scholarly journals The impact of the COVID‐19 pandemic on diagnostic delay of skin cancer: a call to restart screening activities

2021 ◽  
Author(s):  
Clio Dessinioti ◽  
Claus Garbe ◽  
Alexander J Stratigos
Keyword(s):  
Skin Cancer ◽  
Diagnostic Delay ◽  
The Impact

scholarly journals Diagnosis and treatment delay of head and neck cancers during COVID-19 era in a tertiary care academic hospital: what should we expect?

2021 ◽  
Author(s):  
Pietro De Luca ◽  
Antonella Bisogno ◽  
Vito Colacurcio ◽  
Pasquale Marra ◽  
Claudia Cassandro ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Head And Neck ◽  
Retrospective Analysis ◽  
Tertiary Care ◽  
Diagnostic Delay ◽  
Treatment Delay ◽  
Head And Neck Cancers ◽  
Control Measures ◽  
Academic Hospital ◽  
The Impact

Abstract Background Since the spreading of SARS-CoV-2 from China, all deferrable medical activities have been suspended, to redirect resources for the management of COVID patients. The goal of this retrospective study was to investigate the impact of COVID-19 on head and neck cancers’ diagnosis in our Academic Hospital. Methods A retrospective analysis of patients treated for head and neck cancers between March 12 and November 1, 2020 was carried out, and we compared these data with the diagnoses of the same periods of the 5 previous years. Results 47 patients were included in this study. We observed a significative reduction in comparison with the same period of the previous 5 years. Conclusions Our findings suggest that the COVID-19 pandemic is associated with a decrease in the number of new H&N cancers diagnoses, and a substantial diagnostic delay can be attributable to COVID-19 control measures.

scholarly journals Neuropsychiatric, cognitive and sexual impairment in mastocytosis patients

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Fatma Jendoubi ◽  
Maella Severino-Freire ◽  
Mathilde Negretto ◽  
Christophe Arbus ◽  
Carle Paul ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Rating Scale ◽  
Negative Impact ◽  
Diagnostic Delay ◽  
Professional Lives ◽  
Cutaneous Lesions ◽  
Kit Mutation ◽  
Sexual Symptoms ◽  
Organ Systems ◽  
The Impact

Abstract Background Mastocytosis is a rare disease characterised by the accumulation and/or proliferation of abnormal mast cells (MCs) in one or several organs. It may present with a number of different symptoms that involve various organ systems. The current study aims to assess the prevalence of MC mediator-related symptoms in a cohort of mastocytosis patients with a specific focus on neurological, psychiatric, cognitive and sexual symptoms. We also assessed the impact of the disease on patients’ professional lives. Patients were administered a validated multidimensional questionnaire to collect information on patients’ perception of the severity of their symptoms. From the questionnaires we extracted the neurological, cognitive, psychiatric and sexual symptoms and the impact of the disease on patients’ professional lives as well as their grading. The affective status was assessed using the 17-item version of the Hamilton Depression Rating Scale. Results We included 139 patients. Mastocytosis was classified as systemic in 113 patients and cutaneous in 26 patients. The prevalence of MC mediator-related systemic symptoms was as follows: cutaneous (71%), gastro-intestinal (48%), cardio-vascular (36%), musculoskeletal (26.6%), fatigue (24%), urinary (14.4%) and respiratory (10%). Headaches and vertigo were noted in respectively 55% and 32% of patients. Irritability, episodes of memory loss and difficulty concentrating were reported in 54%, 52% and 40% of cases, respectively. Sexual impairment was noted in 24% of patients. No associations were found between neuropsychiatric/cognitive impairment and age, gender, diagnostic delay, disease form, the presence of cutaneous lesions, the level of serum and bone marrow tryptase and the presence of KIT mutation in bone marrow and/or skin. Depression was noted in 49% of patients. One in four patients reported a negative impact of the disease on their professional lives. Conclusion This current study provides some insights regarding symptoms related to mastocytosis and their impact on patients’ professional lives.

scholarly journals Screening for Melanoma and Other Skin Cancer Shows a Higher Early Melanoma Incidence: Social Educational Program “Life Fear-Free”

