Melanoma Screening and Therapeutic Prevention (Chemoprevention) in High-Risk Groups

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Epidemiology and Prevention".

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 12276

Special Issue Editors


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Guest Editor
Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Hygiene and Public Health, University of Padua, Via L. Loredan, 18-35131 Padua, Italy
Interests: public health; melanoma; costs; healthcare system optimization; clinical pathways

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Guest Editor
Unit of Hygiene and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Via L. Loredan, 18-35131 Padua, Italy
Interests: melanoma; target therapies; precision medicine; surgical quality

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Guest Editor
Dermatology Unit, Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
Interests: special populations; stigmatization and psychodermatology; hidradenitis suppurativa; systemic inflammation; dermatoepidemiology; multi-omics integration; machine learning; artificial intelligence; big data; biologics; systemic treatments
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Special Issue Information

Dear Colleagues,

Malignant cutaneous melanoma has shown one of the fastest growing incidence rates globally, and it has been demonstrated that it is expected to continue to rise. Melanoma is thus an important public health issue as well as an economic concern giving the new high-priced treatment options for advanced stages of melanoma. Considering this latest evidence on epidemiological changes and new target therapies, innovative studies on the effectiveness and cost-effectiveness of melanoma screening are warranted to evaluate if it is time to justify a screening campaign in general or in high-risk population groups.

Moreover, novel studies evaluating the efficacy and effectiveness of chemoprevention (i.e., nicotinamide, statins, fibrates, vitamin D) enrolling higher-risk individuals should be useful to assist clinicians and healthcare commissioners in melanoma cancer control. High-risk patients deserve particular attention and more accurate guidelines based on the best evidence.

This Special Issue calls for trials or real-world data studies on these two relevant arguments to shape a new public health scenario of melanoma.

Prof. Dr. Alessandra Buja
Prof. Dr. Simone Mocellin
Dr. Giovanni Damiani
Guest Editors

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Keywords

  • melanoma
  • primary prevention
  • secondary prevention

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Published Papers (2 papers)

