Etiologies of Melanoma Development and Prevention Measures: A Review of the Current Evidence

(1) Melanoma is the most aggressive dermatologic malignancy, with an estimated 106,110 new cases to be diagnosed in 2021. The annual incidence rates continue to climb, which underscores the critical importance of improving the methods to prevent this disease. The interventions to assist with melanoma prevention vary and typically include measures such as UV avoidance and the use of protective clothing, sunscreen, and other chemopreventive agents. However, the evidence is mixed surrounding the use of these and other interventions. This review discusses the heritable etiologies underlying melanoma development before delving into the data surrounding the preventive methods highlighted above. (2) A comprehensive literature review was performed to identify the clinical trials, observational studies, and meta-analyses pertinent to melanoma prevention and incidence. Online resources were queried to identify epidemiologic and clinical trial information. (3) Evidence exists to support population-wide screening programs, the proper use of sunscreen, and community-targeted measures in the prevention of melanoma. Clinical evidence for the majority of the proposed preventive chemotherapeutics is presently minimal but continues to evolve. (4) Further study of these chemotherapeutics, as well as improvement of techniques in artificial intelligence and imaging techniques for melanoma screening, is warranted for continued improvement of melanoma prevention.

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Evaluation of the effectiveness of behavioural economic incentive programmes for the promotion of a healthy diet and physical activity: a protocol for a systematic review and network meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-046035 ◽

2020 ◽

Vol 10 (12) ◽

pp. e046035

Author(s):

Suparee Boonmanunt ◽

Oraluck Pattanaprateep ◽

Boonsong Ongphiphadhanakul ◽

Gareth McKay ◽

John Attia ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Financial Incentives ◽

Meta Analysis ◽

Economic Incentive ◽

Healthy Diet ◽

Current Evidence ◽

Diet And Physical Activity ◽

Behavioural Economic ◽

Meta Analyses

IntroductionObesity and being overweight are major risk factors for metabolic syndrome and non-communicable diseases. Despite the recommendation that a healthy diet and physical activity can reduce the severity of these diseases, many fail to adhere to these measures. From a behavioural economic perspective, adherence to such measures can be encouraged through financial incentives. However, additional related behavioural economic approaches may improve the effectiveness of an incentive programme. As such, we have developed a protocol for a systematic review and network meta-analysis to summarise the current evidence from financial incentive programmes with and without behavioural economic insights for promoting healthy diet and physical activity.Methods and analysisPrevious systematic reviews, meta-analyses and individual studies were identified from Medline and Scopus in June 2020 and will be updated until December 2020. Individual studies will be selected and data extracted by two reviewers. Disagreement will be resolved by consensus or adjudicated by a third reviewer. A descriptive analysis will summarise the effectiveness of behavioural economic incentive programmes for promoting healthy diet and physical activity. Moreover, individual studies will be pooled using network meta-analyses where possible. I2 statistics and Cochran’s Q test will be used to assess heterogeneity. Risk of bias and publication bias, if appropriate, will be evaluated, as well as the overall strength of the evidence.Ethics and disseminationEthics approval for a systematic review and meta-analysis is not required. The findings will be published in a peer-reviewed journal.PROSPERO registration numberCRD42020198024.

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Cancer services in Sri Lanka: current status and future directions

Journal of the Egyptian National Cancer Institute ◽

10.1186/s43046-021-00070-8 ◽

2021 ◽

Vol 33 (1) ◽

Author(s):

Umesh Jayarajah ◽

Anuruddha M. Abeygunasekera

Keyword(s):

