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Relation between personality dimensions and symptomatology of depression in skin cancer patients. Ramírez-de Los Santos M L,López-Navarro A,Ramírez-de Los Santos S,Guzmán-Flores J M,Pereira-Suárez A L,López-Pulido E I BioPsychoSocial medicine BACKGROUND:Environmental psychological factors such as mood states can modify and trigger an organic response; depressive disorder is considered a risk factor for oncological development, leading to alterations both in the genesis and in the progression of the disease. Some authors have identified that personality relates to mood since a high score in neuroticism is associated with intense and long-lasting emotions of stress and therefore with the development of depressive behaviors. The objective of this study was to analyze the relationship between personality and depression in skin cancer patients. METHODS:A total of forty-seven clinically and histopathologically diagnosed patients were scheduled for an hour-long interview, during which they provided informed consent and sociodemographic information. The psychological questionnaires applied were the revised Eysenck Personality Questionnaire and the clinical questionnaire for the diagnosis of the depressive syndrome. RESULTS:The patient's mean age was 66.5 years (SD ± 12.4) and the majority were diagnosed with basal cell carcinoma (70.2%). The frequency of anxious/depressive symptoms was 42.5%, with an increase in depression scores in the female gender (p < 0.001). Furthermore, a difference was found in the neuroticism dimension related to gender, with higher values in women (p = 0.002). Depressive symptomatologic portraits were correlated with the dimensions of neuroticism (p < 0.001, r = 0.705), psychoticism (p = 0.003, r = 0.422) and lying (p = 0.028, r = - 0.321). CONCLUSIONS:Our results support the hypothesis that personality dimensions are related to the presence of anxiety/depressive symptomatology in patients with skin cancer, especially in the female gender. Highlighting the need for future research that delves into the implications at the psychological level, the quality of life, and the biological mechanisms that link personality and depressive symptoms in the development and evolution of skin cancer. 10.1186/s13030-021-00220-3
Teens, Tweets, and Tanning Beds: Rethinking the Use of Social Media for Skin Cancer Prevention. Falzone Ashley E,Brindis Claire D,Chren Mary-Margaret,Junn Alexandra,Pagoto Sherry,Wehner Mackenzie,Linos Eleni American journal of preventive medicine The incidence of skin cancer is rising in the U.S., and melanoma, the deadliest form, is increasing disproportionately among young white women. Indoor tanning is a modifiable risk factor for all skin cancers and continues to be used at the highest rates in young white women. Adolescents and young adults report personal appearance-based reasons for using indoor tanning. Previous research has explored the influences on tanning bed use, including individual factors as well as relationships with peers, family, schools, media influences, legislation, and societal beauty norms. Adolescents and young adults also have high rates of social media usage, and research is emerging on how best to utilize these platforms for prevention. Social media has the potential to be a cost-effective way to reach large numbers of young people and target messages at characteristics of specific audiences. Recent prevention efforts have shown that comprehensive prevention campaigns that include technology and social media are promising in reducing rates of indoor tanning among young adults. This review examines the literature on psychosocial influences on indoor tanning among adolescents and young adults, and highlights ways in which technology and social media can be used for prevention efforts. 10.1016/j.amepre.2017.04.027
Association of poor mental health and skin cancer development: a cross-sectional study of adults in the United States. Tkachenko Elizabeth,Singer Sean,Mostaghimi Arash,Hartman Rebecca I European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) The relationship between mental health and skin cancer is poorly characterized. This cross-sectional study used 2016 Behavioral Risk Factor Surveillance System data to evaluate the association between mental health problems and skin cancer development. Multivariate logistic regression analyses were performed to calculate adjusted odds ratio (aOR) for skin cancer development by mental health problems, adjusting for potentially confounding demographic and lifestyle factors. Odds of skin cancer were significantly higher in those with mental health problems problems [aOR 1.24, 95% confidence interval (CI) 1.17-1.31, P < 0.001]; this finding remained in sensitivity analysis adjusting for sunburn history (aOR 1.34, 95% CI 1.09-1.63, P = 0.004). Our findings reveal an association between poor mental health and increased skin cancer prevalence. The direction of this association is unclear. Distress of a skin cancer diagnosis may promote mental health problems, while, conversely, mental health problems may biologically potentiate skin cancer or be associated with risk factors like indoor tanning. Nevertheless, we demonstrate an elevated prevalence of mental health problems in patients with skin cancer. 10.1097/CEJ.0000000000000567
