Publications (8)38.68 Total impact
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Article: Skin Examination Behavior: The Role of Melanoma History, Skin Type, Psychosocial Factors, and Region of Residence in Determining Clinical and Self-conducted Skin Examination.
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ABSTRACT: OBJECTIVE To examine the frequency and correlates of skin examination behaviors in an international sample of individuals at varying risk of developing melanoma. DESIGN A cross-sectional, web-based survey. SETTING Data were collected from the general population over a 20-month period on behalf of the Melanoma Genetics Consortium (GenoMEL). PARTICIPANTS A total of 8178 adults from Northern (32%), Central (33%), and Southern (14%) Europe, Australia (13%), and the United States (8%). MAIN OUTCOME MEASURES Self-reported frequency of skin self-examination (SSE) and clinical skin examination (CSE). RESULTS After adjustment for age and sex, frequency of skin examination was higher in both Australia (odds ratio [OR]SSE = 1.80 [99% CI, 1.49-2.18]; ORCSE = 2.68 [99% CI, 2.23-3.23]) and the United States (ORSSE = 2.28 [99% CI, 1.76-2.94]; ORCSE = 3.39 [99% CI, 2.60-4.18]) than in the 3 European regions combined. Within Europe, participants from Southern Europe reported higher rates of SSE than those in Northern Europe (ORSSE = 1.61 [99% CI, 1.31-1.97]), and frequency of CSE was higher in both Central (ORCSE = 1.47 [99% CI, 1.22-1.78]) and Southern Europe (ORCSE = 3.46 [99% CI, 2.78, 4.31]) than in Northern Europe. Skin examination behavior also varied according to melanoma history: participants with no history of melanoma reported the lowest levels of skin examination, while participants with a previous melanoma diagnosis reported the highest levels. After adjustment for region, and taking into account the role of age, sex, skin type, and mole count, engagement in SSE and CSE was associated with a range of psychosocial factors, including perceived risk of developing melanoma; perceived benefits of, and barriers to, skin examination; perceived confidence in one's ability to engage in screening; and social norms. In addition, among those with no history of melanoma, higher cancer-related worry was associated with greater frequency of SSE. CONCLUSIONS Given the strong association between psychosocial factors and skin examination behaviors, particularly among people with no history of melanoma, we recommend that greater attempts be made to integrate psycho-education into the fabric of public health initiatives and clinical care, with clinicians, researchers, and advocacy groups playing a key role in guiding individuals to appropriate tools and resources.Archives of dermatology 07/2012; · 4.76 Impact Factor -
Article: Role of serum S100B and PET-CT in follow-up of patients with cutaneous melanoma.
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ABSTRACT: Increased level of serum S100B can serve as a marker of metastatic spread in patients with cutaneous melanoma (CM). In patients with elevated S100 B and/or clinical signs of disease progression PET-CT scan is a valuable tool for discovering metastases and planning treatment.The aims of this study were to determine whether regular measurements of serum S100B are a useful tool for discovering patients with CM metastases and to evaluate the diagnostic value of PET-CT during the follow-up. From September 2007 to February 2010, 115 CM patients included in regular follow up at the Institute of Oncology Ljubljana were appointed to PET-CT. There were 82 (71.3%) patients with clinical signs of disease progression and 33 (28.7%) asymptomatic patients with two subsequent elevated values of S100B. Sensitivity, specificity, positive and negative predictive value (PPV, NPV) of S100B and PET-CT were calculated using standard procedures. Disease progression was confirmed in 81.7% of patients (in 86.5% of patients with clinical signs of disease progression and in 69.7% of asymptomatic patients with elevated S100B). Sensitivity, specificity, PPV and NPV of S100B was 33.8%, 90.9%, 96.0% and 17.5% in patients with clinical signs of disease progression. In 20.0% of patients increased serum S100B was the only sign of disease progression. Sensitivity and PPV of S100 in this group of patients were 100.0% and 69.7%.With PET-CT disease progression was diagnosed in 84.2% of symptomatic patients and in 72.7% of asymptomatic patients with elevated S100B. The sensitivity, specificity, PPV and NPV of PET-CT for symptomatic patients was 98.5%, 90.9%, 98.5% and 90.9% and 100%, 90.0%, 95.8% and 100% for asymptomatic patients with elevated S100. Measurements of serum S100B during regular follow-up of patients with CM are a useful tool for discovering disease progression in asymptomatic patients. The value of its use increases if measurements are followed by extended whole body PET-CT.BMC Cancer 08/2011; 11:328. · 3.01 Impact Factor -
Article: Predictors of sun protection behaviors and severe sunburn in an international online study.
