The non-fatal burden of cancer in Belgium, 2004–2019: a nationwide registry-based study

Background The importance of assessing and monitoring the health status of a population has grown in the last decades. Consistent and high quality data on the morbidity and mortality impact of a disease represent the key element for this assessment. Being increasingly used in global and national burden of diseases (BoD) studies, the Disability-Adjusted Life Year (DALY) is an indicator that combines healthy life years lost due to living with disease (Years Lived with Disability; YLD) and due to dying prematurely (Years of Life Lost; YLL). As a step towards a comprehensive national burden of disease study, this study aims to estimate the non-fatal burden of cancer in Belgium using national data. Methods We estimated the Belgian cancer burden from 2004 to 2019 in terms of YLD, using national population-based cancer registry data and international disease models. We developed a microsimulation model to translate incidence- into prevalence-based estimates, and used expert elicitation to integrate the long-term impact of increased disability due to surgical treatment. Results The age-standardized non-fatal burden of cancer increased from 2004 to 2019 by 6 and 3% respectively for incidence- and prevalence-based YLDs. In 2019, in Belgium, breast cancer had the highest morbidity impact among women, followed by colorectal and non-melanoma skin cancer. Among men, prostate cancer had the highest morbidity impact, followed by colorectal and non-melanoma skin cancer. Between 2004 and 2019, non-melanoma skin cancer significantly increased for both sexes in terms of age-standardized incidence-based YLD per 100,000, from 49 to 111 for men and from 15 to 44 for women. Important decreases were seen for colorectal cancer for both sexes in terms of age-standardized incidence-based YLD per 100,000, from 105 to 84 for men and from 66 to 58 for women. Conclusions Breast and prostate cancers represent the greatest proportion of cancer morbidity, while for both sexes the morbidity burden of skin cancer has shown an important increase from 2004 onwards. Integrating the current study in the Belgian national burden of disease study will allow monitoring of the burden of cancer over time, highlighting new trends and assessing the impact of public health policies.

Immunotherapy in skin cancers - A narrative review

Immunotherapy, in the context of cancers, involves the use of various drugs to stimulate the immune system to target cancer cells. Immunotherapy is being increasingly used for cutaneous malignancies, especially melanoma. Immunity plays an important part in protection against cancer. One of the factors limiting the effectiveness of host immunity is improper recognition of cancer cells. Sometimes, despite recognizing the cancer cells as abnormal, the immune response, for various reasons might not be strong enough to deal effectively with the cancer cells. Immunotherapy basically tries to address the two points mentioned above by improving the capacity of the immune system to recognize and effectively destroy cancer cells. In skin cancers, immunotherapy is best established for melanomas, but is increasingly being used for non-melanoma skin cancers too. This article reviews some of the general concepts about immunotherapy in cancer and discusses in detail, the available options and future possibilities in the applications of immunotherapy in skin cancer.

Somatic Mutations in TP53 Gene in Colombian Patients With Non-melanoma Skin Cancer

Background/Aim: Non-melanoma skin cancer is the most common cancer in the world. Somatic mutations in the TP53 gene are associated with the development of this cancer. To describe mutations in exons 5-8 of the TP53 gene in a sample of Colombian patients with non-melanoma skin cancer. Materials and Methods: One hundred and fifteen patients with non-melanoma skin cancer were included. Exons 5-8 were amplified and analyzed by PCR-High Resolution Melting and Sanger sequencing. Results: Fifty-seven patients with basal cell carcinomas and 58 with squamous cell carcinomas were studied. 16% of patients with basal cell carcinoma and 26% of patients with squamous cell carcinoma had mutations in the TP53 gene. The most frequent mutations were substitutions, while three patients had deletions. The most frequent mutation was p.R158G. Conclusion: The analysis showed that Colombian individuals with non-melanoma skin cancer have genetic TP53 variants different from those reported as recurrent for this disease.

Metastatic basal cell carcinoma: A report of two cases and a review of the literature

Basal cell carcinomas (BCCs) are among the most common non-melanoma skin cancers in the world. However, given their slowly progressive nature, metastatic BCCs are a relatively uncommon entity. Below, we discuss two separate cases of metastatic BCC that we encountered in our clinical practice. The first is the case of a 57-year-old male with a right cheek BCC and bilateral pulmonary metastases. The second is the case of a 71-year-old male who also presented with a right BCC and pulmonary metastases. We discuss their altered clinical courses. We also conducted a review of the literature focusing on the use of the relatively novel hedgehog inhibitors as a treatment option for individuals diagnosed with metastatic BCC.

