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Breast Cancer

Shining a Light on Skin Cancer Risk: Misconceptions and Sociodemographic Factors

Experiencing five or more severe sunburns between the ages of 15 and 20 increases the risk of melanoma by 80% and nonmelanoma skin cancer by 68%. This study is among the few to examine the relationship between perceived cancer risk, concern about being diagnosed, confidence in health, sunburn history, and the prevalence of sun protection behaviors, all in relation to sociodemographic factors in U.S. adults. Findings reveal statistically significant associations between the number of sunburns and sociodemographic factors.

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The most common cancer in the United States is skin cancer, with millions of non-melanoma cases and tens of thousands of melanomas diagnosed annually. Treating skin cancer costs the U.S. approximately $8.9 billion annually. Those at higher risk include individuals with fair skin, a history of sun exposure or tanning bed use, and a genetic predisposition.

A study by researchers at Florida Atlantic University’s Charles E. Schmidt College of Medicine explored associations between reported number of sunburns and sociodemographic characteristics, examining prevalence of protective skin behaviors adopted by the U.S. adult population in a nationally representative sample.

According to the American Academy of Dermatology, experiencing five or more blistering sunburns between ages 15 and 20 increases one’s melanoma risk by 80% and nonmelanoma skin cancer risk by 68%.

Using data from the U.S. National Cancer Institute’s 2022 Health Information National Trends Survey 6 (HINTS 6), researchers selected questions focused on respondents’ confidence in their health, perceived cancer risk, and worry about getting diagnosed with cancer, as well as their sunburn experiences over the past year.

Among 6,252 participants surveyed, most respondents felt either very confident (44%) or completely confident (27.3%) about their ability to take good care of their own health. Findings also showed that most respondents had moderate concerns about skin cancer risk, with only 9.1% reporting being extremely worried, while the majority were either somewhat (26.6%) or slightly (25.6%) concerned.

For sunburn and skin protection, 67.6% reported no sunburns in the past year, while 30.3% had 1-5 sunburns. Additionally, 6.4% reported consuming alcohol while sunburned, a known risk factor for increased sunburn incidence.

Using multinomial regression analysis, statistically significant associations were reported between the number of sunburns and sociodemographic factors. Adults (over 40) had lower sunburn risks, as did women. Disabled, unemployed, and multi-occupation participants reported fewer sunburns. Married or partnered individuals had higher risks of sunburn, while divorced or single participants had lower risks.

Higher education levels, being Hispanic, Black, Asian or of mixed race were linked to lower sunburn risks. Higher income groups had significantly higher risks of sunburns, with the highest income group being more than four times more likely to report a sunburn.

“Social determinants such as race/ethnicity, sex, income and employment status are closely linked to sunburn and skin cancer risk,” said Lea Sacca, Ph.D., senior author and assistant professor of medicine at Florida Atlantic University. “Our study underscores the importance of raising awareness about skin cancer susceptibility as we found that all sociodemographic factors were significantly linked to the number of reported sunburns in the past year.”

According to the American Cancer Society and other health organizations, practicing sun safety and skin awareness is vital to preventing skin cancer. Regularly applying a broad-spectrum sunscreen with an SPF of 30 or higher, especially when spending time outdoors, and reapplying every two hours is essential as a first step for skin cancer prevention.

Avoiding direct sunlight, particularly between 10 a.m. and 4 p.m., when UV rays are strongest, and seeking shade whenever possible are also additional preventive strategies to consider to reduce the risk of this disease. Moreover, protecting skin further by wearing long-sleeve clothing, wide-brimmed hats and sunglasses with 100% UVA/UVB protection has also been recommended.

It’s also crucial to avoid tanning beds, as they increase the risk of skin cancer. Regular self-exams of the skin for any unusual moles or changes, along with professional skin screenings by a dermatologist, can help with early detection.

Surfaces like water, sand and snow also can reflect UV rays, so reapply sunscreen more frequently in these environments. Finally, staying hydrated supports skin health and resilience against UV damage.

The study co-authors include Nada Eldawy; Sahar Kaleem; Austin Lent; Adrienne Dean; Ayden Dunn; Paige Brinzo; and Samantha Jimenez, all medical students in the Schmidt College of Medicine at Florida Atlantic University.