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ABSTRACT: The incidence of melanoma continues to increase in many countries, and primary prevention of melanoma includes avoidance of sunburn as well as adequate sun protection behavior. The aim of this study was to examine the prevalence of self-reported sun protection behaviors and sunburn in users of the Internet, and to identify the demographic, clinical, and attitudinal/motivational correlates of sun protection behaviors. Self-report data were gathered on behalf of the GenoMEL consortium using an online survey available in 10 different languages, and 8,178 individuals successfully completed at least 80% of survey items, with 73% of respondents from Europe, 12% from Australia, 7% from the United States, 2% from Israel, and 6% from other countries. Half of all respondents and 27% of those with a previous melanoma reported at least one severe sunburn during the previous 12 months. The strongest factors associated with sun protection behavior were perceived barriers to protection (beta = -0.44/beta = -0.37), and respondents who reported a positive attitude toward suntans were less likely to protect (beta = -0.16/beta = -0.14). Reported use of protective clothing and shade, as well as avoidance of midday sun exposure, were more strongly related to reduced risk of sunburn than sunscreen use. Despite widespread dissemination of public health messages about the importance of sun protection, a substantial proportion of this international sample, including respondents with a previous melanoma, reported inadequate sun protection behaviors resulting in severe sunburn. Future strategies to decrease sunburn should target the practical, social, and psychological barriers associated with nonuptake of sun protection.Cancer Epidemiology Biomarkers & Prevention 09/2010; 19(9):2199-210. · 4.12 Impact Factor -
Article: Melanoma risk factors, perceived threat and intentional tanning: an international online survey.
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ABSTRACT: Cutaneous melanoma continues to increase in incidence in many countries, and intentional tanning is a risk factor for melanoma. The aim of this study was to understand how melanoma risk factors, perceived threat and preferences for a suntan relate to intentional tanning. Self-report data were collected on behalf of GenoMEL (www.genomel.org) from the general population using an online survey. A total of 8178 individuals completed the survey, with 72.8% of respondents being from Europe, 12.1% from Australia, 7.1% from the US, 2.5% from Israel and 5.5% from other countries. Seven percent of respondents had previously been diagnosed with melanoma and 8% had at least one first-degree relative with a previous melanoma. Overall, 70% reported some degree of intentional tanning during the past year, and 38% of respondents previously diagnosed with melanoma had intentionally tanned. The total number of risk factors was positively correlated with perceived risk of melanoma [correlation coefficient (rho) = 0.27], and negatively correlated with intentional tanning (rho = -0.16). Preference for a dark suntan was the strongest predictor of intentional tanning [regression coefficient (beta) = 0.35, P<0.001], even in those with a previous melanoma (beta = 0.33, P<0.01). A substantial proportion of participants reported having phenotypic and behavioural risk factors for melanoma. The preference regarding suntans seemed more important in the participants' decision to intentionally tan than their perceived risk of developing melanoma, and this finding was consistent among respondents from different countries. The drive to sunbathe to tan is a key factor to be moderated if melanoma incidence is to be reduced.European journal of cancer prevention: the official journal of the European Cancer Prevention Organisation (ECP) 05/2010; 19(3):216-26. · 2.21 Impact Factor -
Article: Different natural course of disease in patients with melanoma.
Journal of Clinical Oncology 02/2009; 27(6):998; author reply 999. · 18.37 Impact Factor -
Article: Predictive factors of carcinoma in 327 patients with follicular neoplasm of the thyroid.
