Interviews, Dermatology, JAMA, Melanoma / 17.03.2021

MedicalResearch.com Interview with: Anne Cust | PhD, Professor of Cancer Epidemiology The University of Sydney Faculty of Medicine and Health Sydney School of Public Health MedicalResearch.com: What is the background for this study? Are the screeners specially trained, use full body photographs, dermoscopy etc? Response: The Melanoma High-risk Clinic Study was developed to optimise the early detection of new melanomas in people at high risk of developing melanoma. A previous single-centre study observed fewer excisions and healthcare costs, thinner melanomas and better quality of life when surveillance of high risk patients was conducted in a melanoma dermatology clinic with a structured surveillance protocol involving 6-monthly full body examinations aided by total body photography (TBP) and sequential digital dermoscopy imaging (SDDI). The initial pilot study was performed in a single tertiary referral specialist centre using trained dermatologists who routinely used the diagnostic interventions. Our objective was to examine longer-term sustainability and expansion of the program to multiple practices including a primary care skin cancer clinic setting. The hypothesis was that the outcomes would be similar if using the same protocol and diagnostic tools. The participating doctors were trained to follow the protocol, which included instruction on how to respond and interpret changing lesions, but not in use of dermoscopy or skin examinations, which were routinely and consistently used in all clinics prior to the study commencing. There were 593 participants assessed as very high risk of melanoma who participated in the Melanoma High-risk Clinic Study from 2012-2018. Nearly all of the participants had had a previous melanoma and had additional melanoma risk factors. 57% were male and the median age at study entry was 58 years. (more…)
Author Interviews, Cancer Research, Dermatology, NEJM / 11.02.2021

MedicalResearch.com Interview with: Jane Fang, MD Clinical Athenex, Inc.  MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by actinic keratoses? How common are they and who is primarily affected? Response: Actinic keratosis is a very common precancerous skin condition that affects about 58 millions people in the US. Most commonly affected people are older (over 40 years old) men with fair skin type. Actinic keratosis lesions are red scaly bumps on sun-damaged skin mostly on the face, scalp, back of hands, forearms and legs. As there is a risk of 0.025-16% per year for each actinic keratosis to progress to skin cancer and it is not possible to predict which actinic keratosis will become cancerous, early treatment of actinic keratosis is generally recommended. Currently approved topical treatments require weeks or months of application and may lead to intolerable side effects that undermine compliance and reduce efficacy of treatment. Tirbanibulin ointment is a novel anti-proliferative agent that inhibits tubulin polymerization and disrupts Src kinase signaling, and has the potential to inhibit growth of abnormal skin cells in actinic keratosis. The current report described two Phase 3 randomized vehicle or placebo-controlled clinical studies that demonstrated that a 5-day course of tirbanibulin ointment applied once daily by patients was safe, well-tolerated, and effective in clearing actinic keratosis on the face or scalp compared to vehicle control. (more…)
Author Interviews, Dermatology, Genetic Research, Melanoma / 19.11.2020

MedicalResearch.com Interview with: Sarah I. Estrada, M.D., FCAP  Laboratory Director Affiliated Dermatology® www.affderm.com MedicalResearch.com: What is the background for this study? What are the main findings? Response: As a dermatopathologist who makes diagnoses on lesions that may be melanoma, I’m faced with the reality that my accurate interpretation of biopsy tissue is key for the patient to be treated most effectively. Often histopathological evaluation is straightforward but not as often as I would like. The study presented here offers a new test that can be used in conjunction with my evaluation to determine if a questionable lesion is in fact melanoma. The test was developed to take into account the gene expression of the lesion which may factor in characteristics that I cannot visually observe. The test was validated and has shown very promising accuracy metrics. (more…)
Author Interviews, Cancer Research, Dermatology, JAMA / 30.10.2020

