Risk factors for malignant melanoma in an Icelandic population sample

OBJECTIVES: To describe the constitutional risk factors for malignant melanoma and exposure to sunlight in a population sample in Iceland. METHODS: Information on various risk factors for malignant melanoma was collected through mailed questionnaires sent to a random sample of the Icelandic population. The information collected was the first phase of a prospective study on malignant melanoma among aircrew members as compared to a population sample. RESULTS: The overall participation rate was about 50%. Seven percent of women and six percent of men had red hair color. Blue or green eye color was reported among 89% of women and 87% of men. Sixteen percent of women aged 20 to 39 had used sun beds more than 100 times during their lifetime, while the corresponding figure was 12% for men of the same age. Younger age groups had more sunny vacations than the older age groups. The frequency of sunburn differed in the groups with reported different skin types according to Fitzpatrick classification. CONCLUSION: The high prevalence of sun bed usage among young women is concurrent with the increased incidence of malignant melanoma among young women registered in the nationwide cancer registry. Young people have more often used sun beds and taken sunny vacation than the older, indicating a changed behavior in the population.     

Risk factors of malignant skin melanoma in Italian population: review of results of a case-control study

Cutaneous melanoma incidence rates are rapidly increasing worldwide, including in the Mediterranean countries. Sunlight exposure has been associated with melanoma, but the mechanisms of UV radiation-induced carcinogenesis is still largely unknown. In mammalian cells, UV radiation induces DNA damage that can be repaired mostly by the nucleotide excision repair system. We summarize here the results of a case-control study conducted at the Bufalini Hospital in Cesena, Italy to assess host and environmental risk factors for melanoma. We recruited 183 incident cutaneous melanoma cases and 179 controls selected predominantly among partners or close friends of the cases. Presence of dysplasticlatypical nevi (OR: 4.2; 95% CI: 2.4-7.4), low propensity to tan (OR: 2.4; 95% CI 1.1-5.0), light skin (OR: 4.1; 95% CI: 1.4-12.1), and light eye color (OR: 2.4; 95% CI: 1.1-5.2) were the strongest risk factors for melanoma in this population. A chart identifying melanoma risk associated with multiple combinations of these factors is presented. We used the host-cell reactivation assay on subjects' lymphocytes to measure individual DNA repair capacity (DRC) after UV-induced DNA damage. Subjects with low tanning ability and low DRC had a higher melanoma risk (OR: 8.6; 95% CI: 2.7-27.5) than those with higher tanning ability and high DRC. Subjects with dysplastic nevi and low DRC had a higher risk (OR: 6.7; 95% CI: 2.4-18.6) than those lacking dysplastic nevi and with high DRC. These results may help identify high-risk subjects in the Mediterranean populations who would the benefit from preventive measures.     

Risk factors for legal involvement among a nationally representative sample of Hispanic adolescents

Adolescent legal involvement is a public health concern nationwide. Despite the existing national limits of arrest data by Hispanic origin, previous research has found that minority youth are at increased risk for being confined. The purpose of our study was to investigate whether sex, age, authoritarian parenting, school experiences, depression, recent alcohol use, binge drinking and perceived social norms predicted legal involvement among Hispanic adolescents aged 12–17 years old nationwide. Legal involvement was operationally defined as ever being arrested, on parole or on probation. A secondary data analysis of the 2012 National Survey on Drug Use and Health (NSDUH) was conducted including a total of 3,457 U.S. Hispanic adolescents. First, unadjusted odds ratios were computed by conducting a univariate logistic regression analyses. Then, all variables that were significant in the univariate logistic regression analyses were retained and included in a final multiple logistic regression model. A total of 7.6% of Hispanic adolescents reported legal involvement. Unadjusted odds ratios indicated that sex, age, authoritarian parenting, school experiences, depression, recent alcohol use, binge drinking and perceived student use of alcohol were statistically significant predictors of legal involvement. All variables were subsequently retained and included in the final multiple regression models. The final multiple regression model significantly predicted legal involvement. Specifically, results indicated Hispanic adolescents at increased risk for legal involvement were males, aged 16–17 years, experienced authoritarian parenting, had negative school experiences and recently used alcohol. The combined influence of predictors on legal involvement for Hispanic adolescents was explored. Based on study findings, intervention programs should target all Hispanic youth, especially males and aged 14–17 years, to effectively address this problematic behaviour. Families, schools, communities and juvenile justice systems should work together to decrease illegal involvement among Hispanic adolescents.     

