A Randomized, 12-Year Primary-Prevention Trial of Beta Carotene Supplementation for Nonmelanoma Skin Cancer in the Physicians' Health Study

Frieling, Uta; Schaumberg, Debra A.; Kupper, Thomas S.; Muntwyler, Jörg; Hennekens, Charles H.

doi:10.1001/archderm.136.2.179

Cited by 121 publications

(69 citation statements)

References 41 publications

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“…Observational data on the relation between carotenoids and risk of nonmelanoma skin cancer are sparse and inconsistent (Kune et al, 1992;Wei et al, 1994;van Dam et al, 2000). No effects were found in a large randomized trials of supplementation with b-carotene on nonmelanoma skin cancer (Greenberg et al, 1990;Frieling et al, 2000). The relation between skin sensitivity to UV light, as measured by MED, and the resulting risk of skin cancer is not established.…”

Section: Discussionmentioning

confidence: 99%

Determinants of skin sensitivity to solar irradiation

et al. 2003

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Background: Acute effects of UV irradiation include UV-induced erythema. Sunlight plays an important role in the development of skin cancer. Several predictive factors of UV-induced erythema could also be predictive for skin cancer. Objective: Our objective was to quantitatively assess phenotypical and nutritional determinants of sensitivity to UV irradiation, as assessed by the minimal erythema dose (MED). Design: We conducted a cross-sectional study among 335 volunteers. Sensitivity to UV irradiation was established through assessment of the MED. Phenotypical determinants, including skin melanin content, hair color and iris color were determined by skin reflectance spectrometry, a subjective questionnaire and an objective classification system, respectively. Furthermore, dietary exposure was measured by carotenoids, vitamin C, retinol and a-tocopherol in serum. Results: Male subjects were found to be more sensitive to UV irradiation; that is, the MED was significantly lower compared to female subjects. Skin melanin content, which was positively associated with iris color in both sexes and with hair color in men, was the main phenotypical determinant of sensitivity to UV irradiation. No associations were found between serum carotenoids and MED in the total study group. Vitamin C was inversely associated with MED. However, associations between carotenoids concentrations and MED showed a positive trend in subjects with melanin values above and a negative trend in subjects below the median after adjustment for gender and total cholesterol. Conclusions: Skin melanin content and gender are important determinants of sensitivity to UV irradiation. No relation was found between serum carotenoids and MED in the total study group. The inverse association between vitamin C and MED was against our hypothesis. For the modifying effect of melanin on the association between carotenoids and MED, we do not have a clear biological explanation.

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Section: Discussionmentioning

confidence: 99%

Determinants of skin sensitivity to solar irradiation

et al. 2003

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“…In addition, we obtained information on clinical diagnoses of dry eye syndrome from our population of knowledgeable female health professionals, and reporting of medical diagnoses has proven reliable among such populations. 29,30 Information on HRT was obtained without knowledge of dry eye status (and vice-versa). The results of the present study consistently showed a higher prevalence of dry eye syndrome among women who used HRT, regardless of the way in which we defined dry eye syndrome.…”

Section: Commentmentioning

confidence: 99%

Hormone replacement therapy and dry eye syndrome.

Schaumberg

Buring²,

Sullivan³

et al. 2002

American Journal of Ophthalmology

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“…Treatment of sporadic BCCs with topical retinoids such as tazarotene can be successful; however complete tumor regression occurs in less than 50% of BCCs so treated (Bianchi et al, 2004). A retinoid precursor, β-carotene, and other less toxic agents such as non-steroidal anti-inflammatory agents (NSAIDs), do not have a significant effect in lowering BCC risk (Frieling et al, 2000) (Grau et al, 2006). One provocative study has suggested that BCC may also be prevented with a low-fat diet.…”

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confidence: 99%

Novel Hedgehog pathway targets against basal cell carcinoma

Tang

Epstein

2007

Toxicology and Applied Pharmacology

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The Hedgehog signaling pathway plays a key role in directing growth and patterning during embryonic development and is required in vertebrates for the normal development of many structures, including the neural tube, axial skeleton, skin, and hair. Aberrant activation of the Hedgehog (Hh) pathway in adult tissue is associated with the development of basal cell carcinoma (BCC), medulloblastoma, and a subset of pancreatic, gastro-intestinal, and other cancers. This review will provide an overview of what is known about the mechanisms by which activation of Hedgehog signaling leads to the development of BCCs and will review two recent papers suggesting that agents that modulate sterol levels might influence the Hh pathway. Thus, sterols may be a new therapeutic target for the treatment of BCCs, and readily available agents such as statins (HMG-CoA reductase inhibitors) or vitamin D might be helpful in reducing BCC incidence. Epidemiology of Basal cell carcinoma (BCC)Basal cell carcinoma (BCC), the most common of all human cancers, affects close to 1 million Americans a year. Over the past 40 years there has been a dramatic increase in the incidence of BCC, and it is estimated that nearly 30% of Caucasians living in areas of high ambient sun exposure will develop a BCC (Miller and Weinstock, 1994). Furthermore, the incidence of BCC is rising in younger populations, especially among women (Christenson et al., 2005). Although the case fatality rate of BCCs is low, the high incidence and frequent occurrence of multiple primary tumors in affected individuals leads to significant morbidity. BCCs characteristically arise in sun-exposed body areas, most commonly on the head and neck, but also occur on the trunk and extremities. There are three accepted environmental insults for BCC development: ultraviolet radiation (UV), ionizing radiation (IR), and arsenic. Interindividual differences in the susceptibility to BCC development have been recognized for many years. Epidemiologic studies have identified phenotypic features such as fair skin and freckling tendency that are associated with an increased susceptibility to BCCs (Rubin et al., 2005).It is generally accepted that BCC can be caused by UV exposure from the sun. While the risk of squamous cell carcinoma is strongly related to cumulative sun exposure, sunlight's exact role in BCC development remains less clear (Armstrong and Kricker, 2001). Thus, epidemiologic studies have shown that BCC risk correlates better with intermittent sun exposure (i.e. childhood sunburns, weekend sun exposure) than with cumulative lifetime sun exposure (Corona et al., 2001). Hence, the timing, dose, and duration of UV exposure are critical to carcinogenesis, but UV seems to have a different role in SCC versus BCC carcinogenesis development. Consistent with this, a randomized clinical trial of daily sunscreen use showed that sunscreen reduced the incidence of SCC but not BCC. The daily application of an SPF 15 sunscreen to the head, neck, arms, and hands over a 4-5 year period had no e...

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A Randomized, 12-Year Primary-Prevention Trial of Beta Carotene Supplementation for Nonmelanoma Skin Cancer in the Physicians' Health Study

Cited by 121 publications

References 41 publications

Determinants of skin sensitivity to solar irradiation

Determinants of skin sensitivity to solar irradiation

Hormone replacement therapy and dry eye syndrome.

Novel Hedgehog pathway targets against basal cell carcinoma

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