MedicalResearch.com Interview with: Selin Tokez, PhD Student Department of Dermatology Erasmus MC, Rotterdam MedicalResearch.com: What is the background for this study? Response: Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer worldwide with still increasing incidence rates. Given these high incidence rates together with the associated health costs and possibility of fatal progression, it is extremely important to have accurate and complete data on the epidemiology of this disease. Nevertheless, national cancer registries in many countries do not routinely record cSCC cases and therefore currently known numbers are mainly based on incomplete data sources. Additionally, if cSCC cases are registered, this usually only concerns the first cSCC per patient while we know that, contrary to many other malignant neoplasms, patients may develop numerous cSCCs over time. MedicalResearch.com: What are the main findings? Response:  In the present study, we analyzed Dutch nationwide data comprising about 145,000 patients with a first invasive cSCC diagnosis between the years 1989 and 2017. We found that the incidence rates of a first cSCC per patient almost tripled in male patients and increased about fivefold in female patients in this 30-year time period. Also, we had data on all cSCCs per patient for the year 2017 and could therefore compare this with the data on only the first cSCC per patient: incidence rates increased by 58% for men and 35% for women when multiple cSCCs were considered. In absolute numbers, this resulted in an increase of 45% in cSCC diagnoses in 2017. Lastly, we extended our analyses by predicting future cSCC incidence rates up to 2027. Given that no substantially effective measures are undertaken in the near future, current cSCC incidence rates will increase with 23% in males and 29% in females in the next decade. (more…)
Author Interviews / 14.09.2020

MedicalResearch.com Interview with: Dr Mario Falchi Head of Bioinformatics for the School of Life Course Sciences Department of Twin Research & Genetic Epidemiology King’s College London MedicalResearch.com: What is the background for this study? Response: The relationship between sun exposure and health is a double-edged sword, on one side there is the beneficial effect of vitamin D production and on the other the increased risk of skin cancer, depending on length and frequency of exposure, and on the individual skin type. Despite public health campaigns, changing sun-seeking behaviour seems to be challenging for some people, even for those with a familial or personal history of skin cancer. Previous investigations have suggested that exposure to UV could be addictive.  (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Dermatology / 09.09.2020

MedicalResearch.com Interview with: Jennifer Huang, MD  Dr. Huang is a pediatric dermatologist at Boston Children’s Hospital and Dana-Farber Cancer Institute. She is an Associate Professor of Dermatology at Harvard Medical School. Dr. Huang is a member of the Society for Pediatric Dermatology. Connie Zhong, MD, MSc Dr. Zhong is an intern at Brigham and Women’s Hospital She will be doing her dermatology residency at the Harvard Combined Dermatology Program. She is a member of the Society for Pediatric Dermatology.  MedicalResearch.com: What is the background for this study? Response: Pediatric nonmelanoma skin cancers (NMSC) are rare and when they do occur, are often associated with genetic/predisposing skin conditions or iatrogenic risk factors. There are some pediatric patients who develop NMSCs who do not have identifiable risk factors. The objective of our study was to describe the demographic and clinical features of these children without identifiable risk factors and compare them with those who have either genetic or iatrogenic risk factors. We conducted a retrospective study at 11 tertiary care institutions across North America through the Pediatric Dermatology Research Alliance (PeDRA) (more…)
Author Interviews, Biomarkers, Lymphoma / 14.08.2020

MedicalResearch.com Interview with: Dr. Ivana Špaková Pavol Jozef Šafárik University Košice, Slovakia MedicalResearch.com: What is the background for this study? Response:  The background is the plenty of space for studying "waste metabolites" which tell us more about the metabolism of the whole body as well as about the metabolism of the smallest compartment - cell. So we decided to study what is the difference in urine spectra (absorbance, excitation, and emission spectra) in patients with malignant melanoma and healthy subjects without positive cancer history. MedicalResearch.com: What are the main findings? Response: The main findings are "discovery" (it is not true discovery because the target molecules or metabolites are known for decades) of molecules{metabolites which together describe the stage of malignant melanoma. These findings could be used for future tracking the patient's response for treatment or for tracking the previously treated patients for malignant melanoma and are healthy at the moment of sampling. (more…)
Author Interviews, Dermatology, Melanoma, Nature, Technology / 23.06.2020

MedicalResearch.com Interview with: Professor Harald Kittler, MD ViDIR Group, Department of Dermatology Medical University of Vienna Vienna, Austria MedicalResearch.com: What is the background for this study?  What types of skin cancers were assessed? (melanoma, SCC, Merkel etc). Response: Some researchers believe that AI will make human intelligence dispensable. It is, however, still a matter of debate how exactly AI will influence diagnostic medicine in the future. The current narrative is focused on a competition between human and artificial intelligence. We sought to shift the direction of this narrative more towards human/AI collaboration. To this end we studied the use-case of skin cancer diagnosis including the most common types of skin cancer such as melanoma, basal cell- and squamous cell carcinoma. The initial idea was to explore the effects of varied representations of AI support across different levels of clinical expertise and to address the question of how humans and machines work together as a team. (more…)
Author Interviews, Dermatology, Melanoma, Technology / 17.06.2020