Varicella seroprevalence in a random sample of the Turkish population

Chicken pox highly contagious and common throughout the world, is an infectious disease caused by varicella zoster virus (VZV). This study was conducted to determine the seroprevalence of VZV in a population under age 30 and to identify the relationship of VZV seroprevalence and several characteristics of the study subjects in nine provinces of Turkey. The sampling method of 30 clusters recommended for field studies was used for selecting subjects of a pre-determined number in the rural and urban areas in each province. For this, a total of 60 groups, 30 clusters in the rural and 30 in the urban areas were determined. It was planned that a total of 4800 subjects, including 600 subjects from five big provinces (Istanbul, Ankara, Izmir, Adana, Diyarbakir) and 450 subjects from the remaining smaller provinces (Samsun, Erzurum, Trabzon, Edirne), be included in the study. ELISA method was used to examine the blood samples for VZV seropositivity. Positive VZV seroprevalence was detected in 77.8% of 4387 subjects under age 30 in nine provinces of Turkey. There was no difference in seroprevalence rate between rural and urban areas. Seroprevalence was found to be 79.0% in urban areas and 76.3% in rural areas. Seroprevalence increased with age. Seroprevalence was 20% at the age of 1 year, subsequently increased to 40% at the age of 4 years, 60% at the age 6 years, 80% at the age of 8 years, 85% at the age of 10 years, and then remained at 85-90% in subjects over the age of 10 years. In order to develop vaccination protocols and take appropriate preventive health care measures against diseases in different countries, it is very important to know the seroprevalence of any disease for an individual country.     

Risk factors for inguinal hernia among adults in the US population

The authors examined risk factors for incident inguinal hernia among US adults (5,316 men and 8,136 women) participating in the First National Health and Nutrition Examination Survey (1971-1975) who were followed through 1992-1993 for a hospital (International Classification of Diseases, Ninth Revision, Clinical Modification, code 550) or physician diagnosis of inguinal hernia. Ninety-six percent of the baseline cohort was recontacted, with a median follow-up of 18.2 years (range, 0.02-22.1 years). Because the cumulative incidence of inguinal hernia was higher among men (13.9%) than among women (2.1%), more detailed analyses were conducted in men. Among men in multivariate analysis, a higher incidence (p < 0.05) of inguinal hernia was associated with an age of 40-59 years (hazard ratio (HR) = 2.2, 95% confidence interval (CI): 1.7, 2.8), an age of 60-74 years (HR = 2.8, 95% CI: 2.2, 3.6), and hiatal hernia (HR = 1.8, 95% CI: 1.2, 2.7), while Black race (HR = 0.58, 95% CI: 0.42, 0.79), being overweight (HR = 0.79, 95% CI: 0.66, 0.95), and obesity (HR = 0.51, 95% CI: 0.36, 0.71) were associated with a lower incidence. Among women, older age, rural residence, greater height, chronic cough, and umbilical hernia were associated with inguinal hernia. In the United States, inguinal hernias are common among men, especially with aging. The lower risk among heavier men was unexpected and bears further study.     

Risk and protective factors for depressive symptomatology among a community sample of adolescents and young adults

OBJECTIVES: The study explores the risk and protective factors for current depressive symptomatology in a large community sample of 15-to-24-year-olds. METHODS: The study was designed as a cross-sectional household survey, which used telephone recruitment followed by an anonymous self-report postal questionnaire. The final sample included 3,082 adolescents and young adults from Queensland, Australia. RESULTS: The vast majority of measured risk and protective factors were associated with current depressive symptomatology. Key risk factors included high levels of neuroticism, perceived problems with parents, sexual abuse, relationship break-ups, educational failure and sexual identity conflict. A different profile of protective factors was evident for each of these high-risk groups. Of particular note was the importance of well-developed intrapersonal skills as protective for both males and females. The significance of social connectedness as a protective factor for the males overall and across a range of high-risk groups was a central finding. CONCLUSIONS AND IMPLICATIONS: The implications of these findings in relation to a range of mental health promotion and mental illness prevention and early intervention initiatives are discussed. Supported initiatives include parenting programs that consider the realities of modem families, increasing community awareness of the impact on young people of the breakdown of their intimate relationships, initiatives in educational settings and workplaces to increase tolerance of gay/lesbian and bisexual lifestyles and the enhancement of social connectedness.     