Optimistically biased perception of one's own skin cancer risk: Representative nationwide findings. Diehl Katharina,Görig Tatiana,Osenbrügge Nina,Schilling Laura,Greinert Rüdiger,Schneider Sven Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG BACKGROUND:Previous research has shown that individuals tend to have unrealistic comparative optimism (UCO) for different diseases and health outcomes. Our aim was to analyze UCO in relation to skin cancer for the first time in a representative nationwide sample. The results will be important for planning future prevention. METHODS:The National Cancer Aid Monitoring on Sunbed Use (NCAM, wave 3) is a representative nationwide German survey (n = 3,000, 14-45 years). We assessed UCO in relation to skin cancer and analyzed its association with sociodemographics, tanning and health-related risk behaviors, skin cancer risk, and skin cancer risk awareness. RESULTS:Four out of ten (43.3 %) respondents believed themselves to have a lower risk of developing skin cancer than other people of the same age and sex. Younger individuals were more likely to be optimistic. Individuals with an increased risk of skin cancer were more likely to perceive this higher risk. CONCLUSION:While it is realistic for those who actually have a higher risk of skin cancer to perceive it that way, the findings for the general population (and specifically for younger individuals) are concerning. It seems important to explain to people that their perception of their own risk of skin cancer is unrealistic, as this may affect their individual screening and prevention behavior. 10.1111/ddg.13897
FACE-Q Skin Cancer Module for measuring patient-reported outcomes following facial skin cancer surgery. Lee E H,Klassen A F,Cano S J,Nehal K S,Pusic A L The British journal of dermatology BACKGROUND:The patient's perspective of their facial scar after skin cancer surgery influences perception of care and quality of life (QoL). Appearance satisfaction after surgery is also an important but often overlooked treatment outcome. OBJECTIVES:To report the psychometric validation of the FACE-Q Skin Cancer Module consisting of five scales, measuring appearance satisfaction (Satisfaction with Facial Appearance, Appraisal of Scars), QoL (Cancer Worry, Appearance-related Psychosocial Distress) and the patient experience (Satisfaction with Information: Appearance). METHODS:Participants underwent Mohs surgery for facial basal or squamous cell carcinoma or excision of early facial melanoma. Cohort 1 received a set of scales before and after surgery. Cohort 2 received the scales on two occasions in the postoperative period for test-retest reliability. Rasch measurement theory was used to select (item-reduce) the most clinically meaningful items for the scales. Reliability, validity, floor and ceiling effects and responsiveness were also analysed. RESULTS:Of 334 patients, 209 (response rate 62·6%) were included. Rasch analysis reduced the total scale items from 77 to 41. All items had ordered thresholds and good psychometric fit. Reliability was high (Person separation index and Cronbach's α ≥ 0·90) and scales measuring similar constructs were correlated. High floor and ceiling effects were seen for the scales. The Cancer Worry scale demonstrated responsiveness (P = 0·004). CONCLUSIONS:The FACE-Q Skin Cancer Module meet the requirements of the Rasch model providing linearized measurement. Discriminating between patients with minimal appearance or worry impairment may be a limitation. The scales can be used for larger validation studies, clinical practice and research. 10.1111/bjd.16671
Factors contributing to cancer worry in the skin cancer population. Khoshab Nima,Vaidya Toral S,Dusza Stephen,Nehal Kishwer S,Lee Erica H Journal of the American Academy of Dermatology 10.1016/j.jaad.2019.09.068