Sri Lanka ◽

Cancer Prevention ◽

Systemic Therapy ◽

Cancer Care ◽

Current Status ◽

Main Body ◽

Prevention Measures ◽

High Quality Research ◽

Screening Programs ◽

Cancer Services

Abstract Background The burden of cancer in Sri Lanka is on the rise. The overall incidence of cancer in Sri Lanka has doubled over the past 25 years with a parallel rise in cancer-related mortality. Cancer has become the second commonest cause of hospital mortality in Sri Lanka. In this review, we aim to provide an overview of the current status and future direction of cancer care in Sri Lanka. Main body In Sri Lanka, cancer services are predominantly provided by the state sector free of charge to the general public. With the establishment of national cancer policy on cancer prevention and control, there has been a commendable improvement in the cancer services provided island-wide. An increasing number of breast, oropharyngeal, thyroid, oesophageal, colorectal, lung, and gastric cancers are being diagnosed and treated annually. Primary prevention measures include restrictions in tobacco and HPV vaccination. Screening programs for selected cancers such as breast, oral and cervical cancers are delivered. Medical oncology units with facilities for systemic therapy and adequately supported by surgical, pathology, and radiology departments have been established in each district general hospital island-wide. Although the current progress is commendable, future changes are necessary to overcome the current limitations and to cater the ever increasing burden of cancer. Measures are necessary to enhance the coverage of Sri Lanka Cancer Registry. Timely high-quality research and audits are essential. Community participation in planning strategies for cancer prevention and treatment is minimal. Community-based palliative care facilities and radiation and other systemic therapy should be made available in all provinces. A culture of multi-disciplinary care with proper referral pathways would help to improve the current setting. Conclusion In conclusion, Sri Lanka has a reasonably balanced and continuously expanding program for prevention, screening, and treatment of cancers. Emphasis on preventive strategies related to reducing tobacco smoking, chewing betel, and obesity, making cancers a notifiable disease, involving the community in planning cancer care and prevention strategies, conducting research to evaluate cost-effectiveness of existing treatment and increasing radiotherapy facilities would further improve the cancer services in Sri Lanka.

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Effectiveness of e-cigarettes in smoking cessation: a systematic review and meta-analysis

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1226 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M Oberndorfer ◽

I Grabovac ◽

S Haider ◽

T E Dorner

Keyword(s):

Systematic Review ◽

Smoking Cessation ◽

Meta Analysis ◽

Current Evidence ◽

Promising Alternative ◽

Quality Of Evidence ◽

Different Populations ◽

Meta Analyses

Abstract Background Reports of the effectiveness of e-cigarettes (ECs) for smoking cessation vary across different studies making implementation recommendations hard to attain. We performed a systematic review and meta-analysis to synthesise the current evidence regarding the effectiveness of ECs for smoking cessation. Methods PubMed, PsycInfo and Embase databases were searched for randomized controlled trials comparing nicotine ECs with non-nicotine ECs or with established smoking cessation interventions (nicotine replacement therapy (NRT) and or counselling) published between 01/01/2014 and 01/05/2019. Data from eligible studies were extracted and used for random-effects meta-analyses. Results Our literature review yielded 13190 publications with 10 studies being identified as eligible for systematic review, covering 8362 participants, and 8 for meta-analyses (n = 30 - 6006). Using the last follow-up of eligible studies, the proportion of smokers achieving abstinence was 1.67 [95CI:0.99 - 2.81] times higher in nicotine EC users compared to non-nicotine EC users. The proportion of abstinent smokers was 1.69 [95CI:1.25 - 2.27] times higher in EC users compared to participants receiving NRT. EC users showed a 2.70 [95CI:1.15 - 6.30] times higher proportion of abstinent smokers in comparison to participants solely receiving counselling. Conclusions Our analysis showed modest effects of nicotine-ECs compared to non-nicotine ECs. When compared to NRT or counselling, results suggest that nicotine EC may be more effective for smoking cessation. As ECs also help maintaining routinized behaviour and social aspects of smoking, we hypothesise that this may explain their advantage as a tool for smoking cessation. However, given the small number of included studies, different populations, heterogeneous designs, and the overall moderate to low quality of evidence, it is not possible to offer clear recommendations. More comparable data is needed to strengthen confidence in the quality of evidence. Key messages The number of previous studies assessing the effectiveness of ECs for smoking cessation is limited. Further, comparability of these studies is restricted, weakening the quality of evidence. Although current evidence on the effectiveness of ECs for smoking cessation is inconclusive, our meta-analyses suggest that ECs could be a promising alternative tool in attempts to achieve abstinence.