Choice of spread by a random sample of the British population. Association with socio-economic status and risk factors for cardiovascular disease

The usual choice of spread used on bread, and the calculated total amount of fat spread on bread per day, were related to socio-economic and coronary artery disease risk factors in 9003 respondents in the Health and Lifestyle Survey. Butter was the most popular spread, regardless of social group or income. Polyunsaturated margarine and low fat spread were chosen significantly more frequently by those in the higher socio-economic groups and by non-smokers in each group. A past history of heart disease was associated with the choice of polyunsaturated margarine, low fat spread, or no spread at all; this was most apparent in men. No such relationship was found between choice of spread and family history of heart disease or hypertension. Overweight and obese respondents were a little more likely than lean respondents to choose low fat spread or no spread. Men over 60 years consumed less fat, as spread, than younger men, but in women there was a tendency for consumption to increase with age. In both sexes, the non-manual groups consumed less spread than the manual at comparable ages. Smokers in each group consumed significantly more than non-smokers. The amount of spread consumed was not associated with body mass index, a past history or family history of heart disease or previously diagnosed hypertension. These findings suggest that current recommendations to reduce total fat intake and to reduce the proportion of saturated fats used are not being followed, at least in respect of spread, by those at greatest risk of coronary heart disease.     

Risk factors for insomnia in a rural population

PURPOSE: This study compared in one data set the relative importance of most previously examined risk factors for different symptoms of insomnia. METHODS: Data were obtained from personal interviews of 1,588 adults in a rural area. Statistical methods evaluated the association of 42 risk factors with any insomnia and each of four insomnia subtypes: difficulty with initiating sleep (DIS), difficulty maintaining sleep (DMS), early morning awakening (EMA), and restless sleep (RS). RESULTS: Insomnia rates were greater in this rural population than most U.S. studies and greater in the United States than other countries. The correlations between insomnia subtype and energy level was highest for RS, -0.29, and lowest for EMA, -0.11. All sleep disturbances increased monotonically with depressive symptoms, but the increase was greatest for RS (r = 0.57) and weakest for EMA (r = 0.24). Anxiety and pain also were independently associated with each insomnia subtype. Insomnia problems of spouses were uncorrelated. Other risk factors were independently associated with some insomnia subtypes but not others. For example, the association of age with difficulty maintaining sleep was independent of health measures. CONCLUSION: The results suggest that different insomnias have different rates and risk factors and therefore possibly different etiologies and management strategies.     

Dietary patterns among a national random sample of British adults

STUDY OBJECTIVES: To identify groups within the UK male and female population who report similar patterns of diet. DESIGN: National representative dietary survey, using seven day weighed dietary records, of men and women aged 16-64 years living in private households in Great Britain in 1986-7. Cluster analysis was used to aggregate participants into diet groups. SETTING: Great Britain. PARTICIPANTS: 1087 men and 1110 women. RESULTS: 93% of men and 86% of women fell into one of four distinct diet groups. Among men the most prevalent diet group was "beer and convenience food" (34% of the male population); second was "traditional British diet" (18%); third was "healthier but sweet diet" (17.5%) and fourth was "healthier diet " (17%). Among women, the most prevalent diet group was " traditional British diet" (32%); second, was "healthy cosmopolitan diet" (25%); third was a "convenience food diet" (21%); and fourth was "healthier but sweet diet" (15%). There were important differences in nutrient profile, sociodemographic and behavioural characteristics between diet groups. CONCLUSIONS: Cluster analysis identified four diet groups among men and four among women, which differed not only in terms of reported dietary intakes, but also with respect to nutrient, social and behavioural profiles. The groups identified could provide a useful basis for development, monitoring and targeting of public health nutrition policy in the UK.     

Reproductive risk factors for cutaneous melanoma in women: a case-control study

Reproductive hormonal factors may have a potential role in cutaneous melanoma. This study estimated the risk of melanoma in women related to self-reported changes in nevi during pregnancy, while using oral contraceptives and/or hormone replacement therapy. Trained interviewers administered a questionnaire obtaining information about oral contraceptive use, hormone replacement therapy, reproductive history, sun exposure, occupation, and medical history from 318 Caucasian women newly diagnosed between 1991 and 1992 from two pigmented lesion clinics in San Francisco, California, and Philadelphia, Pennsylvania. A total of 395 frequency-matched control participants were recruited from hospital-affiliated outpatient clinics. Clinicians conducted skin examinations to assess the number and type of nevi, extent of freckling, solar damage, and skin type. For women aged less than 55 years, there was an association between a livebirth 5 years before diagnosis (odds ratio = 2.6, 95% confidence interval: 1.3, 5.3) and between number of births and melanoma risk (for > or = 3 births: odds ratio = 3.3, 95% confidence interval: 1.7, 6.5; ptrend < 0.001). Changes in nevi during recent pregnancies were a risk factor for melanoma, based upon small numbers (odds ratio = 2.9, 95% confidence interval: 1.1, 8.1). Oral contraceptive use and hormone replacement therapy were not associated with melanoma risk.     