MedicalResearch.com Interview with: Chi Hwan Lee PhD Assistant Professor of Biomedical Engineering and Mechanical Engineering, and by Courtesy, of Materials Engineering, and Speech, Language, & Hearing Sciences Purdue University  MedicalResearch.com: What is the background for this study? Response: Conventional melanoma therapies, including chemotherapy and radiotherapy, suffer from the toxicity and side effects of repeated treatments due to the aggressive and recurrent nature of melanoma cells. Less-invasive topical chemotherapies by utilizing miniaturized polymeric microneedles are emerged as an alternative, but the sustained, long-lasting release of drug cargos remains challenged due to the rapidly dissolving behavior of polymers (typically, within 15 min-2 hrs). In addition, the size of the microneedles is still large for small, curvilinear and sensitive areas of tissues such as cornea (for ocular melanoma). (more…)
Author Interviews, Dermatology, Technology / 03.04.2020

MedicalResearch.com Interview with: Jung-Im Na, MD PhD Associate Professor, Department of Dermatology Seoul National University Bundang Hospital Korea  MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by a convolutional neural network? Response: When a very young child looks at a picture, she can easily identify cats and dogs, however, even the most advanced computers had struggled at this task until recently. Computers began to “see” with the recent advancement of Deep Learning techniques. Deep Learning is a machine learning technique that teaches computers to learn from raw data. Most deep learning methods use artificial neural network architectures, imitating human brain, and convolutional neural networks (CNN) is a particular type of deep learning architecture, imitating the visual cortex. CNN is especially powerful for recognizing images. CNN exploit the information contained in image datasets to automatically learn features and patterns. (more…)
Author Interviews, Cancer Research, Environmental Risks, Melanoma / 19.02.2020

MedicalResearch.com Interview with: Farhad Islami, MD PhD Scientific Director, Surveillance Research American Cancer Society, Inc  MedicalResearch.com: What is the background for this study? Response: Many cases of cutaneous melanoma (melanoma) in the United States have been attributed to ultraviolet (UV) radiation, but there was little information on the state-by-state burden of melanoma due to UV exposure. We estimated numbers, proportions and age-standardized incidence rates of malignant melanomas attributable to UV radiation in each US state by calculating the difference between observed melanomas during 2011–2015 and expected cases based on rates in a population with theoretically minimum UV exposure. As there is no population completely unexposed to UV radiation, the reference rates we used were historical melanoma incidence rates in Connecticut during 1942–1954, when the melanoma burden was low. For most adults, melanomas diagnosed in that period likely reflected UV exposure accumulated in the 1930s or earlier, when exposure was minimized by clothing style and limited recreational exposure. We estimated that 338,701 melanoma cases (91.0% of total, 372,335) in the United States during 2011–2015 were attributable to UV exposure; 94.3% of all these UV-attributable cases (or 319,412 cases) occurred in non-Hispanic whites. UV-attributable melanoma incidence rates and cases were higher among males than females, but attributable rates and cases in ages <45 years were higher among females. (more…)
Author Interviews, BMJ, Dermatology, Technology / 13.02.2020