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Consequences of the COVID-19 Syndemic for Nutritional Health: A Systematic Review

Nutrients ◽

10.3390/nu13041168 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1168

Author(s):

Cristian Neira ◽

Rejane Godinho ◽

Fabio Rincón ◽

Rodrigo Mardones ◽

Janari Pedroso

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Preventive Measures ◽

Physical Contact ◽

Current Evidence ◽

Study Objective ◽

Eating Style ◽

Healthy Nutrition ◽

Meta Analyses ◽

The Impact

Confinement at home, quarantine, and social distancing are some measures adopted worldwide to prevent the spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov-2), which has been generating an important alteration in the routines and qualities of life of people. The impact on health is still being evaluated, and consequences in the nutritional field are not entirely clear. The study objective was to evaluate the current evidence about the impact that preventive measures of physical contact restriction causes in healthy nutrition. A systematic review was carried out according to the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” PRISMA Group and Cochrane method for rapid systematic reviews. Searching was performed in six electronic databases and evaluated articles published between 2010 and 2020, including among their participants adult subjects who had been exposed to the preventive measures of physical contact restriction. Seven studies met the selection criteria and reported an overall increase in food consumption, weight, Body Mass Index (BMI), and a change in eating style. Findings suggest that healthy nutrition is affected by preventive measures to restrict physical contact as a result of the COVID-19 syndemic.

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Polyphenols and Cognition In Humans: An Overview of Current Evidence from Recent Systematic Reviews and Meta-Analyses

Brain Plasticity ◽

10.3233/bpl-200111 ◽

2020 ◽

pp. 1-15

Author(s):

Daniel Joseph Lamport ◽

Claire Michelle Williams

Keyword(s):

Systematic Reviews ◽

Evidence Base ◽

Epidemiological Studies ◽

Cognitive Outcome ◽

Current Evidence ◽

Duration Of Treatment ◽

Current Evidence Base ◽

Cognitive Benefits ◽

Meta Analyses ◽

The Impact

There is increasing interest in the impact of dietary influences on the brain throughout the lifespan, ranging from improving cognitive development in children through to attenuating ageing related cognitive decline and reducing risk of neurodegenerative diseases. Polyphenols, phytochemicals naturally present in a host of fruits, vegetables, tea, cocoa and other foods, have received particular attention in this regard, and there is now a substantial body of evidence from experimental and epidemiological studies examining whether their consumption is associated with cognitive benefits. The purpose of this overview is to synthesise and evaluate the best available evidence from two sources, namely meta-analyses and systematic reviews, in order to give an accurate reflection of the current evidence base for an association between polyphenols and cognitive benefits. Four meta-analyses and thirteen systematic reviews published between 2017–2020 were included, and were categorised according to whether they reviewed specific polyphenol-rich foods and classes or all polyphenols. A requirement for inclusion was assessment of a behavioural cognitive outcome in humans. A clear and consistent theme emerged that whilst there is support for an association between polyphenol consumption and cognitive benefits, this conclusion is tentative, and by no means definitive. Considerable methodological heterogeneity was repeatedly highlighted as problematic such that the current evidence base does not support reliable conclusions relating to efficacy of specific doses, duration of treatment, or sensitivity in specific populations or certain cognitive domains. The complexity of multiple interactions between a range of direct and indirect mechanisms of action is discussed. Further research is required to strengthen the reliability of the evidence base.

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Robotic colorectal surgery: more than a fantastic toy?

Innovative Surgical Sciences ◽

10.1515/iss-2017-0046 ◽

2018 ◽

Vol 3 (1) ◽

pp. 65-68 ◽

Cited By ~ 1

Author(s):

James W.T. Toh ◽

Kevin Phan ◽

Seon-Hahn Kim

Keyword(s):

Rectal Cancer ◽

Colorectal Surgery ◽

Da Vinci Surgical System ◽

Current Evidence ◽

Rectal Cancer Surgery ◽

Cancer Trial ◽

Robotic Colorectal Surgery ◽

Significant Difference ◽

Meta Analyses ◽

Laparoscopic Assisted

AbstractThere has been a rapid rise in the number of robotic colorectal procedures worldwide since the da Vinci Surgical System robotic technology was approved for surgical procedures in the year 2000. Several recent meta-analyses and systematic reviews have shown a significant difference in outcomes between robotic and laparoscopic rectal cancer surgery. However, these results from pooled data have not been supported by the initial results reported from the Robotic assisted versus laparoscopic assisted resection for rectal cancer trial. In this article, we examine the current evidence for robotic colorectal surgery, assess its features and functionality, evaluate its learning curve and provide our perspective on its future.

