Intake of Furocoumarins and Risk of Skin Cancer in 2 Prospective US Cohort Studies

ABSTRACT Background In prior studies, higher citrus consumption was associated with higher risk of cutaneous malignant melanoma, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC). Furocoumarins, compounds with phototoxicity and photocarcinogenicity in citrus, may be responsible for the association. Objectives The objective of the study was to investigate the association between furocoumarin intake and skin cancer risk. Methods A total of 47,453 men from the Health Professionals Follow-Up Study (HPFS) and 75,291 women from the Nurses’ Health Study (NHS) with diet data collected every 2–4 y in the 2 prospective cohort studies were included. A furocoumarin food composition database for 7 common furocoumarins [bergaptol, psoralen, 8-methoxypsoralen, bergapten, 6',7'-dihydroxybergamottin (6'7'-DHB), epoxybergamottin, and bergamottin] was developed and used to calculate participants’ cumulative average and energy-adjusted furocoumarin intake. Multivariate HRs and 95% CIs of the associations between furocoumarin intake and skin cancer risk were estimated using Cox proportional hazards models. Analyses were performed separately in each cohort as well as pooled using a fixed-effects model. Results Throughout follow-up (1984–2012 in the NHS and 1986–2012 in the HPFS), we identified 1593 melanoma, 4066 SCC, and 28,630 BCC cases. Higher intake of total furocoumarins was associated with an increased risk of BCC; the pooled HR comparing the top with the bottom quintile was 1.16 (95% CI: 1.11, 1.21; P-trend = 0.002). Higher intakes of bergaptol, bergapten, 6'7'-DHB, and bergamottin were also significantly associated with increased BCC risk. No significant associations were found between intake of total furocoumarins and the risks of SCC or melanoma. Conclusions Intakes of total furocoumarins as well as some individual furocoumarins were associated with an increased risk of skin cancer, especially BCC, in 2 cohorts of US health professionals.

Download Full-text

Photosensitizing Medications and Skin Cancer: A Comprehensive Review

Cancers ◽

10.3390/cancers13102344 ◽

2021 ◽

Vol 13 (10) ◽

pp. 2344

Author(s):

Elisabeth A. George ◽

Navya Baranwal ◽

Jae H. Kang ◽

Abrar A. Qureshi ◽

Aaron M. Drucker ◽

...

Keyword(s):

Skin Cancer ◽

Cancer Risk ◽

Cell Carcinoma ◽

The United States ◽

In Vivo Studies ◽

Cancer Risk Factors ◽

Skin Cancer Risk ◽

Number Of Patients

(1) The incidence of skin cancer is increasing in the United States (US) despite scientific advances in our understanding of skin cancer risk factors and treatments. In vitro and in vivo studies have provided evidence that suggests that certain photosensitizing medications (PSMs) increase skin cancer risk. This review summarizes current epidemiological evidence on the association between common PSMs and skin cancer. (2) A comprehensive literature search was conducted to identify meta-analyses, observational studies and clinical trials that report on skin cancer events in PSM users. The associated risks of keratinocyte carcinoma (squamous cell carcinoma and basal cell carcinoma) and melanoma are summarized, for each PSM. (3) There are extensive reports on antihypertensives and statins relative to other PSMs, with positive and null findings, respectively. Fewer studies have explored amiodarone, metformin, antimicrobials and vemurafenib. No studies report on the individual skin cancer risks in glyburide, naproxen, piroxicam, chlorpromazine, thioridazine and nalidixic acid users. (4) The research gaps in understanding the relationship between PSMs and skin cancer outlined in this review should be prioritized because the US population is aging. Thus the number of patients prescribed PSMs is likely to continue to rise.

Download Full-text

Large-Scale Evaluation of Genetic Variants in Candidate Genes for Colorectal Cancer Risk in the Nurses' Health Study and the Health Professionals' Follow-up Study

Cancer Epidemiology Biomarkers & Prevention ◽

10.1158/1055-9965.epi-07-0195 ◽

2008 ◽

Vol 17 (2) ◽

pp. 311-319 ◽

Cited By ~ 12

Author(s):

Aditi Hazra ◽

Stephen Chanock ◽

Edward Giovannucci ◽

David G. Cox ◽

Tianhua Niu ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Risk ◽

Candidate Genes ◽

Health Professionals ◽

Genetic Variants ◽

Large Scale ◽

Health Study ◽

Scale Evaluation ◽

Follow Up Study

Download Full-text

Known colorectal cancer susceptibility loci and survival after colorectal cancer diagnosis.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.4_suppl.394 ◽

2012 ◽

Vol 30 (4_suppl) ◽

pp. 394-394 ◽

Cited By ~ 1

Author(s):

Amanda Phipps ◽

Xabier Garcia-Albeniz ◽

Carolyn Hutter ◽

Emily White ◽

Charles S. Fuchs ◽

...