MedicalResearch.com Interview with: Professor Jon Deeks PhD, CStat Institute of Applied Health Research Professor of Biostatistics College of Medical and Dental Sciences University of Birmingham, UK MedicalResearch.com: What is the background for this study? Response: Skin cancer is one of the most common cancers in the world, and the incidence is increasing. In 2003, the World Health Organization estimated that between two and three million skin cancers occur globally each year, 80% of which are basal cell carcinoma, 16% cutaneous squamous cell carcinoma, and 4% melanoma. The potential for melanoma to metastasise to other parts of the body means that it is responsible for up to 75% of skin cancer deaths. Five year survival can be as high as 91-95% for melanoma if it is identified early, which makes early detection and treatment key to improving survival. Early detection of melanoma is reliant on people with new or changing moles seeking early advice from medical professionals. Skin cancer smartphone applications (“apps”) provide a technological approach to assist people with suspicious lesions to decide whether they should seek further medical attention. Of increasing interest are smartphone apps that use inbuilt algorithms (or “artificial intelligence”) that catalogue and classify images of lesions into high or low risk for skin cancer (usually melanoma). Apps with inbuilt algorithms that make a medical claim are now classified as medical devices that require regulatory approval. These apps could be harmful if recommendations are erroneous, particularly if false reassurance leads to delays in people obtaining medical assessment.  CE (Conformit Europenne) marking has been applied to allow distribution of two algorithm based apps in Europe (SkinScan and SkinVision), one of which is also available in Australia and New Zealand. However, no apps currently have United States Food and Drug Administration (FDA) approval to allow their distribution in the US and Canada. We have completed a systematic review of studies that examine the accuracy of all apps that use inbuilt algorithms to identify skin cancer in users of smartphones.  We report on the scope, findings, and validity of the evidence. (more…)
Author Interviews, Brigham & Women's - Harvard, Dermatology, Gender Differences, JAMA, Melanoma / 12.02.2020

MedicalResearch.com Interview with: Arash Mostaghimi, MD, MPA, MPH Director, Inpatient Dermatology , Brigham and Women's Hospital Instructor, Harvard Medical School Department of Dermatology Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Smaller studies have demonstrated increased risk for skin cancer among gay men.  Prior to this study this data had not been confirmed in a nationally representative database. (more…)
Author Interviews, Cancer Research, JAMA, Melanoma, Surgical Research, Weight Research / 30.10.2019

MedicalResearch.com Interview with: Magdalena Taube, PhD Institute of Medicine, Dept of Molecular and Clinical Medicine Sahlgrenska Academy at Gothenburg University Wallenberg laboratory Gothenburg Sweden  MedicalResearch.com: What is the background for this study? Response: Obesity is a cancer risk factor, and bariatric surgery in patients with obesity is associated with reduced cancer risk. However, evidence of an association among obesity, bariatric surgery and skin cancer is limited. In this study we used data from the Swedish Obese Subjects (SOS) study– a prospective controlled intervention trial examining bariatric surgery outcomes – to analyze the impact of bariatric surgery on skin cancer incidence. (more…)
Author Interviews, Environmental Risks, Global Health, Melanoma / 10.10.2019

MedicalResearch.com Interview with: Suzanne Dobbinson, PhD Senior Research Fellow Centre for Behavioural Research in Cancer Behavioural Science Division Australia MedicalResearch.com: What is the background for this study? Response: Skin cancer prevention programs, such as the SunSmart program in Victoria, have been implemented in Australia over 30 years with the aim of reducing the population’s exposure to ultraviolet radiation (UV), the main cause of skin cancer. A recent reduction in melanoma rates among younger Australians has led to this paper which examines the extent of behaviour change in Melbourne, Australia, and the potential contribution of prevention programs to the decline in melanoma rates. Previous population-based studies assessing the impact of these programs have focused on measuring the change in the prevalence of individual sun protection behaviours, and thus have largely overlooked the use of sun avoidance and composite sun protection behaviours. The focus on tracking individual behaviours may have underestimated the behaviour change associated with these programs. We analysed data from a series of cross-sectional surveys conducted in Melbourne during summer months between 1987 and 2017. These data include the summer before the SunSmart program commenced (1987-88) and across summers in three subsequent decades. (more…)
Author Interviews, Dermatology, Melanoma, Technology / 19.09.2019

SkinVision   MedicalResearch.com Interview with:  Andreea Udrea, PhD Associate Professor University Politehnica of Bucharest   MedicalResearch.com: What is the background for this study? The skin cancer incidence rate is increasing worldwide. Early diagnosis and prevention can reduce morbidity and are also linked to decreased healthcare costs. During the last years, efforts have been made in developing smartphone applications for skin lesion risk assessment to be used by laypersons. In parallel, as machine learning (ML) is on the rise, and medical image databases are increasing in size, a series of algorithms have been developed and compared in clinical studies to dermatologists for skin cancer diagnosis. The accuracy of the algorithms and experts were comparable. One drawback of these clinical studies is that they use images acquired by professionals in standardized conditions. So, there is little knowledge of what the accuracy will be when including an ML algorithm in an app and testing it in a non-clinical setup where the image quality may be lower, and the variability in image taking scenarios is higher as images are acquired by non-professionals using the smartphone camera. This study is one of the first that evaluates the accuracy of an app (SkinVision) when being used for risk assessment of skin lesions in the general population. (more…)
Author Interviews, Cancer Research, Dermatology / 14.08.2019