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Colorectal Cancer in Young and Older Adults in Uruguay: Changes in Recent Incidence and Mortality Trends

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158232 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8232

Author(s):

Carina Musetti ◽

Mariela Garau ◽

Rafael Alonso ◽

Marion Piñeros ◽

Isabelle Soerjomataram ◽

...

Keyword(s):

Colorectal Cancer ◽

Older Adults ◽

Cancer Incidence ◽

Age Groups ◽

Incidence Rates ◽

Mortality Trends ◽

Screening Programs ◽

Lifestyle Risk Factors ◽

Incidence And Mortality ◽

Colorectal Cancer Incidence

Uruguay has the highest colorectal cancer incidence rates in Latin America. Previous studies reported a stable incidence and a slight increase in mortality among males. We aimed to assess colorectal cancer incidence (2002–2017) and mortality trends (1990–2017) by age groups and sex, using data from the National Cancer Registry. Annual percent changes (APCs) were estimated using joinpoint regression models. We included 27,561 colorectal cancer cases and 25,403 deaths. We found an increasing incidence among both males and females aged 40–49, with annual increases of 3.1% (95%CI: 1.21–5.03) and 2.1% (95%CI: 0.49–3.66), respectively, and an increasein the rate in older males (70+) of 0.60% (95%CI: 0.02–1.20) per year between 2002 and 2017. Mortality remained stable among those younger than 50, whereas it decreased for older females aged 50–69 and 70+ (APC: −0.61% (−1.07–0.14) and −0.68% (−1.02–0.34), respectively), and increased for the oldest males (70+; APC: 0.74 (0.47–1.01)). In conclusion, we found rising colorectal cancer incidence accompanied by stable mortality in young adults. Sex disparities were also found among the older adults, with a more favorable pattern for females. Exposures to dietary and lifestyle risk factors, and inequalities in access to and awareness of screening programs, are probably among the main underlying causes and deserve further investigation.

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SP1.1.16Endoscopic evaluation after acute colonic diverticulitis: Review of literature

British Journal of Surgery ◽

10.1093/bjs/znab361.011 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Hazim A. Eltyeb ◽

Sriram Subramonia

Keyword(s):

Colorectal Cancer ◽

Confidence Interval ◽

Acute Diverticulitis ◽

Significant Risk ◽

Acute Attack ◽

Current Evidence ◽

Colonic Diverticulitis ◽

Endoscopic Evaluation ◽

Medical Societies ◽

Meta Analyses

Abstract Aim To compare the current evidence for routine endoscopic evaluation of the colon after an episode of acute diverticulitis against existing guidelines in the United Kingdom. Methodology A systematic literature search of Medline, Embase and Cochrane databases was performed using keywords “Diverticular disease”, “Diverticulitis”, “acute”, “Colorectal Cancer” and “endoscopy”. Recommendations from guidelines of specialist medical societies were reviewed. Available literature was explored to assess the risk of colorectal cancer in patients presenting with acute diverticulitis. Results The most recent UK guideline (Royal College of Surgeons Commissioning guide 2014 supported by ACPGBI) recommends the routine evaluation of colonic lumen after resolution of an acute attack of diverticulitis. More recent guidelines from specialist medical societies (European Society of Coloproctology 2020, World Society of Emergency Surgery 2020, European Association for Endoscopic Surgery and Society of American Gastrointestinal and Endoscopic Surgeons 2018) do not recommend routine endoscopic evaluation after recovery from uncomplicated colonic diverticulitis. Two meta-analyses as well as three large cohort studies showed no significant risk of colorectal cancer ((1.22% (95% confidence interval 0.63-1.97) and (0.7%; confidence interval 0.3%−1.4%)) following uncomplicated acute diverticulitis. Conclusion Existing UK guidance on routine colonic luminal evaluation after resolution of acute diverticulitis should be revised based on current evidence.

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Abstract P060: Major Dietary Risk Factors for Chronic Diseases: A Systematic Review of the Current Evidence for Causal Effects and Effect Sizes

Circulation ◽

10.1161/circ.125.suppl_10.ap060 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Shahab Khatibzadeh ◽

Renata Micha ◽

Ashkan Afshin ◽

Mayuree Rao ◽

Mohammad Y Yakoob ◽

...

