Latest news with #JAMADermatology
Hans India
24-05-2025
- Health
- Hans India
Skin cancer surges worldwide in older men in last 30 years: Study
New Delhi: There has been a sharp uptick in the burden of skin cancer, especially in older adults, in the last three decades, according to a study. Besides ageing, researchers at the First Affiliated Hospital of Chongqing Medical University in China attributed the surge to the increase in population growth. The study also cited a disproportionately higher burden of skin cancers in countries with higher sociodemographic index (SDI) levels. 'The older population (particularly male individuals and those living in high-SDI countries) is facing a substantial growing burden of skin cancer,' said the team in the paper published in JAMA Dermatology. 'The results highlight the urgency for more effective prevention and management strategies targeting high-risk groups,' they added. In the study, researchers analysed about 4.4 million new skin-cancer cases -- melanoma, squamous cell carcinoma, and basal cell carcinoma -- recorded in 2021 among older adults aged above 65 years and older. The data is based on the Global Burden of Diseases 2021, covering 204 countries and territories. The findings showed that the incidence of squamous cell carcinoma -- that starts as a growth of cells on the skin -- soared by roughly 2 per cent per year from 1990 to 2021. Basal cell carcinoma -- most often develops on areas of skin exposed to the sun, such as the face; and melanoma -- the most serious type of skin cancer -- showed similarly steady gains. Further, the study found that squamous cell carcinoma produced the steepest toll in terms of healthy years lost (DALYs) by 2021 compared with three decades earlier. New Zealand and Australia recorded the highest 65 and older melanoma rates in 2021. East Asia experienced the most rapid rise in basal cell carcinoma burden from 1990 to 2021, with average annual percentage increases exceeding 6 per cent for incidence, prevalence, and DALYs. "These findings highlight the urgent need for targeted prevention strategies and resource allocation to address the growing public health challenge of skin cancer among the ageing population,' the researchers said.
Medscape
22-05-2025
- Health
- Medscape
FDA Approves Roflumilast Foam for Scalp, Body Psoriasis
The foam formulation of the phosphodiesterase-4 (PDE4) inhibitor roflumilast has been approved by the US Food and Drug Administration (FDA) for treating plaque psoriasis of the scalp and body in adults and adolescents aged 12 years and older, according to an announcement from the manufacturer Arcutis Biotherapeutics. The 0.3% foam formulation of roflumilast (Zoryve) was previously approved for the treatment of seborrheic dermatitis in adults and children aged 9 years and older. The company has since then filed a supplemental New Drug Application with the FDA in September 2024. A 0.3% cream version is approved as a topical treatment for plaque psoriasis in adults and children aged 6 years and older. And the 0.15% cream formulation of roflumilast is approved for treatment of mild-to-moderate atopic dermatitis for the same population. Approval is based on data from phase 2b and 3 studies. In the pivotal phase 3 ARRECTOR study recently published in JAMA Dermatology , 432 patients with scalp and body psoriasis aged 12 years and older were randomized to once-daily application of 0.3% roflumilast foam or a vehicle for 8 weeks. Medscape also reported the findings. Significantly more patients in the roflumilast group vs the vehicle group achieved the primary endpoints of Scalp-Investigator Global Assessment (S-IGA) and Body-IGA (B-IGA) success — defined as clear or almost clear — plus two or more grades of improvement from baseline after 8 weeks of treatment (66.4% vs 27.8% for S-IGA; 45.5% vs 20.1% for B-IGA; P < .001 for both). In addition, significantly more patients who received roflumilast achieved a clinically significant reduction of itch (defined as a change of ≥ 4 points from baseline on the Scalp Itch-Numeric Rating Scale) compared with those on the vehicle after 8 weeks (65.3% vs 30.3%). Significantly more roflumilast-treated patients with baseline scalp itch also showed significant improvement compared with placebo patients after 2 weeks and 4 weeks of treatment (25.2% vs 8.0%; 46.2% vs 16.8%, respectively; P < .001 for all). Body itch scores also improved significantly in the roflumilast patients compared to those in the vehicle group. Rates of adverse events were similar and low in both treatment and placebo groups, as were treatment-emergent adverse events and rates of discontinuation because of adverse events, the researchers noted. The most common adverse events reported among patients treated with 0.3% roflumilast foam were headache (1.1%), nausea (1.3%), and nasopharyngitis (1.5%), according to the company's press release. It is contraindicated in patients with moderate-to-severe liver impairment (Child-Pugh B or C).