Reproductive history and cutaneous malignant melanoma: a comparison between women and men

To evaluate whether previously observed associations between parity and cutaneous malignant melanoma (CMM) risk in women reflected a biologic mechanism or resulted from uncontrolled confounding by lifestyle factors associated with parity (e.g., patterns of sun exposure), the authors investigated the effect of reproductive history (parenthood) on CMM risk in both women and men. Using information from Danish national registers (1968-2003), the authors established a population-based cohort of more than 3,500,000 persons with information on parenthood and CMM. Relative risks were estimated using Poisson regression models. Overall, number of children was significantly associated with a woman's risk of CMM (p = 0.004), with the lowest risk being seen among women with many births. Women aged 25 years or older at their first birth had a 24% (95% confidence interval: 16, 33) higher risk of CMM than younger women. Ten or more years after the birth of her youngest child, a woman had a 15% (95% confidence interval: 5, 27) higher risk of CMM than she did in the first 10 years. Similar results were observed in men. The similarity of effects for men and women suggests that lifestyle factors, rather than exposure to pregnancy hormones, may be responsible for the observed associations between reproductive history and CMM risk in women.     

Risk for cutaneous melanoma in recent Connecticut birth cohorts.

Mortality trends suggest that increases in Connecticut incidence for cutaneous melanoma (CM) equal or under estimate increases for the entire country. One-sixth of CM in Connecticut occurs under age 35. In the 1955 birth cohort, modeled incidence rates per 100,000 age-adjusted to the 1960 US population are 38.2 in males and 28.9 in females. These estimated rates for CM rival those for colon cancer (now the third most common malignancy in the United States) and have special implications for young adults.     

Distribution and population determinants of gamma-glutamyltransferase in a random sample of Sardinian inhabitants

The relation of a number of determinants to serum gamma-glutamyltransferase (GGT) was studied in a random sample of Sardinian inhabitants of 2283 males and 2520 females aged 20–59 years. The aim of the study was to assess the influence of environmental, behavioural and biochemical factors on GGT levels. Mean values were higher in males than in females and increased with age in both sexes. In sex-specific multiple regression analysis, GGT showed a positive association with body mass index (BMI), alcohol use, total serum cholesterol (T-C), HDL cholesterol (HDL-C), triglycerides (TG), apolipoprotein B (ApoB) and age, and a negative one with coffee consumption and physical activity in males, while in females the enzyme was positively associated with BMI, alcohol use, age, T -C, ApoB, TG and cigarette smoking. The negative association between coffee drinking and serum GGT observed in males suggests that coffee may inhibit the inducing effects of other factors, particularly alcohol use, on GGT in the liver. No biological mechanism has been suggested to explain the association of GGT with BMI, age or physical activity. This study confirms the importance of GGT as a strong marker for alcohol use; but a number of variables, ranging from life-style to biological characteristics, are also important determinants of its plasma values in the normal population.The ATS-SARDEGNA research group: S. Muntoni, F. Pintus, P. Mascia, P. Pintus, G.F. Cabiddu, P. Tronci, E. Ganga, P.P. Contini, E. Podda, P. Congiu, A. Trudu, G.M. Baule, A. Sanna, D. Onorato, P Mereu, S. Contini, F. Seccareccia, A. Menotti     

Knowledge of health information and services in a random sample of the population of Glasgow

A RANDOM sample of adults in Glasgow was surveyed by trained interviewers to determine public knowledge on four topics chosen specifically for each of four age groups. The topics were: Welfare rights and services; Coronary Heart Disease (CHD) and individual action that can reduce risk; The dangers of smoking in pregnancy; and fluoride and its functions and the connections between good health and habitual behaviour.     