2021 ◽  
Vol 8 (1) ◽  
pp. 54-68
Author(s):  
Lev Demidov ◽  
Igor Samoylenko ◽  
Nina Vand ◽  
Igor Utyashev ◽  
Irina Shubina ◽  
...  
Keyword(s):  
Skin Cancer ◽  
Screening Program ◽  
Excisional Biopsy ◽  
Skin Lesions ◽  
Detection Methods ◽  
Non Melanoma Skin Cancer ◽  
The Social ◽  
Educational Campaign ◽  
Skin Cancer Detection ◽  
The Impact

Background: The screening program Life Fear-Free (LFF) aimed at early diagnosis of cutaneous melanoma (CM) was introduced in Samara, Chelyabinsk, Yekaterinburg, and Krasnodar (Russia) in 2019. Objectives: To analyze the impact of the program on early CM and non-melanoma skin cancer (NMSC) detection. Methods: According to the social educational campaign, people were informed about CM risk factors and symptoms and were invited for skin examination. The program planned to involve 3200 participants in total. Participants with suspicious lesions were invited for excisional biopsy. Results: 3143 participants, including 75.4% women, were examined for skin lesions. The average age of the participants was 43.7 years. Mostly skin phototypes II and III were registered (48.2% and 41.0%, respectively); 3 patients had CM, 15 had basal cell carcinoma, and 1 had Bowen’s disease, which were confirmed histologically. All detected melanomas had Breslow’s thickness of 1 mm. Conclusion: The participants showed high interest in early skin cancer detection programs. The incidence rate of CM and NMSCs among the program participants was higher than in general public. The early disease grade was proven for the detected CMs and NMSCs. The study has shown that it is important to continue such programs.

scholarly journals POS1189 THE IMPACT OF TELEMEDICINE AND COVID-19 ON A TERTIARY RHEUMATOLOGY SERVICE: A RETROSPECTIVE AUDIT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 876-877
Author(s):  
W. Zhu ◽  
T. De Silva ◽  
L. Eades ◽  
S. Morton ◽  
S. Ayoub ◽  
...  
Keyword(s):  
Immunosuppressive Therapy ◽  
Univariate Analysis ◽  
Diagnostic Delay ◽  
Cohort Differences ◽  
Phone Calls ◽  
Retrospective Audit ◽  
Common Diagnosis ◽  
Significant Difference ◽  
The Impact

Background:Telemedicine was widely utilised to complement face-to-face (F2F) care in 2020 during the COVID-19 pandemic, but the impact of this on patient care is poorly understood.Objectives:To investigate the impact of telemedicine during COVID-19 on outpatient rheumatology services.Methods:We retrospectively audited patient electronic medical records from rheumatology outpatient clinics in an urban tertiary rheumatology centre between April-May 2020 (telemedicine cohort) and April-May 2019 (comparator cohort). Differences in age, sex, primary diagnosis, medications, and proportion of new/review appointments were assessed using Mann-Whitney U and Chi-square tests. Univariate analysis was used to estimate associations between telemedicine usage and the ability to assign a diagnosis in patients without a prior rheumatological diagnosis, the frequency of changes to immunosuppression, subsequent F2F review, planned admissions or procedures, follow-up phone calls, and time to next appointment.Results:3,040 outpatient appointments were audited: 1,443 from 2019 and 1,597 from 2020. There was no statistically significant difference in the age, sex, proportion of new/review appointments, or frequency of immunosuppression use between the cohorts. Inflammatory arthritis (IA) was a more common diagnosis in the 2020 cohort (35.1% vs 31%, p=0.024). 96.7% (n=1,444) of patients seen in the 2020 cohort were reviewed via telemedicine. In patients without an existing rheumatological diagnosis, the odds of making a diagnosis at the appointment were significantly lower in 2020 (28.6% vs 57.4%; OR 0.30 [95% CI 0.16-0.53]; p<0.001). Clinicians were also less likely to change immunosuppressive therapy in 2020 (22.6% vs 27.4%; OR 0.78 [95% CI 0.65-0.92]; p=0.004). This was mostly driven by less de-escalation in therapy (10% vs 12.6%; OR 0.75 [95% CI 0.59-0.95]; p=0.019) as there was no statistically significant difference in the escalation or switching of immunosuppressive therapies. There was no significant difference in frequency of follow-up phone calls, however, patients seen in 2020 required earlier follow-up appointments (p<0.001). There was also no difference in unplanned rheumatological presentations but significantly fewer planned admissions and procedures in 2020 (1% vs 2.6%, p=0.002). Appointment non-attendance reduced in 2020 to 6.5% from 10.9% in 2019 (OR 0.57 [95% CI 0.44-0.74]; p<0.001), however the odds of discharging a patient from care were significantly lower in 2020 (3.9% vs 6%; OR 0.64 [95% CI 0.46-0.89]; p=0.008), although there was no significance when patients who failed to attend were excluded. Amongst patients seen via telemedicine in 2020, a subsequent F2F appointment was required in 9.4%. The predictors of needing a F2F review were being a new patient (OR 6.28 [95% CI 4.10-9.64]; p<0.001), not having a prior rheumatological diagnosis (OR 18.43 [95% CI: 2.35-144.63]; p=0.006), or having a diagnosis of IA (OR 2.85 [95% CI: 1.40-5.80]; p=0.004) or connective tissue disease (OR 3.22 [95% CI: 1.11-9.32]; p=0.031).Conclusion:Most patients in the 2020 cohort were seen via telemedicine. Telemedicine use during the COVID-19 pandemic was associated with reduced clinic non-attendance, but with diagnostic delay, reduced likelihood of changing existing immunosuppressive therapy, earlier requirement for review, and lower likelihood of discharge. While the effects of telemedicine cannot be differentiated from changes in practice related to other aspects of the pandemic, they suggest that telemedicine may have a negative impact on the timeliness of management of rheumatology patients.Disclosure of Interests:None declared.