Keyword(s):

Colorectal Cancer ◽

Overall Survival ◽

Fixed Effects ◽

Cancer Susceptibility ◽

Association Studies ◽

Cox Proportional Hazards ◽

Health Study ◽

Genome Wide Association Studies ◽

Increased Risk

394 Background: Beyond clinicopathologic stage, there are few established markers of prognosis in colorectal cancer (CRC). Recent genome-wide association studies have identified 17 germline single nucleotide polymorphisms (SNPs) significantly associated with incident CRC. However, it is unclear if these CRC susceptibility SNPs influence survival after CRC diagnosis. Although the functionality of many of these SNPs remains unknown, a few, including rs4939827 in SMAD7, map to genes with plausible biological mechanisms associated with both cancer risk and prognosis. We examined 17 CRC susceptibility SNPs in relation to survival after CRC diagnosis. Methods: We genotyped 2,611 men and women enrolled in five prospective cohort studies who were diagnosed with invasive CRC during study follow-up: the Physicians’ Health Study (N=281), Health Professionals Follow-up Study (N=268), Nurses’ Health Study (N=367), Vitamins and Lifestyle Study (N=281), and the Women’s Health Initiative (N=1414). Analyses were limited to Caucasians with known vital status, cause of death, and survival time. We used Cox proportional hazards regression to assess associations between each SNP and CRC-specific and overall survival in study-specific models adjusted for age, sex, and stage; SNPs were modeled additively to reflect associations per copy of the minor allele. Study-specific results were combined via fixed-effects meta-analysis. Results: The G allele in rs4939827 was associated with poorer CRC-specific survival [hazard ratio (HR)=1.16, p=0.02] and overall survival (HR=1.13, p=0.03) in CRC patients. The A alleles in rs10795668 and in rs4925386 were associated with a 1.14-fold increased risk of overall mortality (both p-values=0.03) but not CRC-specific mortality. Other evaluated SNPs were not associated with survival. Conclusions: Genetic variation in rs4939827 (SMAD7) is associated with CRC-specific and overall survival. These results suggest that SMAD7 may have a role in CRC progression, and provide proof-of-principle that common germline variation may provide prognostic information beyond traditional considerations such as stage.

Download Full-text

Vitamin B2 intake and colorectal cancer risk; results from the Nurses' Health Study and the Health Professionals Follow-Up Study cohort

International Journal of Cancer ◽

10.1002/ijc.30141 ◽

2016 ◽

Vol 139 (5) ◽

pp. 996-1008 ◽

Cited By ~ 4

Author(s):

Yeong Sook Yoon ◽

Seungyoun Jung ◽

Xuehong Zhang ◽

Shuji Ogino ◽

Edward L. Giovannucci ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Risk ◽

Health Professionals ◽

Colorectal Cancer Risk ◽

Health Study ◽

Study Cohort ◽

Vitamin B2 ◽

Follow Up Study

Download Full-text

Serum Antioxidants and Skin Cancer Risk: An 8-Year Community-Based Follow-up Study

Cancer Epidemiology Biomarkers & Prevention ◽

10.1158/1055-9965.epi-08-1211 ◽

2009 ◽

Vol 18 (4) ◽

pp. 1167-1173 ◽

Cited By ~ 25

Author(s):

Jolieke C. van der Pols ◽

Mirjam M. Heinen ◽

Maria Celia Hughes ◽

Torukiri I. Ibiebele ◽

Geoffrey C. Marks ◽

...

Keyword(s):

Skin Cancer ◽

Cancer Risk ◽

Community Based ◽

Follow Up Study ◽

Skin Cancer Risk

Download Full-text

Recommendation-based dietary indexes and risk of colorectal cancer in the Nurses’ Health Study and Health Professionals Follow-up Study

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqy171 ◽

2018 ◽

Vol 108 (5) ◽

pp. 1092-1103 ◽

Cited By ~ 18

Author(s):