MedicalResearch.com Interview with: Dr Alessia Visconti, PhD Department of Twin Research King's College London, London MedicalResearch.com: What is the background for this study? Response: We know from previous studies that the body site where melanoma skin cancer develops varies according to sex, with men having melanoma more often on the head, neck, and trunk, and women on the legs. The body site where moles, a major risk factor for melanoma development, are more abundant also varies according to sex, at least in childhood, with boys having more moles on the head, neck, and trunk, and girls on the legs. (more…)
Author Interviews, Cancer Research, Genetic Research / 08.08.2019

MedicalResearch.com Interview with: Upekha Liyanage MBBS |  PhD Student School of Medicine | University of Queensland Statistical Genetics Laboratory QIMR Berghofer Medical Research Institute MedicalResearch.com: What is the background for this study? What types of skin cancers are linked to these genes? Response: Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) collectively referred to as “keratinocyte cancers” are the commonest forms of cancers of the skin. Although these cancers are less aggressive than melanoma, due to their large numbers, they pose a significant burden to the healthcare expenditure. Also, these cancers are relatively understudied when compared with melanoma. Notably, BCC and SCC are not routinely reported in cancer registries. In Australia, Medicare data are used to estimate the incidence and costs associated with these cancers. Expenditure in Australia for the diagnosis, treatment and pathology, almost exceeds $700 million for both BCC and squamous cell carcinoma. In Unites States, the average annual cost for skin cancer including melanoma is approximately $8.1 billion. Previous research has led to identification of 29 BCC and 11 squamous cell carcinoma genetic risk variants and 7 of them overlap with both BCC and SCC risk. So, to strengthen the preventive efforts and to reveal new therapeutics, it is very timely and critical to explore more on the genetic susceptibility of these deadly cancers. We analysed ~48,000 cancer cases with ~630,000 skin cancer free controls from European ancestry population in Australia, UK and USA.  (more…)
Author Interviews, Dermatology, JAMA / 01.08.2019

MedicalResearch.com Interview with: Eunyoung Cho, Sc.D. Associate Professor Director of Research, Department of Dermatology The Warren Alpert Medical School of Brown University Associate Professor, Department of Epidemiology Brown School of Public Health Channing Division of Network Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: Cutaneous squamous cell carcinoma (SCC) is a common skin cancer in people with fair skin. Vitamin A is a fat-soluble vitamin that is naturally present in many foods such as green leafy vegetables, fruits including cantaloupe, apricots, and mangos, and dairy products. We studied whether vitamin A intake is beneficial against SCC risk because there are few ways to prevent skin cancer. (more…)
Author Interviews, Dermatology, Environmental Risks, FDA, JAMA / 06.05.2019

MedicalResearch.com Interview with: David Strauss, MD, PhD Director, Division of Applied Regulatory Science U.S. Food and Drug Administration Center for Drug Evaluation and Research MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is unknown whether most active ingredients in sunscreens are absorbed. FDA has provided guidance that sunscreen active ingredients with systemic absorption greater than 0.5 ng/mL or with safety concerns should undergo nonclinical toxicology assessment including systemic carcinogenicity and additional developmental and reproductive studies. This randomized clinical trial demonstrated systemic exposure of 4 commonly used sunscreen active ingredients on application of sunscreen products under maximal use conditions consistent with current sunscreen labeling. All 4 sunscreen active ingredients tested resulted in exposures exceeding 0.5 ng/mL.  (more…)
Author Interviews, Cancer Research, NEJM / 13.03.2019