scholarly journals Immune Checkpoint Blockade for Metastatic Uveal Melanoma: Patterns of Response and Survival According to the Presence of Hepatic and Extrahepatic Metastasis

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3359
Author(s):  
Elias Koch ◽  
Anne Petzold ◽  
Anja Wessely ◽  
Edgar Dippel ◽  
Anja Gesierich ◽  
...  
Keyword(s):  
Skin Cancer ◽  
Uveal Melanoma ◽  
Hepatic Metastasis ◽  
Immune Checkpoint ◽  
Objective Response ◽  
Immune Checkpoint Blockade ◽  
Checkpoint Blockade ◽  
Response To Treatment ◽  
Extrahepatic Metastasis ◽  
The Impact

Background: Since there is no standardized and effective treatment for advanced uveal melanoma (UM), the prognosis is dismal once metastases develop. Due to the availability of immune checkpoint blockade (ICB) in the real-world setting, the prognosis of metastatic UM has improved. However, it is unclear how the presence of hepatic and extrahepatic metastasis impacts the response and survival after ICB. Methods: A total of 178 patients with metastatic UM treated with ICB were included in this analysis. Patients were recruited from German skin cancer centers and the German national skin cancer registry (ADOReg). To investigate the impact of hepatic metastasis, two cohorts were compared: patients with liver metastasis only (cohort A, n = 55) versus those with both liver and extra-hepatic metastasis (cohort B, n = 123). Data were analyzed in both cohorts for response to treatment, progression-free survival (PFS), and overall survival (OS). The survival and progression probabilities were calculated with the Kaplan–Meier method. Log-rank tests, χ2 tests, and t-tests were performed to detect significant differences between both cohorts. Results: The median OS of the overall population was 16 months (95% CI 13.4–23.7) and the median PFS, 2.8 months (95% CI 2.5–3.0). The median OS was longer in cohort B than in cohort A (18.2 vs. 6.1 months; p = 0.071). The best objective response rate to dual ICB was 13.8% and to anti-PD-1 monotherapy 8.9% in the entire population. Patients with liver metastases only had a lower response to dual ICB, yet without significance (cohort A 8.7% vs. cohort B 16.7%; p = 0.45). Adverse events (AE) occurred in 41.6%. Severe AE were observed in 26.3% and evenly distributed between both cohorts. Conclusion: The survival of this large cohort of patients with advanced UM was more favorable than reported in previous benchmark studies. Patients with both hepatic and extrahepatic metastasis showed more favorable survival and higher response to dual ICB than those with hepatic metastasis only.

scholarly journals The impact of structural factors on diagnostic delay in diffuse large B‐cell lymphoma

