Differences in Thickness-Specific Incidence and Factors Associated With Cutaneous Melanoma in the US From 2010 to 2018

Chen, Michael L; Hunt, Isabella de Vere; John, Esther M.; Weinstock, Martin A.; Swetter, Susan M.; Linos, Eleni

doi:10.1001/jamaoncol.2022.0134

Cited by 24 publications

(29 citation statements)

References 15 publications

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“…Our analysis revealed strikingly low awareness of melanoma among participants, with the term ‘melanoma’ meaningless to many, echoing previous findings of low melanoma awareness from 2011 focus groups among Asian, African-American and Hispanic participants. 17 Recent evidence suggests stabilisation of overall melanoma incidence in the USA, but an increase in thicker melanomas which are more common among black patients, 5 highlighting the importance of exploring current understanding of melanoma among the black community to guide tailored public health messaging. Our finding of low awareness of the potential to develop melanoma is a crucial barrier to potential interventions promoting early detection of melanoma: the value-expectancy theory the health belief model 17 posits that engaging in a particular public health behaviour is determined by perceived susceptibility to the health threat and perceived costs versus benefits of the recommended behaviour.…”

Section: Discussionmentioning

confidence: 99%

“… 4 In a recent cohort study of 187 487 patients diagnosed with cutaneous melanoma in the USA between 2010 and 2018, melanoma incidence rates were found to have stabilised after nearly a century of increase. 5 But concerningly, the incidence of the thickest melanomas continued to increase, and individuals from racial and ethnic minority groups were more likely to be diagnosed with thicker tumours. Yet despite having the worst survival outcomes and the continued increase in incidence of the thickest melanomas, black people are generally excluded from melanoma public health campaigns: in a recent study of skin cancer prevention campaigns on social media, all 62 skin cancers depicted were on lighter Fitzpatrick I or II skin.…”

Section: Introductionmentioning

confidence: 99%

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Qualitative exploration of melanoma awareness in black people in the USA

et al. 2023

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ObjectiveAlthough black patients are more likely to have advanced melanomas at diagnosis, with a 5-year survival rate among black patients of 70% compared with 92% for white patients, black people are generally not the focus of melanoma public health campaigns. We sought to explore awareness and perspectives of melanoma among black people to inform the development of relevant and valued public health messages to promote early detection of melanoma.DesignInductive thematic analysis of in-depth semistructured interviews.SettingInterviews were conducted with participants via video software or telephone in the USA.ParticipantsParticipants were adults from the USA who self-identified as African American or black. Recruitment flyers were posted around the San Francisco Bay Area and shared on our team Facebook page, with further participants identified through snowball sampling.ResultsWe interviewed 26 participants from 10 different states. Overall, 12 were men and 14 were women, with a mean age of 43 years (range 18–85). We identified five key themes regarding melanoma awareness in black people: (1) lack of understanding of term ‘melanoma’ and features of skin cancer; (2) do not feel at risk of melanoma skin cancer; (3) surprise that melanoma can occur on palms, soles and nails; (4) skin cancer awareness messages do not apply to or include black people; and (5) Importance of relationship with healthcare and habits of utilisation.ConclusionsAnalysis of these in-depth semistructured interviews illuminate the pressing need for health information on melanoma designed specifically for black people. We highlight two key points for focused public health messaging: (1) melanoma skin cancer does occur in black people and (2) high-risk sites for melanoma in black people include the palms, soles and nail beds. Therefore, public health messages for black people and their healthcare providers may involve productively checking these body surface areas.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Qualitative exploration of melanoma awareness in black people in the USA

et al. 2023

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“…A study of trends in melanoma incidence using data from the Surveillance, Epidemiology, and End Results (SEER) programme in the United States showed that across all ethnicities incidence stabilised between 2010 and 2018 (average annual percent change [AAPC], 0.39%; 95% CI − 0.40 to 1.18%), following five decades of continuous increases [ 73 ]. However, the incidence of the thickest melanomas (T4, > 4.0 mm) continued to rise (AAPC 3.32%; 95% CI 2.06–4.60%).…”