Coronary heart disease risk factors among religious groupings in a Jewish population sample in Jerusalem

The hypothesis that plasma lipids, blood pressure, smoking and dietary intake differed according to degree of religiosity was examined in a sample of Jewish residents of Jerusalem. Religiosity was classified according to the subject's self-ranking of his perceived degree of religiosity. Prevalence of smoking, and plasma levels of cholesterol, triglycerides, and low-density lipoprotein cholesterol were higher in secular participants than in the orthodox group. No differences in blood pressure and in high-density lipoprotein cholesterol were observed. Secular subjects consumed more total fat, more saturated fatty acids and less carbohydrate than religious subjects. These differences in nutrient intake among the religious groups reflected differences in their food selection, notably consumption of dairy products. These findings of parallel differences in plasma lipids and in dietary intake are consistent with the differing incidence of myocardial infarction in the religious groups which has been shown in the Israeli population.     

The association of cutaneous malignant melanoma with the use of sunbeds and sunlamps

Data are presented from a large case-control study (583 cases, 608 controls) to estimate the association of melanoma with the use of sunbeds and sunlamps. Odds ratios of 1.88 and 1.45 were found for ever having used a sunbed or sunlamp in males and females, respectively, which was statistically significant in males and of borderline significance in females. These effects persisted when adjustments were made for age and a variety of potential confounders. The effect was slightly stronger for lentigo maligna and for lesions of the face, head, neck, and arms. The risk was greater and significant for both sexes for domestic use of sunbeds/sunlamps, and increased with duration and amount of use. A comparison of 43 cases interviewed before a diagnosis of melanoma had been made with the other 540 cases suggests that recall bias was not responsible for the association. The authors conclude that use of artificial tanning devices appears to be a risk factor for melanoma.     

The association of cutaneous malignant melanoma and fluorescent light exposure.

Data are presented from an interview case-control study (583 cases and 608 controls), performed in southern Ontario, Canada, from October 1984 to September 1986, on the association of cutaneous malignant melanoma with exposure to fluorescent light. Males showed a significant trend with cumulative years of occupational exposure and with various indices of exposure to domestic fluorescent light. The risk was more pronounced for lesions on the arms and for superficial spreading melanomas. There was no consistent association in females. These effects were similar when adjusted for other major risk factors for melanoma, including the amount of time spent outdoors occupationally. Comparisons of melanoma cases interviewed before or after diagnosis revealed no evidence of rumination bias. Comparisons of sample data from the same cases and controls by interview and mail questionnaire showed reasonable levels of reliability with no evidence of recall bias. A small sample of subjects was also selected for exposure validation with employers; this revealed very accurate recall of occupational exposure. On the basis of these results, previous epidemiologic studies, and clinical and animal evidence, the authors conclude that fluorescent light exposure remains a potential risk factor for melanoma.     

Beliefs about the risk factors for cervical cancer in a British population sample

BACKGROUND: The introduction of human papillomavirus (HPV) testing into cervical screening has the potential to alter public perceptions of cervical cancer by making explicit the role of a sexually transmitted virus in its etiology. HPV knowledge has been found to be poor, although there is evidence of public awareness of a link between sexual activity and cervical cancer risk. We explored beliefs about the risk factors for cervical cancer in a large population sample. METHODS: Face-to-face interviews were carried out with a representative sample of the British population. All participants were asked what they thought increased a women's chances of developing cervical cancer. RESULTS: The response rate was 71% (n = 1940). The most common single response was 'don't know' (38%). Forty-one percent of respondents mentioned factors relating to sex, but only 14% were aware of a link with sexual transmission and fewer than 1% named HPV. Women and more educated people had better knowledge of the established risk factors. The patterning of risk factor awareness by age varied across risk factors. CONCLUSIONS: Awareness of the role of a sexually transmitted virus in the etiology of cervical cancer is very low in Britain. Provision of information associated with the introduction of HPV testing could change public perceptions of cervical cancer.     

Late metastases of abdominal cutaneous malignant melanoma in the small and large bowels

The authors reported the case of a 56 years old man, who was operated with abdominal cutaneous malignant melanoma 5 years ago. He had chemo-immunotherapy. His complaints were epigastric pain, melena, hematochezia, anorexia, lack of appetite, fatigue. The upper panendoscopy showed tumor mass in the duodenojejunal flexure and the colonoscopy showed tumor in the large bowel. The patient underwent jejunal resection and right hemicolectomy. The authors survey the metastases of malignant melanoma as well as their clinical signs, therapeutic measures and prognosis.