The Age
17-05-2025
- Health
- The Age
$10m was spent on these melanoma scanners. Doctors were better at detecting cancer
A huge and much-hyped government investment into 3D skin cancer scanners has hit an unexpected snag after early data showed the scanners performed no better than a simple skin check from a GP – and may lead to overdiagnosis. The new data has stunned researchers, who are debating whether this represents a blip that will be ironed out as the tech improves or a cautionary tale about the promise and perils of shiny new medical technology. The Australian Cancer Research Foundation spent about $10 million in 2018 to set up 15 3D full-body cameras across Australia. The Queensland-based research centre established to run the network received another $25 million in federal government research funding, as well as funding from the camera's manufacturer. The scanners, each of which cost about $500,000, use dozens of cameras to generate a 3D image of a person, tracking the location of each mole and blemish. When the first machines were installed in Australia 2017 as part of a separate project, a glowing press release said the tech would ' revolutionise melanoma detection '. That revolution is not yet here. In a study published earlier this year in JAMA Dermatology, researchers found adding the cameras to usual care led to a lot more lesions being cut out from volunteers' skin – but no more melanoma being detected compared to standard skin checks. And the scanners added $945 per patient in healthcare costs. 'This study is like a cautionary tale,' said one leading melanoma researcher, working on a related project and granted anonymity to speak freely about the trial. 'These are very costly devices. And they might not work if you don't implement it properly. And you're just wasting lots of money and potentially doing harm.' 'It does present a challenge for us going forward,' said Professor David Whiteman, a researcher at QIMR Berghofer and co-author of the study. 'It does temper the enthusiasm a little for just how we go about dealing with skin cancer and its detection in Australia.'
Sydney Morning Herald
17-05-2025
- Health
- Sydney Morning Herald
$10m was spent on these melanoma scanners. Doctors were better at detecting cancer
A huge and much-hyped government investment into 3D skin cancer scanners has hit an unexpected snag after early data showed the scanners performed no better than a simple skin check from a GP – and may lead to overdiagnosis. The new data has stunned researchers, who are debating whether this represents a blip that will be ironed out as the tech improves or a cautionary tale about the promise and perils of shiny new medical technology. The Australian Cancer Research Foundation spent about $10 million in 2018 to set up 15 3D full-body cameras across Australia. The Queensland-based research centre established to run the network received another $25 million in federal government research funding, as well as funding from the camera's manufacturer. The scanners, each of which cost about $500,000, use dozens of cameras to generate a 3D image of a person, tracking the location of each mole and blemish. When the first machines were installed in Australia 2017 as part of a separate project, a glowing press release said the tech would ' revolutionise melanoma detection '. That revolution is not yet here. In a study published earlier this year in JAMA Dermatology, researchers found adding the cameras to usual care led to a lot more lesions being cut out from volunteers' skin – but no more melanoma being detected compared to standard skin checks. And the scanners added $945 per patient in healthcare costs. 'This study is like a cautionary tale,' said one leading melanoma researcher, working on a related project and granted anonymity to speak freely about the trial. 'These are very costly devices. And they might not work if you don't implement it properly. And you're just wasting lots of money and potentially doing harm.' 'It does present a challenge for us going forward,' said Professor David Whiteman, a researcher at QIMR Berghofer and co-author of the study. 'It does temper the enthusiasm a little for just how we go about dealing with skin cancer and its detection in Australia.'