MedicalResearch.com Interview with: Maud Jansen, MD | Resident Dermatology | PhD candidate Dermatologie, Maastricht MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Actinic keratosis is the most frequent premalignant skin disease in the white population and is caused by exposure to ultraviolet radiation. With a prevalence of 37.5% among whites 50 years of age or older, actinic keratosis is one of the most frequent reasons for patients to visit a dermatologist. If left untreated, actinic keratosis may develop into squamous cell carcinoma. Current guidelines provide no clear recommendations about which treatment approach is preferred. Currently, the choice of treatment often depends on the preferences of patients and their treating physicians. Evidence from randomized trials with direct comparison between treatments and with long-term follow-up is scarce. Frequently prescribed and studied field-directed treatment approaches are 5-fluorouracil cream, imiquimod cream, photodynamic therapy (PDT), and ingenol mebutate gel. We investigated the effectiveness of these four frequently used field-directed treatments (for multiple lesions in a continuous area). Over 600 patients in four different hospitals (Maastricht UMC+, Zuyderland (Heerlen), VieCuri (Venlo and Venray) en Catharina (Eindhoven)participated in the study. Patients were randomly assigned to one of the four treatments. The main result of our study was that we found that after 12 months of follow-up, 5% fluorouracil cream was the most effective treatment in the treatment of patients with multiple actinic keratosis lesions. Moreover, patient satisfaction and increase in health-related quality of life were highest in the 5-fluorouracil group. (more…)
Author Interviews, Cancer Research, Dermatology, Radiation Therapy / 23.02.2019

MedicalResearch.com Interview with: William I. Roth MD Dermatology and Dermatological Surgery Boynton Beach, FL MedicalResearch.com: What is the background for this study?
  • This retrospective study reviewed medical records of patients with biopsy-proven, primary cutaneous basal and squamous cell carcinoma (BCC and SCC) lesions on the lower extremities. These patients were treated with the Sensus Healthcare’s Superficial Radiation Therapy SRT-100 Unit between 2011 and 2014. The SRT-100 is most amenable for treating non-melanoma skin cancer (NMSC) in patients aged 65 and older although many younger patients are treated as well when a non-scarring method is desired.
  • The types of skin cancers treated included superficial, well differentiated and moderately differentiated squamous cell carcinomas, squamous cell carcinoma in situ and basal cell carcinomas including infiltrative basal cell carcinomas. Higher energy linear accelerator radiation units have been reported to have a high incidence of healing problems. With the SRT-100 the radiation is concentrated primarily in the higher layers of the skin where the skin cancer is located and thus the treatments are well tolerated.
(more…)
Author Interviews, Dermatology, JAMA, Kidney Disease, Melanoma, Transplantation / 11.02.2019

MedicalResearch.com Interview with "Kidney Model 9" by GreenFlames09 is licensed under CC BY 2.0. To view a copy of this license, visit: https://creativecommons.org/licenses/by/2.0Donal J. Sexton, MD, PhD Department of Nephrology and Kidney Transplantation Beaumont Hospital Royal College of Surgeons in Ireland Dublin, Ireland MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Patients who receive a kidney transplant as treatment for end stage kidney disease are at risk of malignancy due to immunosuppression. In contrast to other solid organ transplant types, when kidney transplants fail it is possible for recipients to return to dialysis. Immunosuppression is usually reduced or completely stopped when  the allograft fails due to the risk of infection on dialysis. We decided to investigate what the trajectory of risk for non-melanoma skin cancer and invasive cancers overall (composite group) looked like for patients who have received multiple consecutive kidney transplants with intervening periods of graft failure. We compared cancer risk during periods of allograft failure and periods of functioning kidney transplants.   (more…)
Author Interviews, Cancer Research, Dermatology, Global Health, Melanoma / 08.02.2019

MedicalResearch.com Interview with: Dr. Catherine M. Olsen Associate Professor Cancer Control Group QIMR Berghofer Medical Research Institute MedicalResearch.com: What is the background for this study? Response: Melanoma incidence and mortality rates are increasing globally. Public health campaigns aiming to reduce sun exposure and use of sunbed have been implemented in many parts of the world, but there is significant variability in terms of the history and reach of these campaigns across countries. We examined melanoma incidence rates in eight different countries with different patterns of sun exposure and varying approaches to melanoma control. (more…)
Author Interviews, Cancer Research, Dermatology / 15.12.2018