Aplikasi Mobile Deteksi Dini Kanker Kulit Berdasarkan Image Processing

Currently, between 2 and 3 million non-melanoma skin cancers and 132,000 melanoma skin cancers occur globally each year (WHO, 2017). Skin cancer is one type of cancer that can cause death for many people. Because of this, an application is needed to easily detect skin cancer early that the cancer can be handled with more quickly. Besides, consultations with dermatologists have better prognosis (Avilés-Izquierdo et. al., 2016). Due to that, we built an early skin cancer detection application with dermatologist consultation. Our application helps to diagnose skin cancer before it grows into a life-threatening condition and is crucial to preserving lifestyle, future health, and aesthetics. Besides, thanks to online doctor consultations we have, however, getting diagnosed, prescribed and treated for your issues without spending time travelling to and from the doctors and waiting in queues can be just as effective. We used three management techniques such as machine learning to create data pipelines, build a model, and convert the model to TensorFlow lite with post-training quantization. Android to deploy the TensorFlow lite model and create the application. The application has a real-time connection using firebase. Moreover, cloud to create a simple database for doctor and diagnosis services on firebase.

Analysis of the Histopathological Profile and Surgical Margins Resulting from Resection of Nonmelanoma Skin Cancers

: Introduction: Non-melanoma skin cancer is a group of malignant neoplasms composed basically by sarcomas, basal cell carcinoma and squamous cell carcinoma. Its etiology is multifactorial with specificity for each of the two types, except for exposure to ultraviolet radiation, which is a common factor between both. When detected early, it has a high cure rate, and surgical excision with safety margins being the treatment of choice in most cases. Thus, it is important to recognize the profile of the patients, as well as the histopathological characteristics of the lesions and the medical approach used to avoid recurrences. Purpose: This study aimed to analyze the histopathological profile and surgical margins resulting from the resection of non-melanoma skin cancers in patients treated at a plastic surgery facility in Brazil. Methods: The cases of squamous cell carcinoma and the histopathological types of the basal cell carcinoma were individually analyzed for compromised margins, and later divided into a low-risk group and a high-risk group. Results: 228 lesions were resected from 141 patients. Gender distribution was 55.3% female and 44.6% male. The most affected age group was over 70 years old. The predominant histological type was basal cell carcinoma (74.6%) followed by squamous cell carcinoma (25.4%); the most affected site was the cephalic-cervical segment (71.92%). Surgical margins were compromised in 12.3% with no significant difference between the two types of carcinoma. Conclusion: There was a predominance of basal cell carcinoma (nodular type) in women over 40 years old, predominantly in the cephalic-cervical region. The number of recurrences was proportionally higher in the BCC, unrelated to the presence of positive margins. Keywords: Skin Neoplasms, Basal Cell Carcinoma, Squamous Cell Carcinoma, Recurrence, Margins of Excision.

Preoperative AI-Driven Fluorescence Diagnosis of Non-Melanoma Skin Cancer

The diagnosis and treatment of non-melanoma skin cancer remain urgent problems. Histological examination of biopsy material—the gold standard of diagnosis—is an invasive procedure that requires a certain amount of time to perform. The ability to detect abnormal cells using fluorescence spectroscopy (FS) has been shown in many studies. This technique is rapidly expanding due to its safety, relative cost-effectiveness, and efficiency. However, skin lesion FS-based diagnosis is challenging due to a number of single overlapping spectra emitted by fluorescent molecules, making it difficult to distinguish changes in the overall spectrum and the molecular basis for it. We applied deep learning (DL) algorithms to quantitatively assess the ability of FS to differentiate between pathologies and normal skin. A total of 137 patients with various forms of primary and recurrent basal cell carcinoma (BCC) were observed by a multispectral laser-based device with a built-in neural network (NN) “DSL-1”. We measured the fluorescence spectra of suspected non-melanoma skin cancers and compared them with “normal” skin spectra. These spectra were input into DL algorithms to determine whether the skin is normal, pigmented normal, benign, or BCC. The preoperative differential AI-driven fluorescence diagnosis method correctly predicted the BCC lesions. We obtained an average sensitivity of 62% and average specificity of 83% in our experiments. Thus, the presented “DSL-1” diagnostic device can be a viable tool for the real-time diagnosis and guidance of non-melanoma skin cancer resection.

Immune Checkpoint Inhibition in Non-Melanoma Skin Cancer: A Review of Current Evidence

Immuno-oncology is a rapidly evolving field with growing relevance in the treatment of numerous malignancies. The prior study of immunotherapy in dermatologic oncology has largely focused on cutaneous melanoma. However, recent focus has shifted to the use of immunotherapy to treat non-melanoma skin cancers (NMSCs), such as basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (cSCC), and Merkel cell carcinoma (MCC). NMSCs represent the most ubiquitous cancers globally and, while they have a lower propensity to develop into advanced disease than cutaneous melanoma, their absolute mortality burden has recently surpassed that of melanoma. Patients with advanced NMSC are now benefiting from the successes of immunotherapy, including checkpoint inhibition with anti-CTLA-4 and anti-PD-1 monoclonal antibodies. In this review, we discuss the existing clinical evidence for immunotherapy in the treatment of NMSCs, with an emphasis on checkpoint inhibitor therapies. We highlight key studies in the field and provide up-to-date clinical evidence regarding ongoing clinical trials, as well as future study directions. Our review demonstrates that checkpoint inhibitors are positioned to provide unparalleled results in the previously challenging landscape of advanced NMSC treatment.