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Research

12 pages, 1524 KiB  
Article
Impact of Distribution of a Tip Sheet to Increase Early Detection and Prevention Behavior among First-Degree Relatives of Melanoma Patients: A Randomized Cluster Trial
by Diane Marcé, Floriane Le Vilain-Abraham, Morgiane Bridou, Gaelle Quéreux, Alain Dupuy, Thierry Lesimple, Yannick Le Corre, Ewa Wierzbicka-Hainaut, Delphine Legoupil, Philippe Célérier, Hervé Maillard, Laurent Machet and Agnès Caille
Cancers 2022, 14(16), 3864; https://doi.org/10.3390/cancers14163864 - 10 Aug 2022
Cited by 1 | Viewed by 1848
Abstract
Background: First-degree relatives (FDRs, defined as parents, children, and siblings) of melanoma patients are at a two-to-fivefold increased risk of developing melanoma themselves. FDRs are advised to perform self-skin examination (SSE) and annual medical total cutaneous examination (TCE) performed either by a dermatologist [...] Read more.
Background: First-degree relatives (FDRs, defined as parents, children, and siblings) of melanoma patients are at a two-to-fivefold increased risk of developing melanoma themselves. FDRs are advised to perform self-skin examination (SSE) and annual medical total cutaneous examination (TCE) performed either by a dermatologist or a general practitioner, and to change their sun-related behavior. This advice is given orally to melanoma patients who are asked to relay the information to their FDRs. Objective: Our aim was to determine the impact of providing a tip sheet to melanoma patients intended to their first-degree relatives (FDRs) on early detection and sun-related behaviors in this group at increased risk of melanoma. Methods: A superiority, cluster-randomized trial was conducted at nine hospital centers. In the intervention group, dermatologists were asked to deliver to melanoma patients (index cases) the tip sheet and oral advice intended to their FDRs. The control group were asked to deliver the usual oral advice alone. The primary outcome was early detection of melanoma in FDRs with a medical TCE performed within one year after the first visit of the index case. Secondary outcomes were SSE and sun-related behaviors in FDRs. Results: A total of 48 index cases and 114 FDRS in the control group, 60 index cases and 166 FDRS in the intervention group were recruited. In the intervention group, 36.1% of FDRs performed a medical TCE as compared to 39.5% of FDRs in the control group (OR 0.9 [95% CI 0.5 to 1.5], p = 0.63). We did not find a between-group difference in SSE and sun-related behaviors. Conclusion: A tip sheet added to the usual oral advice did not increase medical TCE among FDRs of melanoma patients. Overall, the rate of TCE among FDRs was low. Research on other strategies is needed to increase melanoma detection in this population. Full article
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16 pages, 550 KiB  
Article
Dermoscopy of Small Diameter Melanomas with the Diagnostic Feasibility of Selected Algorithms—A Clinical Retrospective Multicenter Study
by Monika Slowinska, Grazyna Kaminska-Winciorek, Elzbieta Kowalska-Oledzka, Iwona Czarnecka, Robert Czarnecki, Anna Nasierowska-Guttmejer, Elwira Paluchowska and Witold Owczarek
Cancers 2021, 13(23), 6095; https://doi.org/10.3390/cancers13236095 - 3 Dec 2021
Cited by 4 | Viewed by 9768
Abstract
Objective: The aim of the study was to verify two hypotheses. The first concerned the possibility of diagnostic dermoscopic differentiation between cutaneous melanomas of the histopathological category in situ (pTis) and thin melanomas (pT1a) in terms of their diameter. The second assessed the [...] Read more.
Objective: The aim of the study was to verify two hypotheses. The first concerned the possibility of diagnostic dermoscopic differentiation between cutaneous melanomas of the histopathological category in situ (pTis) and thin melanomas (pT1a) in terms of their diameter. The second assessed the diagnostic feasibility of two dermoscopic algorithms aiming to detect ≤ 5.0 mm-sized melanomas histopathologically confirmed as pTis and pT1a. Methods: Dermoscopic images of consecutive cases of histopathologically confirmed melanomas were evaluated by three independent investigators for the presence of the predefined criteria. The melanomas were subdivided according to their diameter into small melanomas, so-called micromelanomas (microM)—sized ≤ 5.0 mm and >5.0 mm, according to published definitions of small melanocytic lesions. The Triage Amalgamated Dermoscopic Algorithm (TADA) and the revisited 7-point checklist of dermoscopy (7-point) algorithm were chosen for the diagnostic feasibility. Odds ratios and corresponding 95% confidence limits (CL) were calculated using the logistic regression adjusted for age for the melanoma-specific dermoscopic structures, the dermoscopic patterns and the diagnostic feasibility of the 7-point checklist and TADA algorithms. The p-values of the results were corrected using the Bonferroni method. Results: In total, 106 patients with 109 melanomas, 50 sized ≤ 5.0 mm and 59 exceeding the diameter of 5.0 mm, were retrospectively analyzed. The prevalent general pattern of microM was the spitzoid one (48% vs. 11.86%, p = 0.0013). Furthermore, 40% of microM vs. 6.78% melanomas sized > 5.0 mm (p = 0.0023) did not present melanoma-specific patterns. The asymmetric multicomponent pattern was present in 64.41% melanomas sized > 5.0 mm and in 26.00% microM (p = 0.0034). The asymmetry of structures or colors was detected in 56% microM vs. 89.83% (p = 0.0020) and 56% microM and 94.92% (p = 0.000034) melanoma sized > 5.0 mm, respectively. The differences in frequency of the detected dermoscopic structures specific to melanomas revealed that microM are almost deprived of negative networks (p = 0.04), shiny white structures (p = 0.0027) and regression features (p = 0.00003). Neither prominent skin markings nor angulated lines were found in the entire study group. Out of the vascular structures, microM presented only dotted (32%) or polymorphous (28%) vessels, although more rarely than melanomas sized > 5.0 mm (66.1% p = 0.017 and 49% p > 0.05, respectively). The diagnostic feasibility revealed a score ≥ 3 of the 7-point algorithm (indicative for malignancy) in 60% microM and 98.31% melanomas sized > 5.0 mm (p = 0.000006). The TADA algorithm revealed melanoma-specific patterns in 64% microM and 96.61% > 5.0 mm-sized melanomas (p = 0.00006) and melanoma-specific structures in 72% and 91.53% (p > 0.05), respectively. Conclusion: In the dermoscopy, 40% of micromelanomas histopathologically staged as pTis and pT1a did not reveal melanoma-specific patterns. Among the general melanocytic patterns, the spitzoid one was the most frequently found in melanomas sized ≤ 5.0 mm. The 7-point checklist and TADA dermoscopic algorithms were helpful in the identification of the majority of melanomas sized ≤ 5.0 mm. Full article
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