MedicalResearch.com Interview with: Dr. Kristine A. Romine MD CEO and Founder of Camelback Dermatology & Skin Surgery Phoenix, AZ MedicalResearch.com: Would you give a brief overview of the different types of skin cancer? Response: There are multiple types of skin cancer, including: melanoma, basal cell carcinoma, squamous cell carcinoma, and actinic keratosis. Known as the deadliest form of skin cancer, melanoma develops when irreparable DNA damage results in malignant transformation of melanocytes. This type of skin cancer is most commonly caused by intense UV exposure from the sun or tanning beds, which activate mutations that lead skin cells to rapidly multiply and form malignant tumors. Melanoma can range in color from dark brown to black and are rarely red or even skin colored. They are usually irregular and asymmetrical. In 2018, there were an estimated 91,270 new cases of melanoma (American Cancer Society, 2018). Basal cell carcinoma (BCC) is the most common type of skin cancer and cancer diagnosed. BCCs arise in the skins’ outermost layers. BCCs resemble open sores, red or pink plaques, pearly nodules with telangiectasia, or scars. It is estimated that 4.3 million BCCs are diagnosed in the U.S. every year (Skin Cancer Foundation, 2018). Squamous cell carcinoma (SCC), the second most common type of skin cancer, arises from the squamous cells in the skin that have been exposed to UV over long periods of time. SCCs appear as scaly red or pink macules, papules, or plaques. They can be crusted and appear eroded and can commonly arise within a solar keratosis. More than 1 million cases of SCC are diagnosed in the U.S. every year (Skin Cancer Foundation, 2018). Lastly, actinic keratoses (AKs) are the most common pre-cancerous skin growth that can develop into a SCC if left untreated. Similar to all other types, AKs are caused by exposure to UV light and, in rare cases, high exposures to x-rays. AKs can appear on sun-exposed areas, including the face, scalp, ears, shoulders, and legs. They resemble pink, scaly rough patches on the skin. (more…)
Author Interviews / 11.12.2018

MedicalResearch.comInterview with:

polarized-light-dermatoscope-wikipedia-image

Jac Dinnes PhD, MSc, MA, PGDip
Senior Researcher
Test Evaluation Research Group
Institute of Applied Health Research
University of Birmingham

MedicalResearch.com:  What is thebackground for this study? Would you briefly explain the benefits of dermoscopy?

Response: This systematic review was one of a series of Cochrane Reviews of studies evaluating different tests for diagnosing skin cancer. Within creasing rates of skin cancer and an increasing number of more specialised tests becoming available in both primary care and in specialist settings, a thorough review of all available evidence was timely.

The diagnosis of melanoma and other skin cancers fundamentally relies on clinical examination, including history taking, and visual inspection of the concerning skin lesion (mole or patch of skin) and surrounding skin (and other lesions). A dermatoscope is a handheld device using visible light (such as from incandescent or LED bulbs), that allows more detailed examination of the skin compared to examination by the naked eye alone.

Knowing the diagnostic accuracy of dermoscopy added to visual inspection alone, across a range of observers and settings, is critical to understanding its contribution for the diagnosis of melanoma and to future understanding of the potential role of the growing number of other high-resolution image analysis techniques.

(more…)
Author Interviews / 11.12.2018

MedicalResearch.com Interview with:

Kenneth H. Kraemer,M.D.
Chief DNA Repair Section
Laboratory of Cancer Biology and Genetics, Center for Cancer Research
National Cancer Institute

MedicalResearch.com:  What is the background for this study?

Response: At the National Cancer Institute, we have been examining patients with xeroderma pigmentosum (XP), a rare, recessively inherited, cancer-prone disease for many years. Therefore, with the increasing use of exome sequencing, we decided to see how closely"big data" corresponded with our clinical observations.  