Appearance-related psychosocial distress following facial skin cancer surgery using the FACE-Q Skin Cancer. Vaidya Toral S,Mori Shoko,Dusza Stephen W,Rossi Anthony M,Nehal Kishwer S,Lee Erica H Archives of dermatological research Over 2 million facial skin cancers occur globally each year. Facial skin cancer surgery can leave scars that may alter appearance and impact psychosocial functioning. The objective of this study is to assess patient-reported appearance-related psychosocial distress following facial skin cancer surgery, and to identify independent predictors of psychosocial impairment. This was a single-center, cross-sectional study at a tertiary care cancer center including patients who underwent dermatologic surgery on the face from March 1, 2016 to March 31, 2018. Patients completed the FACE-Q Skin Cancer Appearance-related Psychosocial Distress scale postoperatively between May 21, 2018 and October 1, 2018. Patient responses were rated on a 4-point Likert scale and converted on a scale from 0 to 100. In total, 359 patients completed the questionnaire (34.2% response rate). Overall, patients reported a low level of psychosocial distress. Patients most frequently reported items of self-consciousness, unhappiness, and insecurity < 3 months following surgery. Though psychosocial distress significantly improved over time, self-consciousness continued to be reported in the long-term postoperative period. Linear regression analysis determined that younger age, history of anxiety and/or depression, surgery on the nose, and repair by flap were independently predictive of psychosocial distress. Marginal predicted values for distress scores based on age demonstrated an indirect relationship. Patient-reported appearance-related psychosocial distress is low following facial skin cancer surgery, and report of distress decreases over time. The identified predictors of distress may be used as indicators for offering psycho-oncologic support and early interventions to improve scar appearance. 10.1007/s00403-019-01957-2
Patient Attitudes and Their Awareness Towards Skin Cancer-Related Apps: Cross-Sectional Survey. JMIR mHealth and uHealth BACKGROUND:In the emerging era of digitalization and electronic health, skin cancer-related apps represent useful tools to support dermatologic consultation and examination. Yet, little is known about how patients perceive the value of such apps. OBJECTIVE:The aim of this study was to investigate patient attitudes and their awareness toward skin cancer-related apps. METHODS:A cross-sectional study including 200 patients from the oncological outpatient unit was conducted at the University Hospital (LMU Munich, Germany) between September and December 2018. Patients were asked to complete a self-administered questionnaire on the popularity and usefulness of health-related and skin cancer-related apps. A descriptive analysis was performed with the expression of categorical variables as frequencies and percentages. For continuous variables, the median and range were indicated. Contingency tables and chi-square tests were performed to investigate associations between sociodemographic data and selected items of the questionnaire. RESULTS:A total of 98.9% (195/197) of patients had never used skin cancer-related apps or could not remember. In 49.7% (93/187) of cases, patients were unsure about the usefulness of skin cancer apps, whereas 42.6% (78/183) thought that skin cancer apps could supplement or support the professional skin examination performed by a physician. However, 47.9% (90/188) were interested in acquiring more information by their dermatologists about skin cancer apps. Young age (P=.002), male gender (P=.02), a previous history of melanoma (P=.004), and higher educational level (P=.002) were significantly associated with a positive attitude. Nevertheless, 55.9% (105/188) preferred a printed patient brochure on skin cancer to downloading and using an app. CONCLUSIONS:The experience and knowledge of skin cancer-related apps was surprisingly low in this population, although there was a high general interest in more information about such apps. Printed patient brochures were the preferred information source. 10.2196/13844
Young adults' stigmatizing perceptions about individuals with skin cancer: the influence of potential cancer cause, cancer metaphors, and gender. Psychology & health This study examined the influence of three potential predictors of stigmatising cancer perceptions: the controllability of the cancer cause, metaphors used to describe the cancer experience, and the target's gender. 306 undergraduates (age = 20) were recruited via subject pool, balancing males and females. Participants read a fictitious post by a patient/blogger with skin cancer that described different potential causes for their cancer varying with respect to its controllability, used varying types of commonly invoked cancer metaphors, and indicated their gender with names. Potential stigmatisation of the blogger in the form of negative affective responses, perceptions of flawed character, desired social distance and expectations for post-traumatic growth were assessed using mixed methods. The perceived age of the blogger and expectations for their survival were also explored. More blame, less sympathy, and less favourable perceptions of character were ascribed to the hypothetical blogger when their cancer was described as due to their lifestyle rather than genetics and thus potentially construed as more controllable. Females using a war metaphor resulted in more positive responses compared to a female using no metaphorical language. Stigmatisation of individuals with skin cancer may depend on the potential cause of cancer, and to some extent, metaphors and gender. 10.1080/08870446.2020.1869738