Air Quality

Early-Life Exposure to Air and Light Pollution Linked to Increased Risk of Pediatric Thyroid Cancer

A new study suggests that early-life exposure to two widespread environmental pollutants — small particle air pollution and outdoor artificial light at night — could increase the risk of pediatric thyroid cancer. The study found a ‘significant association’ between exposure to ambient fine particulate matter air pollution (PM2.5) and outdoor artificial light at night (O-ALAN) and increased risk of papillary thyroid cancer in children and young adults up to 19 years old. The exposures occurred during the perinatal stage of life, typically defined as the time from when pregnancy occurs up to a year after birth.

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The study, led by researchers at Yale University, has shed new light on the potential link between early-life exposure to air and light pollution and an increased risk of pediatric thyroid cancer. The findings are concerning, especially given how widespread these exposures are.

The research team analyzed data from 736 individuals diagnosed with papillary thyroid cancer before age 20 and 36,800 matched control participants based on birth year. Using advanced geospatial and satellite modeling, the team assessed individual-level exposure to fine particulate matter air pollution (PM2.5) and outdoor artificial light at night (O-ALAN). The results showed that for every 10 micrograms per cubic meter increase in PM2.5 exposure, the odds of developing thyroid cancer rose by 7% overall.

The strongest association between exposure and thyroid cancer was found among teenagers (15-19 years of age) and Hispanic children. Children born in areas with high levels of O-ALAN exposure were 23-25% more likely to develop thyroid cancer. The study’s lead author, Dr. Nicole Deziel, emphasized that these results are concerning and highlight the importance of addressing environmental factors in childhood cancer research.

Thyroid cancer is among the fastest-growing cancers among children and adolescents, yet we know very little about what causes it in this population. This study suggests that early-life exposure to PM2.5 and O-ALAN may play a role in this concerning trend. The impact of papillary thyroid cancer on children can be extensive, with survivors often suffering from aftereffects such as temperature dysregulation, headaches, physical disabilities, and mental fatigue.

Both PM2.5 and O-ALAN are considered environmental carcinogens that have been shown to disrupt the body’s endocrine system, including thyroid function, in animals and adults. The particles associated with PM2.5 pose a threat because they are small enough to enter the bloodstream and can interfere with hormone signaling, including those involved in regulating cancer pathways.

The current research raises important environmental justice concerns. Communities of color and lower-income populations are often disproportionately exposed to both air pollution and light pollution – inequities that may contribute to the higher thyroid cancer burden observed in Hispanic children.

In conclusion, this study highlights the need for more work to replicate and expand on these findings, ideally using improved exposure metrics and longitudinal designs. In the meantime, the results point to the critical importance of addressing environmental factors in childhood cancer research. Reducing exposures to air pollution and managing light pollution could be important steps in protecting children’s health.

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Breast Cancer

Mapping the Origins of Stomach Cancer: Uncovering Early Mutations and Risk Factors

Researchers have made significant advancements in understanding the earliest stages of stomach cancer, a leading cause of cancer-related deaths worldwide, through two recent innovative studies. With a prevalence rates particularly high in East Asia, including China, this cancer often stems from chronic inflammation caused by Helicobacter pylori infection, which affects approximately 15% of the Hong Kong population. This inflammation can lead to a pre-cancerous stage known as intestinal metaplasia. The innovative studies have uncovered crucial insights into the earliest changes in the stomach that contribute to the development of stomach cancer, laying the foundation for improved prevention and early detection, ultimately saving lives.

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The researchers at the Department of Pathology, School of Clinical Medicine at the LKS Faculty of Medicine of the University of Hong Kong (HKUMed) have made significant strides in understanding the earliest stages of stomach cancer, a leading cause of cancer-related deaths worldwide. Through two innovative studies, they have uncovered crucial insights into the early changes in the stomach that contribute to the development of stomach cancer, laying the foundation for improved prevention and early detection.

While the stomach’s acidic environment aids digestion, it can induce cancer-causing mutations in normal stomach tissues as individuals age. However, the timing and mechanisms of these early changes and how they promote the progression to cancer remain largely unknown. The HKUMed researchers provided valuable insights into these processes.

Mapping the Origins of Stomach Cancer

In a collaborative study, researchers from HKUMed, the Wellcome Sanger Institute, and the Broad Institute of MIT and Harvard analyzed genetic mutations in normal stomach lining tissue using advanced genome sequencing. For the first time, they sequenced whole genomes from 238 samples and performed targeted sequencing on an additional 829 samples from individuals with and without stomach cancer in Hong Kong, the US, and the UK.

