Clustering of prevention behaviours in patients with high‐risk primary melanoma

Green, Adèle C.; Hughes, Maria Celia; Schuckmann, Lena A. von; Khosrotehrani, Kiarash; Smithers, B. Mark

doi:10.1002/pon.4565

Cited by 5 publications

(3 citation statements)

References 21 publications

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“…These results suggest that patients with multiple melanomas can lower their risk of further primary melanomas by applying sunscreen when outdoors. For over 30 years there have been widespread skin cancer awareness and prevention campaigns in Australia, as reflected in the high proportion of participants using sun protective behaviours before diagnosis (195,196). Despite this, at least one-fifth of our study cohort (particularly males) displayed risky sun behaviours before melanoma diagnosis, with little or no change after diagnosis, consistent with other reports (67,68,188).…”

Section: Discussionsupporting

confidence: 85%

Natural history of high-risk cutaneous primary melanoma and risk factors for disease progression

Schuckmann¹

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Background: Melanoma is a potentially fatal cancer of the skin that is associated with high disease burden in Australia. Exposure to ultraviolet radiation is the most important environmental risk factor. When diagnosed early, primary melanoma is curable, however melanomas greater than 1mm in thickness and those with ulceration have a high risk of recurrence and metastases, and little is known about factors influencing their progression.Aims: The primary aim was to describe the natural history of localised high-risk primary melanomas after treatment, for up to 2 years post-diagnosis and to identify risk factors for disease progression. My two secondary aims were to investigate patients' use of health services, and explore sun protection behaviours and risk of subsequent primary melanoma.Methods: This project was conducted among a cohort of patients who had newly-diagnosed primary melanoma (tumour stage T1b-T4b) treated in Queensland, 2010 to 2014. Melanomas were histologically confirmed, and patients completed questionnaires at baseline and at regular intervals thereafter. Statistical techniques, including survival analyses, regression models and latent class analyses were used to answer the research questions.Results: Amongst 700 patients with high-risk primary melanoma, 94 (13%) developed a recurrence within 2 years. Most first recurrences occurred at local or regional sites, whereas subsequent recurrences were more common at distant sites. Higher risk of melanoma recurrence was observed with increasing tumour thickness, tumour ulceration, mitotic rate >3/mm 2 and head or neck location of primary. Ulcerated tumours occurred more commonly in patients with diabetes, whereas patients regularly taking statins had a lower likelihood of an ulcerated tumour. Long-term statin users, especially male users, also had a lower risk of melanoma recurrence. Secondary outcomes demonstrated that patients with inadequate sun protection behaviour after melanoma diagnosis were at higher risk of developing a subsequent

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Section: Discussionsupporting

confidence: 85%

Natural history of high-risk cutaneous primary melanoma and risk factors for disease progression

Schuckmann¹

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“…Two models were generated: unadjusted, and then adjusted for age at diagnosis (<50, 50-69, ≥70 years), sex, frequency of skin checks and energy intake (in tertiles). Skin checking practices has been linked to melanoma thickness (6), education and health related behaviour such as smoking and sun protection practices (43) known to be associated with dietary habits (44). We evaluated effect modification by sex, age, patients' personal history of melanoma, family history of melanoma and co-morbidities by including interaction terms between them and dietary patterns.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Omega-3 and Omega-6 Fatty Acid Dietary Intake and Melanoma Thickness at Diagnosis

Mahamat‐Saleh

Hughes

Miura

et al. 2020

Cancer Epidemiology, Biomarkers &Amp; Prevention

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HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

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“…To test for linear trends, we assigned an ordinal number from 1 (lowest) to 3 (highest tertile) and modelled this as a continuous variable. Our adjusted model included age (<55, 55–60 and >70), sex, frequency of skin checks (known to be associated with melanoma thickness, 42 sun protection practices 43 and diet 44 ), socio‐economic indicators (education and health sector where patient first presented) and energy intake (continuous).…”

Section: Methodsmentioning

confidence: 99%

Diet quality is associated with primary melanoma thickness

Hughes

Malt

Khosrotehrani

et al. 2022

Acad Dermatol Venereol

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Background Patients' diets can influence the outcome of several common cancers, but the effect on melanoma prognosis is unknown. Objective To assess the association between quality of melanoma patients' prediagnosis diets and primary tumour thickness, the main prognostic indicator for melanoma.Methods We used baseline data from patients newly diagnosed with tumour stage Ib to IV cutaneous melanoma, with completed questionnaires about food intake in the past year and other factors. Diet quality was measured by the Healthy Eating Index (HEI) and melanoma thickness was extracted from histopathology reports. We estimated prevalence ratios (PR adj ) and 95% confidence intervals (CIs) adjusted for confounding factors using Poisson regression models to assess associations between HEI scores and melanoma thickness. ResultsOf 634 study patients, 238 (38%) had melanomas >2 mm thick at diagnosis. Patients with the highest HEI scores were significantly less likely to be diagnosed with thick melanoma than patients with lowest HEI scores (PR adj 0.93, 95% CI 0.86-0.99) (P trend = 0.03). There was no evidence of effect modification by age, sex, previous melanoma or comorbidities.Conclusions Melanoma thickness at diagnosis is significantly associated with quality of patients' diets before diagnosis.

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Clustering of prevention behaviours in patients with high‐risk primary melanoma

Abstract: These findings allow tailoring of preventive advice to melanoma patients to reduce their risk of future primary and recurrent disease.

Cited by 5 publications

References 21 publications

Natural history of high-risk cutaneous primary melanoma and risk factors for disease progression

Natural history of high-risk cutaneous primary melanoma and risk factors for disease progression

Patterns of Omega-3 and Omega-6 Fatty Acid Dietary Intake and Melanoma Thickness at Diagnosis

Diet quality is associated with primary melanoma thickness

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