Skin cancer - Primary and secondary prevention (information campaigns and screening) - With a focus on children & sunbeds

Department Molecular Cellbiology, Dermatology Center Buxtehude, Elbekliniken Stade/Buxtehude, Klinikum Buxtehude, Buxtehude, Germany.
Progress in Biophysics and Molecular Biology (Impact Factor: 2.27). 09/2011; 107(3):473-6. DOI: 10.1016/j.pbiomolbio.2011.08.008
Source: PubMed


Solar and artificial (sunbed) UV-exposure is the main risk factor for the development of epithelial skin cancer (basal cell carcinoma, BCC, and squamous cell carcinoma, SCC) as well for malignant melanoma (MM). UV exposure in childhood and adolescence is especially important. Therefore, adequate methods of primary prevention have continuously to be used and to be developed further to target these age-groups in order to reduce the risks of intensive UV-exposure. Primary prevention can effectively be combined with secondary prevention (early detection, screening) to reduce the burden of skin cancer and to decrease incidence, morbidity and mortality.

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    • "Despite all efforts in skin cancer campaigns, there is a subpopulation of patients presenting with giant NMSC.[56] By definition, NMSCs with a diameter of at ≥5 cm are considered as giant. "
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    ABSTRACT: Among nonmelanoma skin cancer (NMSC), basal cell carcinoma (BCC), and squamous cell carcinoma (SCC) are the most common. Giant NMSCs have occasionally reported in the medical literature with particular problems related to diagnosis and treatment. The aim of this study was to analyze patients, treatment, and outcome with giant BCC/SCC. We analyzed our files between January 1, 2008, and December 31, 2011, of an academic teaching hospital in the dermatology department. Patients were analyzed according to demographic factors, clinical presentation, histopathology, treatment, and outcome. American Society of Anesthesiology physical status system was used to assess the fitness of patients before surgery. The frequency of giant NMSC was estimated as 0.4% for both tumor entities. 80% of giant BCC patients were female and 100% of giant SCC patients were male. The mean age was 81.5 ± 8.5 years for BCC) and 79.5 ± 11.4 years for SCC. The major anatomical site was the scalp. Four of 10 BCCs were classified metatypic (basosquamous). Perineural infiltration was seen in 5 NMSCs. Seventy percent of patients had an ASA score ≥3. Surgery was performed in general anaesthesia in 5 (BCC) and 6 (SCC) patients, respectively. All other patients were operated in local or tumescence anesthesia. Blood transfusions were necessary in five patients. The primary treatment was delayed Mohs technique. Defect closure was realized with rotational flaps in most cases. Neoadjuvant chemoimmune therapy and adjuvant combined cetuximab/radiotherapy have been performed in three patients. We observed three deaths, all unrelated to NMSC. 75% of patients achieved complete remission. Giant NMSC is uncommon but not rare. These tumors are high-risk subtypes. Treatment needs an interdisciplinary approach.
    Journal of Cutaneous and Aesthetic Surgery 03/2012; 5(1):12-9. DOI:10.4103/0974-2077.94328
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    ABSTRACT: Background: The Czech Republic has reported one of the highest incidence rates of cutaneous melanoma (CM) in Europe and the rate continues to rise. Our study undertook a detailed investigation of the incidence and mortality of melanoma relative to sex, age and disease stage. The main goals were to elucidate the causes of the rising trends and explain the differences in development relative to sex, age and disease stage. Methods and results: The estimated annual percentage change (EAPC) using the Joinpoint Regression Model was calculated separately for men and women for all age categories and for all T stages of TNM classification. The EAPC for women was slightly higher than for men. This was only found in melanomas thinner than 1 mm (T1). For all other stages (T2, T3 and T4) the situation was worse in men. A higher incidence rate of CM and the higher value of EAPC were found for women in younger age categories (up to 49 years). In the next age category, from 50 to 59 years, the incidence of CM was comparable in both sexes as well as the EAPC. In the older age categories, i.e. 60 years and older, a significant increase was found predominantly in men. The mortality rates were only comparable between men and women in the 20 to 29 year age group. In all other categories there was a higher mortality for men. Conclusions: The number of melanoma cases in the Czech Republic is increasing faster than any other cancer. Despite improved survival rates, the death rate from CM continues to climb as a result of exponential increases in incidence. Thus primary and secondary prevention campaigns are essential for future reductions in CM incidence and mortality in the Czech Republic.
    Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 11/2012; 158(3). DOI:10.5507/bp.2012.081 · 1.20 Impact Factor
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    ABSTRACT: Basal cell carcinoma (BCC) is the most common skin malignancy worldwide. Ultraviolet light exposure is the best known exogenous factor in BCC development. This is also the target for primary prevention. Advanced BCC include locally advanced tumors and metastatic tumors. Prognosis is worse compared to stage I and II BCCs. Mohs or micrographically controlled surgery is the gold standard of treatment. In patients with tumors that cannot be completely removed radiotherapy was the only alternative in the past. More recently new drugs for targeted therapy of signaling pathways like sonic hedgehog or epidermal growth factor receptor became available. More small molecules are under investigation. Since the complete response rates are limited, future research has to evaluate their combination with surgery.
    Wiener Medizinische Wochenschrift 04/2013; 163(15-16). DOI:10.1007/s10354-013-0193-5
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