The study revealed that despite the stomach’s harsh acidic environment, the stomach lining has protective mechanisms that prevent significant mutations. The researchers found that the number of mutations increases with age, with normal stomach glands accumulating approximately 28 mutations annually. In stomach cancer patients, the mutation rate is more than double, especially in the metaplastic glands.

Professor Leung Suet-yi, co-lead author of the research and Chairperson of the Department of Pathology, School of Clinical Medicine, HKUMed, said, “By age 60, nearly 10% of the stomach lining has mutations in known cancer genes, highlighting a gradual accumulation of potential cancer-causing changes over decades. The most surprising finding was that some stomach regions exhibited chromosome abnormalities linked to chronic inflammation.”

Risk Factors and Pre-cancer Model

The researchers identified risk factors for stomach cancer, including smoking, excessive alcohol drinking, a high salt diet, and a Helicobacter pylori infection. Professor Leung elaborated, “Our multinational team found that individuals with long-term stomach inflammation had significantly more mutations or extra chromosomes, indicating the potential role of inflammation in shaping a pre-cancer environment from an early age.”

World’s First Biobank of ‘Intestinal Metaplasia’ Organoid Models

In a related study, researchers from HKUMed and the InnoHK Centre for Oncology and Immunology investigated intestinal metaplasia (IM) in which stomach cells are transformed to resemble intestine cells. This transformation significantly increases the risk of developing stomach cancer, but the process remains poorly understood.

Co-led by Professor Helen Yan Hoi-ning, Assistant Professor in the Department of Pathology at HKUMed, and Professor Suet Yi Leung, the study used organoid culture to make a 3D model of IM. Organoids, tiny versions of organs grown in the lab from a patient’s tissue, provide a realistic model for studying the progression of IM to cancer.

The study revealed that IM organoids contain ‘hybrid’ cells with a mix of both stomach and intestinal characteristics. Typically associated with cancer cells, these traits facilitate tissue spread and make identifying early warning signs crucial. Professor Yan explained, “Using organoid technology, we can identify early changes when stomach cells become pre-cancerous.”

Harnessing Innovation for Early Detection and Prevention

By uncovering the earliest mutations and risk factors associated with stomach cancer and developing a sophisticated pre-cancer model, these studies offer invaluable insights for current prevention and early detection strategies. Professor Leung Suet-yi said, “With a living cell model now available, the potential for drug development to reverse IM becomes increasingly achievable.”

These breakthroughs provide new hope in the fight against stomach cancer, potentially transforming patient outcomes and clinical practices. The findings of these studies have significant implications for the prevention and early detection of stomach cancer, offering new avenues for research and treatment that can improve patient lives worldwide.

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Brain Tumor

Gene-Based Blood Test for Melanoma May Catch Early Signs of Cancer’s Return

Monitoring blood levels of DNA fragments shed by dying tumor cells may accurately predict skin cancer recurrence, a new study shows.

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The study, led by researchers at NYU Langone Health and its Perlmutter Cancer Center, has made a groundbreaking discovery that could change the way melanoma is diagnosed and treated. The researchers have found that monitoring blood levels of DNA fragments shed by dying tumor cells may accurately predict skin cancer recurrence in stage III melanoma patients.

The study showed that approximately 80% of stage III melanoma patients who had detectable levels of circulating tumor DNA (ctDNA) before they started treatment to suppress their tumors went on to experience recurrence. The researchers also found that the disease returned more than four times faster in this group than in those with no detectable levels of the biomarker, and the higher their levels, the faster cancer returned.

“Our findings suggest that circulating tumor DNA tests could help oncologists identify which melanoma patients are most likely to respond well to therapy,” said study lead author Mahrukh Syeda. “In the future, such assessments may be used routinely in the clinic to help guide treatment decisions.”

The research team also found that nearly all of those with detectable levels of ctDNA at three, six, nine, or 12 months into treatment experienced melanoma recurrence. This suggests that if the gene fragments are not observable prior to therapy but appear later on, this could indicate that the disease might be worsening.

The study’s senior author, David Polsky, notes that in some cases, cancer still recurred even though the patient had received a negative ctDNA test before starting therapy. To address this, the authors next plan to improve the sensitivity of their test and explore whether using the biomarker to make treatment decisions can indeed improve patients’ chances of survival and quality of life.

The study’s findings have significant implications for melanoma patients and could potentially save lives by providing early feedback on treatment progress and cancer growth. The researchers are now planning to further investigate the use of ctDNA tests in clinical settings, which could lead to more targeted and effective treatments for this aggressive form of skin cancer.

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