Medscape
14-05-2025
- Health
- Medscape
Calculator Aids With Assessing SNL Metastasis Risk in Melanoma
The Melanoma Institute of Australia (MIA) previously developed a risk calculator for sentinel lymph node (SLN) metastasis risk to help clinicians and patients with primary cutaneous melanoma decide whether to proceed with a SLN biopsy (SLNB). A new study published in JAMA Dermatology provides a validation update on the tool based on a larger and more geographically diverse study population. Not only were the results with a six-factor model using a larger population similar to those from the original dataset but also the calculator showed improved precision with narrowed 95% CIs. Both the original study and the larger validation analysis compared the accuracy of the calculator with the SLNB results that were available for each patient. The full calculator requires the input of age at diagnosis, Breslow tumor thickness (mm) and melanoma subtype (acral, superficial spreading, nodular, pure desmoplastic, or lentigo maligna melanoma). Clinicians can also include tumor mitotic rate (x/mm2 or mitosis present/absent), ulceration (present/absent) and lymphovascular invasion (present/absent) when this information is available. The new analysis included data from the National Danish Melanoma Database (N = 8533), three cancer centers in the United Kingdom (N = 2663), two in the United States (N = 1844), one in New Zealand (N = 449), one in Sweden (N = 1215), and one in Brazil (N = 1027). When pooled with the original cohort, 15,732 patients were included in the validation. What Did the New Study Find? A decision-curve analysis revealed the differences in clinical decision-making using the six-factor model or one using only Breslow thickness and ulceration. In this context, a given threshold probability reflects the minimum level of risk at which a clinician/patient would choose to proceed with an SLNB. Using all six MIA parameters and a threshold of 8% resulted in a favorable balance of minimizing unnecessary biopsies, while maintaining confidence in detecting metastasis. This lower-threshold approach is better suited to patients with a more conservative risk tolerance, who are willing to undergo biopsy when they have a lower risk for metastasis rather than miss one. In contrast, a simpler predictive model using only Breslow thickness and ulceration resulted in a higher net benefit at a 14% threshold for patients with higher risk tolerance. Net benefit refers to the reduced number of unnecessary biopsies (a positive) at the risk of missing some true cases of metastasis (a negative). This may be preferable for patients who want to limit biopsy to a high risk for metastasis. For these patients, avoiding biopsy is a greater concern than missing a true positive. This simpler approach may also be valuable in settings where more detailed information, such as subtype or mitotic rate, is unavailable. 'These findings reinforce the tool's reliability in predicting the risk a melanoma has spread to the lymph nodes in diverse patient groups, providing clinicians worldwide with greater confidence in its use for everyday practice,' primary investigator Alexander Varey, MD, PhD, said in a press statement. In addition, with the larger sample size the 95% CIs shrank with a mean reduction of more than 75%. Thresholds — the probability that reflects the minimum level of risk at which a clinician or patient would choose to proceed with an SLNB — of 5% and 10% are generally considered to be clinically relevant. At the 5% threshold, this increased precision shifted clinical interpretation in more than half of the patients (58%) — who previously had lower CI bounds below 5% — now had lower bounds greater than 5% with the inclusion of more data. In clinical terms, this means having greater confidence that a patient's true risk exceeds the 5% threshold (which reflects a patient's preference for a more conservative approach) improving the reliability of biopsy decisions in patients near that risk cutoff. Similarly, among patients whose upper 95% confidence bounds previously exceeded 10%, roughly a quarter (24%) now had upper bounds that fell below 10%, which increases the certainty that these patients are not at high risk. In clinical terms this supports safer biopsy avoidance in that group. What Makes the Tool Useful in Clinical Practice? 'This calculator is helpful because you can get all of this information just from the pathology report. You don't have to do another assay or spend thousands of dollars on genetic profiling,' said Mark Faries, MD, a surgical oncologist at Cedars‑Sinai and The Angeles Clinic and Research Institute, Los Angeles. He is also the co-director of the Cutaneous Oncology Program at the Cedars-Sinai and heads surgical oncology at The Angeles Clinic. The tool also adds easy-to-understand information for patients to improve the discussion of their care. 'If a patient comes in newly diagnosed with a melanoma, you would be able to put these parameters into the calculator, and it'll give you a number to suggest the risk that they have involvement of their lymph node', said Faries. 'Based on that information, you — together with the patient — can decide whether or not they can just have an excision of the skin site, or if they also need to have a sentinel lymph, node biopsy done.' He added, 'you can use [this calculator] for every patient. Just having that number helps patients understand what they're looking at. Many times, patients come in with a very pessimistic outlook, based on people's general feeling about melanoma. So even if they have a fairly substantial risk of having something in the node that justifies doing the node biopsy, you can reassure them that actually the most likely outcome is that everything's going to be okay. Even from that sort of peace of mind standpoint, it's useful for every patient.' What Does the New Study Add? In this study, 'they've collected a very large additional number of patients from other centers around the world and have further validated the results of the initial analysis…this new work makes the estimates more precise,' said Faries. With the earlier version of the calculator, 'there was a pretty wide range, where the probability might've reasonably fallen for a prediction. Now with these larger numbers [of patients] it's a much smaller range. So you have more confidence that the number you're getting is correct.,' he said. Are There Any Caveats or Room for Improvement? 'There still is some room for improvement at the lowest risk end of the scale,' Faries noted. 'The reason for that is that the calculator was developed based on patients who had a sentinel lymph node biopsy done. So they've already been selected to some extent. Relatively speaking, the number of patients they have at the very bottom end of the risk scale is not very large because those people don't get the lymph biopsy done. So I think when we have somebody who we generally wouldn't recommend doing a sentinel node biopsy for, the calculator is a little bit less definitive. I think there's more work that could be done to help at that very bottom end.' Varey reported receiving personal fees from Novartis AG and Merck & Co., Inc. (MSD).