(more…)
Author Interviews, Dermatology, JAMA, Technology / 01.12.2018

MedicalResearch.com Interview with: Philipp Tschandl, MD PhD, Priv.Doz. Assistant Professor Department of Dermatology Medical University of Vienna MedicalResearch.com: What is the background for this study? What are the main findings? Response: Dermatoscopy is a non-invasive imaging technique, where the surface of the skin is rendered translucent and additional important morphologic features become visible from deeper layers. This is achieved through use of immersion fluid or cross-polarised light - equivalent to the effect when using a pair of goggles to look underwater, or polarised sunglasses to reduce glare on glass surfaces. After the first description of “Dermatoskopie" almost 100 years ago by a German dermatologist (Johann Saphier), this technique has evolved to a successful, low-cost, state-of-the-art technique for clinical skin cancer detection in the last decades. Convolutional neural networks (“CNN”) are powerful machine learning methods, and frequently applied to medical image data in the recent scientific literature. They are highly accurate for basic image classification tasks in experimental settings, and found to be as good as dermatologists in melanoma recognition on clinical or dermatoscopic images. In this study we trained a CNN to diagnose non-pigmented skin lesions (where melanomas are only a minority) through analysis of digital images, and compared the accuracy to >90 human readers including 62 board-certified dermatologists. This study expands knowledge in the following ways compared to previous work: - We applied the network for the detection of non-pigmented skin cancer, which is far more common in the (caucasian) population than melanoma. - We created a prediction model that combines analysis of a dermatoscopic and clinical image (“cCNN”) which is able to further increase diagnostic accuracy. - We compared accuracy not only to experts, but users with different level of experience (more…)
Author Interviews, Environmental Risks, JAMA, Melanoma / 24.11.2018

MedicalResearch.com Interview with: Reza Ghiasvand, PhD Oslo Centre for Biostatistics and Epidemiology Faculty of Medicne University of Oslo Oslo, Norway  MedicalResearch.com: What is the background for this study? Response: Melanoma is the most dangerous type of skin cancer. It is estimated that about 288,000 individuals will be diagnosed and about 61,000 will die from it in 2018, with the majority of patients in Australia, New Zealand, Europe and North America. Ultraviolet (UV) exposure (from both the sun and tanning beds) is the most important preventable risk factor for melanoma. However, the association between UV exposure and melanoma is complex and does not accord with a simple model in which risk increases directly with exposure. An individual risk of melanoma also depends on personal characteristics such as skin color and skin sensitivity to the UV exposure, hair color, number of moles, and age. It has been hypothesized that the pattern of UV exposure may play a role in melanoma development in different body sites. For example, melanoma on the trunk (chest and back) has been linked to the recreational UV exposure such as sunbathing and frequent sunburns in people with high number of moles on their body. In contrast, melanomas on the head and neck have been linked to constant sun exposure such as occupational UV exposure, mainly in older people. Epidemiologic and molecular evidence in support of this hypothesis has been published based on analyses of small datasets. Also, melanoma on legs and arms is less studied under this hypothesis. In our study, we examined UV exposure (sunbathing, sunburn and sunbed use) and pigmentary factors (skin, eye, and hair color, freckling, and number of moles), and risk of melanoma on different body sites. We used information from the Norwegian Women and Cancer Study, a population-based cohort study that started in 1991, and includes more than 161,000 Norwegian women followed for an average of 18 years. (more…)
Author Interviews, Dermatology, Environmental Risks / 15.10.2018

MedicalResearch.com Interview with: Dr. Janet Prystowsky, MD Dr. Prystowsky is a leading board-certified dermatologist in New York City.   In addition to her private practice, Dr. Prystowsky is a senior attending physician at Mount Sinai Roosevelt/St. Luke’s Medical Center. http://www.janetprystowskymd.com/ MedicalResearch.com: When does sun damage to the skin start?  Is there such a thing as a 'safe tan'?  Who is most susceptible to photoaging?  What parts of the body are more likely to show signs of sun damage?  Response: Sun damage will increase a person’s risk of premature aging and skin cancer.  Although tanning does function to help protect your skin from excessive ultraviolet radiation tanning is still a form of sun damage.  Also, people with very fair skin may not tan at all; only burn.  They are the most susceptible to sun damage. Certain medical conditions (e.g., Lupus), medications, cosmetics, and food can make your more reactive (photosensitive) to sunlight. "Sunburn" by Kelly Sue DeConnick is licensed under CC BY-SA 2.0Sunburns are caused by UV damage from sun rays, almost entirely due to UVB rays. UVA rays are weaker for burning but can contribute to blistering sunburns as well. For example, If you get lime peel rubbed on your skin while you are in the sun, you could get a bad burn.  UVA can also cause significant skin damage that can result in premature wrinkling, brown spots, and skin cancer. That's why you'll see dermatologists pushing for broad-spectrum sunscreens as opposed to sunscreens that just protect against UVB rays.  (more…)