Joshua Petimar ◽

Stephanie A Smith-Warner ◽

Teresa T Fung ◽

Bernard Rosner ◽

Andrew T Chan ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Risk ◽

Health Professionals ◽

Cox Regression ◽

Meta Analysis ◽

Healthy Eating Index ◽

Colorectal Cancer Risk ◽

Health Study ◽

Follow Up Study

ABSTRACT Background Many dietary indexes exist for chronic disease prevention, but the optimal dietary pattern for colorectal cancer prevention is unknown. Objective We sought to determine associations between adherence to various dietary indexes and incident colorectal cancer in 2 prospective cohort studies. Design We followed 78,012 women in the Nurses’ Health Study and 46,695 men in the Health Professionals Follow-up Study from 1986 and 1988, respectively, until 2012. We created dietary index scores for the Dietary Approaches to Stop Hypertension (DASH) diet, Alternative Mediterranean Diet (AMED), and Alternative Healthy Eating Index-2010 (AHEI-2010) and used Cox regression to estimate HRs and 95% CIs for risk of colorectal cancer (CRC) and by anatomic subsite. We also conducted latency analyses to examine associations between diet and CRC risk during different windows of exposure. We conducted analyses in men and women separately, and subsequently pooled these results in a random-effects meta-analysis. Results We documented 2690 colorectal cancer cases. Pooled multivariable HRs for colorectal cancer risk comparing the highest to lowest quintile of diet scores were 0.89 (95% CI: 0.74, 1.08; P-trend = 0.10) for DASH, 0.89 (95% CI: 0.73, 1.10; P-trend = 0.31) for AMED, and 0.95 (95% CI: 0.83, 1.09; P-trend = 0.56) for AHEI-2010 (P-heterogeneity ≥ 0.07 for all). In sex-specific analyses, we observed stronger associations in men for all dietary indexes (DASH: multivariable HR = 0.81, 95% CI: 0.66, 0.98; P-trend = 0.003; AMED: multivariable HR = 0.80, 95% CI: 0.65, 0.98; P-trend = 0.02; AHEI-2010: multivariable HR = 0.88, 95% CI: 0.72, 1.07; P-trend = 0.04) than in women (multivariable HRs range from 0.98 to 1.01). Conclusions Adherence to the DASH, AMED, and AHEI-2010 diets was inversely associated with colorectal cancer risk in men. These diets were not associated with colorectal cancer risk in women. This observational study was registered at http://www.clinicaltrials.gov as NCT03364582.

Download Full-text

Risk Factors for the Development of Skin Cancers in Patients with Chronic Lymphocytic Leukemia: A Retrospective Cohort Study

Blood ◽

10.1182/blood-2020-138961 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 15-16

Author(s):

Ivan Landego ◽

Shirley Li ◽

Chao Xue ◽

Vincent Poon ◽

Robert C. Clayden ◽

...

Keyword(s):

Risk Factors ◽

Skin Cancer ◽

Chronic Lymphocytic Leukemia ◽

Cell Carcinoma ◽

Lower Incidence ◽

Research Funding ◽

Lymphocytic Leukemia ◽

Skin Cancers ◽

Increased Risk

Introduction: Individuals with chronic lymphocytic leukemia (CLL) are often immunosuppressed and at increased risk of infection and secondary malignancies. The primary aim of this study was to determine the incidence of skin cancer amongst the CLL population at Kingston Health Sciences Centre (KHSC), Ontario, Canada. Secondly, we sought to identify the risk factors associated with the development of skin cancer in CLL patients. Methods: Consecutive patients seen at KHSC with a diagnosis of CLL between 2014 January 1 and 2019 December 31 formed the primary study cohort. KHSC serves a region of ~ 550,000 including a high proportion of older individuals and those living in rural areas. Approval was provided by Queen's University Research Ethics Board. Four independent reviewers conducted retrospective electronic chart review, initially in duplicate with review of any areas of discrepancy to ensure a standardized approach. Data collected included age, sex, CLL date of diagnosis, stage, genetics and treatment; histological diagnoses of other cancers (skin and other), smoking status (ever/never) and date of last follow up or death. The primary outcome was the development of the first skin cancer (squamous cell carcinoma, basal cell carcinoma, melanoma, or sarcoma) confirmed via pathology reports that are available in our local institution. All statistical analysis was performed using SAS Enterprise v. 7.15. Categorical variables were compared using chi-square or Fisher exact tests, medians using Wilcoxon and Mann-Whitney tests, and continuous variables using t-tests. Risk factors for development of skin cancer were assessed using multivarable Cox-proportional hazard models. Results: Of the total cohort of 377 individuals with CLL, 251 (67%) were male. Median age at diagnosis of CLL was 65 years (range 36 - 93 years of age). Median follow-up from the time of CLL diagnosis was 6.5 years (range 0.27 - 30.98). Of these, 80 individuals (21.2%) developed at least one skin cancer after their diagnosis of CLL, with an age-adjusted incidence of 16.96/1000 patient years (95% CI 12.5 - 23). Among the 297 who did not develop skin cancer post-CLL diagnosis, 13 individuals who had documented skin cancer pre-CLL diagnosis only, are included in the non-skin cancer group (Figure 1). Females had a lower incidence of skin cancer compared with males (63 males versus 17 females, p=0.009). There was no difference between the groups based on Rai stage at diagnosis, smoking history, or IGHV /p53 status. Individuals treated with ibrutinib had a lower incidence of skin cancer (3 versus 49, p=0.002). Development of skin cancer was associated with development of other invasive tumours including CLL transformation (p=0.001) (Table 1). Conclusion: Limitations of this study include its small size, and single institution setting. Our data likely reflect a conservative estimate as skin cancers may be diagnosed outside of the institution, and not all CLL is treated at tertiary care centres. Consistent with other studies we found that males with CLL are at increased risk of developing skin cancer, as compared to females. Individuals with CLL and skin cancer were more likely to develop another malignancy or Richter's transformation. The finding of lower incidence of skin cancer with ibrutinib treatment is novel; further investigation in larger populations is needed to determine if it may offer a protective effect. Disclosures Asai: Sanofi Canada: Honoraria, Research Funding; AllerGen NCE: Research Funding; Pfizer: Honoraria, Research Funding; Janssen: Honoraria; Leo Pharma: Honoraria; Eli Lilly: Honoraria; Novartis: Honoraria; Abbvie: Honoraria, Research Funding; Canadian Institutes of Health Research: Research Funding. Hay:Roche: Research Funding; Janssen: Research Funding.