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ABSTRACT: The aim of this retrospective study was to find predictive factors of carcinoma in patients with follicular neoplasm. The specific aim was to discover whether preoperative serum thyroglobulin (Tg) concentration in patients with thyroid neoplasm can differentiate between those with thyroid carcinoma and those with benign disease. A total of 327 patients (263 females, 64 males, median age: 51.5 years) with follicular neoplasm in whom carcinoma was only suspected and who were surgically treated at the authors' institute in 1988-2004 were included in the study. Patients who had distant and/or regional metastases were excluded. Risk factors for malignancy were identified by the chi-squared test and logistic regression. The histopathological diagnoses were carcinoma, benign goiter, and adenoma in 119 (36%), 104 (32%), and 104 (32%) patients, respectively. The independent predictors of malignancy as shown by multivariate logistic regression were tumor diameter and preoperative Tg concentration. Thyroid carcinoma was more common in the patients with follicular neoplasm and serum Tg concentration over 300 ng/ml than in those with lower Tg concentrations. Predictors of malignancy were tumor diameter and preoperative Tg concentration.Medical science monitor: international medical journal of experimental and clinical research 10/2008; 14(9):CR459-67. · 1.70 Impact Factor -
Article: Prevalence of variations in melanoma susceptibility genes among Slovenian melanoma families.
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ABSTRACT: Two high-risk genes have been implicated in the development of CM (cutaneous melanoma). Germline mutations of the CDKN2A gene are found in < 25% of melanoma-prone families and there are only seven families with mutation of the CDK4 gene reported to date. Beside those high penetrance genes, certain allelic variants of the MC1R gene modify the risk of developing the disease. The aims of our study were: to determine the prevalence of germline CDKN2A mutations and variants in members of families with familial CM and in patients with multiple primary CM; to search for possible CDK4 mutations, and to determine the frequency of variations in the MC1R gene. From January 2001 until January 2007, 64 individuals were included in the study. The group included 28 patients and 7 healthy relatives belonging to 25 families, 26 patients with multiple primary tumors and 3 children with CM. Additionally 54 healthy individuals were included as a control group. Mutations and variants of the melanoma susceptibility genes were identified by direct sequencing. Seven families with CDKN2A mutations were discovered (7/25 or 28.0%). The L94Q mutation found in one family had not been previously reported in other populations. The D84N variant, with possible biological impact, was discovered in the case of patient without family history but with multiple primary CM. Only one mutation carrier was found in the control group. Further analysis revealed that c.540C>T heterozygous carriers were more common in the group of CM patients and their healthy relatives (11/64 vs. 2/54). One p14ARF variant was discovered in the control group and no mutations of the CDK4 gene were found. Most frequently found variants of the MC1R gene were T314T, V60L, V92M, R151C, R160W and R163Q with frequencies slightly higher in the group of patients and their relatives than in the group of controls, but the difference was statistically insignificant. The present study has shown high prevalence of p16INK4A mutations in Slovenian population of familial melanoma patients (37%) and an absence of p14ARF or CDK4 mutations.BMC Medical Genetics 10/2008; 9:86. · 2.33 Impact Factor -
Article: Changing biology of cutaneous melanoma.
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ABSTRACT: Survival of patients with cutaneous melanoma (CM) has improved significantly worldwide despite moderate treatment changes. The aim of our study was to determine whether the time period of diagnosis was an independent prognostic factor. The data of 1752 patients diagnosed with CM in Slovenia between 1983 and 1997 were analyzed. Cox proportional hazards model was used to assess the effect of multiple variables on survival. No significant decrease was observed in mean tumor thickness, whereas mean age at the time of diagnosis increased from 36.58 to 53.32 years. Multivariate analysis confirmed tumor thickness, age at the time of diagnosis, regional metastases and period of diagnosis as independent predictors of survival (P<0.0001). The most important independent predictor of survival of patients diagnosed with CM in the time period from 1983 to 1997 was the time of diagnosis.Melanoma Research 06/2008; 18(3):225-9. · 2.19 Impact Factor
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Institutions
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2008–2011
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Institute of Oncology Ljubljana
Ljubljana, Ljubljana, Slovenia
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