2019 ◽  
Vol 8 (4) ◽  
pp. 1416-1422
Author(s):  
Joanna C. Zurko ◽  
Raymond C. Wade ◽  
Amitkumar Mehta
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Diagnostic Delay ◽  
B Cell Lymphoma ◽  
Structural Factors ◽  
Large B Cell Lymphoma ◽  
The Impact ◽  
Large B Cell

scholarly journals The non-fatal burden of cancer in Belgium, 2004–2018

2021 ◽  
Author(s):  
Vanessa Gorasso ◽  
Geert Silversmit ◽  
Marc Arbyn ◽  
Astrid Cornez ◽  
Robby De Pauw ◽  
...  
Keyword(s):  
Skin Cancer ◽  
Burden Of Disease ◽  
Quality Data ◽  
Years Of Life Lost ◽  
Non Melanoma Skin Cancer ◽  
Life Years ◽  
National Burden ◽  
Disease Study ◽  
The Impact ◽  
Melanoma Skin

Abstract 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 2018 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 2018 by 6% and 2% respectively for incidence- and prevalence-based YLDs. In 2018, 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 2018, non-melanoma skin cancer significantly increased for both sexes in terms of age-standardized incidence-based YLD per 100,000, from 48 to 107 for men and from 15 to 37 for women. Important decreases were seen for colorectal cancer for both sexes in terms of age-standardized incidence-based YLD per 100,000, from 104 to 85 for men and from 52 to 46 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.

scholarly journals MicroRNA-203 represses selection and expansion of oncogenic Hras transformed tumor initiating cells

eLife ◽  
2015 ◽  
Vol 4 ◽  
Author(s):  
Kent Riemondy ◽  
Xiao-jing Wang ◽  
Enrique C Torchia ◽  
Dennis R Roop ◽  
Rui Yi
Keyword(s):  
Cell Division ◽  
Skin Cancer ◽  
Mouse Model ◽  
Mouse Models ◽  
Knockout Mouse ◽  
Selection Process ◽  
Tumor Initiating Cells ◽  
Knockout Mouse Model ◽  
Active Selection ◽  
The Impact

In many mouse models of skin cancer, only a few tumors typically form even though many cells competent for tumorigenesis receive the same oncogenic stimuli. These observations suggest an active selection process for tumor-initiating cells. Here, we use quantitative mRNA- and miR-Seq to determine the impact of HrasG12V on the transcriptome of keratinocytes. We discover that microRNA-203 is downregulated by HrasG12V. Using a knockout mouse model, we demonstrate that loss of microRNA-203 promotes selection and expansion of tumor-initiating cells. Conversely, restoration of microRNA-203 using an inducible model potently inhibits proliferation of these cells. We comprehensively identify microRNA-203 targets required for Hras-initiated tumorigenesis. These targets include critical regulators of the Ras pathway and essential genes required for cell division. This study establishes a role for the loss of microRNA-203 in promoting selection and expansion of Hras mutated cells and identifies a mechanism through which microRNA-203 antagonizes Hras-mediated tumorigenesis.

scholarly journals Good, Bad, and Ugly: Partner Support and Quality of Life Among Couples Facing Skin Cancer

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 430-430
Author(s):  
Laura Butner-Kozimor ◽  
Jyoti Savla
Keyword(s):  
Quality Of Life ◽  
Skin Cancer ◽  
Cancer Diagnosis ◽  
Negative Relationship ◽  
Perceived Support ◽  
Older Couples ◽  
Path Analyses ◽  
The Impact ◽  
Negative Support

Abstract When older adults in partnered relationships face a skin cancer diagnosis of one partner, couples may rely on one another for support. Previous studies have found that perceived support can influence one’s adjustment to the stressors associated with the skin cancer diagnosis, as well as influence the overall quality of life. Using dyadic data from 30 older couples (Mage = 70; SD = 7.25), this study examined positive and negative relationship-focused support strategies each partner provided and effects on the dyad’s quality of life. Dyadic path analyses simultaneously examined the impact of support received by one’s partner and its association with their own quality of life (actor effects) and their partner’s quality of life (partner effects). Positive support received by either partner, in the form of active engagement, was not associated with quality of life. In contrast, negative support in the form of protective buffering received from supporting partners was associated with poorer quality of life for themselves (β = -.37, p = .05) as well as for partners with skin cancer (β = -.43, p = .01). Similarly, overprotection, also a negative support strategy, by supporting partners was associated with poorer quality of life for partners with skin cancer (β = -.63, p &lt; .001). Findings illustrate that not all types of support are beneficial for the overall couple relationship and couple outcomes. Implications for practice and interventions for older couples facing a cancer diagnosis will be discussed.

Sign in / Sign up

Export Citation Format

Share Document