Download Full-text

Dietary Insulinemic Potential and Risk of Total and Cause-Specific Mortality in the Nurses' Health Study and the Health Professionals Follow-up Study

10.2337/figshare.16906060.v1 ◽

2021 ◽

Author(s):

Yi Wan ◽

Fred K. Tabung ◽

Dong Hoon Lee ◽

Teresa T. Fung ◽

Walter C. Willett ◽

...

Keyword(s):

Health Professionals ◽

Insulin Response ◽

Premature Death ◽

Health Study ◽

Follow Up Study ◽

Risk Of Mortality ◽

Increased Risk ◽

Specific Mortality ◽

Design And Methods

Objective: Insulin response is related to overall health. Diet modulates insulin response. We aimed to investigate whether insulinemic potential of diet are associated with risk of all-cause and cause-specific mortality. Research Design and Methods: We prospectively followed 63,464 women from the Nurses’ Health Study (1986-2016) and 42,880 men from the Health Professionals Follow-up Study (1986-2016). Diet was assessed by food frequency questionnaires every 4 years. The insulinemic potential of diet was evaluated using a food-based empirical dietary index for hyperinsulinemia (EDIH), which was pre-defined based on predicting circulating C-peptide concentrations. Results: During <a>2,792,550</a> person-years of follow-up, 38,329 deaths occurred. In the pooled multivariable-adjusted analyses, a higher dietary insulinemic potential was associated with an increased risk of mortality from all-cause (hazard ratio [HR] comparing extreme quintiles: 1.33; 95% confidence interval [CI]: 1.29, 1.38; P-trend<0.001), cardiovascular disease (CVD) (HR: 1.37; 95% CI: 1.27, 1.46; P-trend<0.001), and cancers (HR: 1,20; 95% CI: 1.13, 1.28; P-trend<0.001). <a>These associations were independent of body mass index and remained significant after further adjustment for other well-known dietary indices. </a>Furthermore, <a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a>compared with participants whose EDIH scores were stable over an 8-year period, those with the greatest increases had a higher subsequent risk of all-cause (HR: 1.13; 95%CI: 1.09, 1.18; P-trend<0.001)</a> and CVD (HR: 1.10; 95% CI: 1.01, 1.21; P-trend=0.006) mortality. Conclusions: Higher insulinemic potential of diet was associated with increased risk of all-cause, CVD, and cancer mortality. Adopting a diet with low insulinemic potential might be an effective approach to improve overall health and prevent premature death.

Download Full-text

Interventions to decrease skin cancer risk in outdoor workers: update to a 2007 systematic review

10.32920/14636523.v1 ◽

2021 ◽

Author(s):

Caitlin Horsham ◽

Josephine Auster ◽

Marguerite Sendall ◽

Melissa Stoneham ◽

Philippa Youl ◽

...

Keyword(s):

Skin Cancer ◽

Cancer Risk ◽

Risk Group ◽

Sun Protection ◽

Protective Equipment ◽

Inclusion Criteria ◽

Skin Cancer Risk ◽

Outdoor Workers ◽

Ultraviolet Radiation Exposure

Background Outdoor workers are at high risk of harmful ultraviolet radiation exposure and are identified as an at risk group for the development of skin cancer. This systematic evidence based review provides an update to a previous review published in 2007 about interventions for the prevention of skin cancer in outdoor workers. Results This review includes interventions published between 2007-2012 and presents findings about sun protection behaviours and/or objective measures of skin cancer risk. Six papers met inclusion criteria and were included in the review. Large studies with extended follow-up times demonstrated the efficacy of educational and multi-component interventions to increase sun protection, with some higher use of personal protective equipment such as sunscreen. However, there is less evidence for the effectiveness of policy or specific intervention components. Conclusions Further research aimed at improving overall attitudes towards sun protection in outdoor workers is needed to provide an overarching framework.

Download Full-text