Psychological support of skin cancer patients. Peters E M J The British journal of dermatology The diagnosis of skin cancer imposes a great stress on our patients. Ultraviolet (UV) radiation-induced skin cancers are on the rise and frequently occur in younger patients and unexposed sites despite improved protective behaviour. Environmental factors and lifestyle habits have changed greatly in the last century and in addition to UV radiation exposure, psychosocial stressors and physical inactivity may play a role in the rising tumour incidence. With environmental stressors such as UV radiation they share the capacity to change the stress reaction. So far research into the interaction between stress, cancer and psychosocial intervention has generated some interesting results with respect to improvement of quality of life and the function of the hypothalamic-pituitary-adrenal axis, the sympathetic axis and natural killer cells. These results hint at a suppressive effect of chronic stress on cellular immunity and the importance of a sufficient length and intensity of any psychosocial intervention for it to be effective. Nevertheless, the evidence remains inconclusive and does not take into account the findings of current psychoneuroimmunological research. This research has demonstrated the importance of a third stress axis along which neurotrophins and neuropeptides are effective. Along this axis, regulatory mechanisms may contribute to suppress tumoricidal immune responses. This may be instrumental in the establishment of an immune response that promotes tumour progression and holds important implications for integrated therapeutic strategies. However, research into the psychoneuroimmunological benefits of psychosocial intervention is largely missing, and future interdisciplinary research is warranted for understanding and further promoting improved quality of life and psychological as well as physical well-being after psychosocial intervention. 10.1111/j.1365-2133.2012.11094.x
Skin cancer and skin cancer risk behaviors among sexual and gender minority populations: A systematic review. Singer Sean,Tkachenko Elizabeth,Yeung Howa,Mostaghimi Arash Journal of the American Academy of Dermatology BACKGROUND:Individuals of sexual and gender minorities may have different lifetime risk of skin cancer and ultraviolet radiation exposure than heterosexual persons. OBJECTIVE:To systematically review the prevalence of skin cancer and behaviors that increase risk of skin cancer among sexual and gender minority populations. METHODS:We performed a systematic literature review in PubMed/MEDLINE, Embase, Cochrane, and Web of Science, searching for articles through October 18, 2019, that investigated risk of skin cancer and behaviors among sexual and gender minority populations. RESULTS:Sexual minority men have a higher lifetime risk of any skin cancer (odds ratio range: 1.3-2.1) and indoor tanning bed use (odds ratio range: 2.8-5.9) compared with heterosexual men, whereas sexual minority women may use indoor tanning beds less frequently than heterosexual women and do not have an elevated risk of lifetime history of skin cancer. Gender-nonconforming individuals have higher lifetime prevalence of any skin cancer compared with cisgender men. LIMITATIONS:Most variables rely on self-reporting in their original studies. CONCLUSIONS:Sexual minority men disproportionately engage in use of indoor tanning beds, which may result in increased lifetime risk of skin cancer. Recognition of this risk is important for providing appropriate screening for patients in this population. 10.1016/j.jaad.2020.02.013
Skin cancer: Primary, secondary, and tertiary prevention. Part II. Journal of the American Academy of Dermatology Skin cancer is the most commonly diagnosed cancer worldwide. Understanding the natural history of skin cancer will provide a framework for the creation of prevention and control strategies that aim to reduce skin cancer burden. The strategies include health promotion, primary prevention, secondary prevention, and tertiary prevention. Health promotion and primary prevention were covered in the first part of this 2-part review. The second part covers the secondary and tertiary prevention of skin cancer. In particular, preventive strategies centered on the early detection of skin cancer, the prevention of disease progression, clinical surveillance, and educational and behavioral interventions are highlighted. The summaries of existing recommendations, challenges, opportunities, and future directions are discussed. 10.1016/j.jaad.2022.01.053