Section: Harms Of Exposure To Uv Radiationmentioning

confidence: 99%

The effects of exposure to solar radiation on human health

Neale

Lucas

Byrne

et al. 2023

Photochem Photobiol Sci

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This assessment by the Environmental Effects Assessment Panel (EEAP) of the Montreal Protocol under the United Nations Environment Programme (UNEP) evaluates the effects of ultraviolet (UV) radiation on human health within the context of the Montreal Protocol and its Amendments. We assess work published since our last comprehensive assessment in 2018. Over the last four years gains have been made in knowledge of the links between sun exposure and health outcomes, mechanisms, and estimates of disease burden, including economic impacts. Of particular note, there is new information about the way in which exposure to UV radiation modulates the immune system, causing both harms and benefits for health. The burden of skin cancer remains high, with many lives lost to melanoma and many more people treated for keratinocyte cancer, but it has been estimated that the Montreal Protocol will prevent 11 million cases of melanoma and 432 million cases of keratinocyte cancer that would otherwise have occurred in the United States in people born between 1890 and 2100. While the incidence of skin cancer continues to rise, rates have stabilised in younger populations in some countries. Mortality has also plateaued, partly due to the use of systemic therapies for advanced disease. However, these therapies are very expensive, contributing to the extremely high economic burden of skin cancer, and emphasising the importance and comparative cost-effectiveness of prevention. Photodermatoses, inflammatory skin conditions induced by exposure to UV radiation, can have a marked detrimental impact on the quality of life of sufferers. More information is emerging about their potential link with commonly used drugs, particularly anti-hypertensives. The eyes are also harmed by over-exposure to UV radiation. The incidence of cataract and pterygium is continuing to rise, and there is now evidence of a link between intraocular melanoma and sun exposure. It has been estimated that the Montreal Protocol will prevent 63 million cases of cataract that would otherwise have occurred in the United States in people born between 1890 and 2100. Despite the clearly established harms, exposure to UV radiation also has benefits for human health. While the best recognised benefit is production of vitamin D, beneficial effects mediated by factors other than vitamin D are emerging. For both sun exposure and vitamin D, there is increasingly convincing evidence of a positive role in diseases related to immune function, including both autoimmune diseases and infection. With its influence on the intensity of UV radiation and global warming, the Montreal Protocol has, and will have, both direct and indirect effects on human health, potentially changing the balance of the risks and benefits of spending time outdoors. Graphical abstract

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“…The World Health Organization (WHO) reported that there were approximately 324635 new cases (1.7% of all cancer cases) and 57043 deaths (0.6% of all cancer deaths) worldwide in 2020 [5]. Middleaged people (>30 years old), especially in low-and middleincome countries, were more likely to be diagnosed with advanced cancer due to limited access to early diagnostic measures and suboptimal treatment [6,7]. Due to limited treatment and census resources, population-based cancer screening in high-income areas may be less effective than in low-and middle-income areas [8].…”

Section: Introductionmentioning

confidence: 99%

Distinguish the Value of the Benign Nevus and Melanomas Using Machine Learning: A Meta-Analysis and Systematic Review

Chu

Wang

et al. 2022

Mediators of Inflammation

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Background. Melanomas, the most common human malignancy, are primarily diagnosed visually, beginning with an initial clinical screening and followed potentially by dermoscopic analysis, a biopsy, and histopathological examination. We aimed to systematically review the performance and quality of machine learning-based methods in distinguishing melanoma and benign nevus in the relevant literature. Method. Four databases (Web of Science, PubMed, Embase, and the Cochrane library) were searched to retrieve the relevant studies published until March 26, 2022. The Predictive model Deviation Risk Assessment tool (PROBAST) was used to assess the deviation risk of opposing law. Result. This systematic review included thirty researches with 114007 subjects and 71 machine learning models. The convolutional neural network was the main machine learning method. The pooled sensitivity was 85% (95% CI 82–87%), the specificity was 86% (82–88%), and the C -index was 0.87 (0.84–0.90). Conclusion. The findings of our study showed that ML algorithms had high sensitivity and specificity for distinguishing between melanoma and benign nevi. This suggests that state-of-the-art ML-based algorithms for distinguishing melanoma from benign nevi may be ready for clinical use. However, a large proportion of the earlier published studies had methodological flaws, such as lack of external validation and lack of clinician comparisons. The results of these studies should be interpreted with caution.

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Differences in Thickness-Specific Incidence and Factors Associated With Cutaneous Melanoma in the US From 2010 to 2018

Cited by 24 publications

References 15 publications

Qualitative exploration of melanoma awareness in black people in the USA

Qualitative exploration of melanoma awareness in black people in the USA

The effects of exposure to solar radiation on human health

Distinguish the Value of the Benign Nevus and Melanomas Using Machine Learning: A Meta-Analysis and Systematic Review

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