Keyword(s):

Risk Factors ◽

Dose Response ◽

Convincing Evidence ◽

Dietary Factors ◽

Causal Effects ◽

Effect Sizes ◽

Current Evidence ◽

Dietary Risk Factors ◽

Dietary Risk ◽

Meta Analyses

Background: Diet habits contribute to development of CVD and diabetes. Estimating the impact of diet on these diseases requires identification and quantification of causal effects of dietary factors. Objectives: To assess major dietary risk factors for CVD and diabetes, evaluate current evidence for causal effects, and identify the best unbiased effect estimates on risk. Methods: For multiple dietary risk factors, we evaluated WHO and similar criteria as part of the Global Burden of Diseases (GBD) study to assess probable or convincing evidence for causal effects, including consistency, dose-response, plausibility, and temporality. We performed systematic searches of online databases from 2008 to 2011, including hand-searches of references and author contacts, to identify systematic reviews and meta-analyses of well-designed observational or interventional studies. Meta-analyses were evaluated based on number of studies, design, definition of diet factors and outcomes, sample size, number of events, length of follow-up, statistical methods, evidence of bias, and control for confounders. Meta-analyses with largest numbers of studies and events and least evidence for bias were identified. Effect sizes and uncertainty were quantified per defined units of exposure, including pooling of categorical dose-response estimates using fixed-effects generalized least squares for trend estimation (GLST). Results: We identified 15 dietary risk factors having probable or convincing evidence of causal effects on CVD or diabetes. For 13, data were identified to provide the best pooled unbiased effect size on disease (Table). Conclusions: This systematic evaluation provides the best evidence-based quantitative estimates of the effects of major dietary factors on CVD and diabetes. These findings enable estimation of quantitative impacts on diseases burdens of suboptimal intakes of these factors in specific populations, and also highlight gaps in knowledge related to causality or effect sizes of other dietary factors.

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The Prevalence and Incidence of Congenital Phenylketonuria in 59 Countries: A Systematic Review

Journal of Pediatrics Review ◽

10.32598/jpr.9.2.826.2 ◽

2021 ◽

Vol 9 (2) ◽

pp. 83-96

Author(s):

Nastaran Mojibi ◽

◽

Shabnam Ghazanfari-Sarabi ◽

Seyed Mohammad Bagher Hashemi-Soteh ◽

◽

...

Keyword(s):

Systematic Review ◽

Financial Burden ◽

Incidence Rates ◽

Management Program ◽

Screening Programs ◽

Related Data ◽

Current Systematic Review ◽

High Prevalence ◽

Shed Light

Context: Phenylketonuria (PKU) is the most frequent inborn error of metabolism, in which newborns cannot metabolize phenylalanine to tyrosine. Increased phenylalanine in untreated patients with PKU can cause serious intellectual disability; its onerous financial burden also falls on societies. This review study aimed to systematically indicate the frequency of PKU worldwide. We also intended to highlight the global prevalence of PKU, which might shed light on better clinical management and screening programs. Methods: In this systematic review, two electronic databases, including PubMed and ScienceDirect were searched for the related literature using relevant keywords: “Phenylketonuria” or “PKU” and “Prevalence” or “Incidence” and “Iran” or “Middle East” or “Europe” or “America” or “Asia.” Accordingly, 4306 reports conducted on PKU from January 2007 to December 2018 were retrieved. With the removal of 44 duplicated publications, 44 reports were included in the current systematic review. Prevalence and incidence rates were categorized based on different continents in which nations used various NBS programs to report the incidence and prevalence of PKU. Non-English, non-eligible, duplicated, animal, and in vitro studies are excluded. Results: Based on the reported quantitative data, the prevalence of PKU diagnosed worldwide ranged from 0.00044% to 0.02736% in which Italy possessed the highest prevalence; however, Thailand manifested the lowest prevalence rate. However, for some countries, such as India or Finland, either the related data to the frequency of PKU was outdated or overlooked applying any newborn screening programs respecting PKU. Conclusions: The current study revealed an elevated prevalence of PKU in Iran, compared with other Asian countries; thus, it demands a more serious management program. Moreover, the high prevalence of PKU in European countries should not be underestimated.

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