Problematic End Points in a Keratinocyte Carcinoma Chemoprevention Trial —Reply

In Reply We appreciate the close scrutiny of our published work and the opportunity to elaborate on the end points we used for analysis of the trial data. The VAKCC Trial primary end point was the rate of occurrence of keratinocyte carcinoma (KC) over the course of the 4-year trial. In the process of creating and executing this trial, however, the study team explicitly discussed that there were other important outcomes. In particular, while we did not have evidence to guide our estimation of the timing and duration of the effect of our intervention, if any, on the occurrence of KC, basal cell carcinoma, or squamous cell carcinoma (SCC), we realized that a short-term effect on risk (eg, during the first year) could be of considerable clinical importance even if the effect did not persist for the entire duration of the trial. We further recognized that even if there was a substantial effect in the first year, it could be lost in the 4-year results unless specifically examined. Hence, when analysis plans were discussed prior to unblinding the data, it was explicitly stated by the study chair, and summarized in the form of email guidance to the study statistician, that outcomes at 1 year were important to calculate and report. With the focus on completing the report, we chose not to officially amend the statistical analysis plan. This was an administrative decision that did not prevent appropriate analysis and should not prevent appropriate scientific interpretation. The final an...
Source: JAMA Dermatology - Category: Dermatology Source Type: research

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(Bentham Science Publishers) The three prevalent skin cancers, according to the literature are melanoma, basal cell carcinoma and squamous cell carcinoma.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news
ConclusionAggressive SCC should be suspected in cases of persistent and relapsing purulent lesions in all patients.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
A 78-year-old Caucasian man presented with a 5 mm pink and black papule on his right back. The patient was receiving treatment for squamous cell carcinoma of the tongue and had previously received treatment for basal cell carcinoma. The patient was unaware of the lesion until it was identified by his oncology team, and he denied any associated symptoms. The remainder of the TBSE was unremarkable. Dermoscopic exam revealed central yellow-orange and black clods and small, gray dots which were encircled by a pigmented black-blue annulus.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
Skin cancer is the most common malignancy in the white population worldwide. It is divided into melanoma and nonmelanoma skin cancer (NMSC). Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the most common subtypes of NMSC and it is estimated that 2-3 million new cases occur globally each year. Malignant melanoma is the least common skin cancer; however, it is the most fatal one its incidence is alarmingly increasing. According to worldwide trends, skin cancer is the most prevalent malignancy in Colombia, by 2010 reached up to 20.2% of all cancer cases attended.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
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Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
Introduction: Approximately 3 million Americans are diagnosed and treated annually with nonmelanoma skin cancer (NMSC), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Traditionally these cancers are diagnosed by shave biopsy or punch biopsy. Although shave biopsy is often used in diagnosis of NMSC, limited data exists regarding the persistence of residual tumor at the time of definitive treatment, such as excision. Literature suggests that 15%-40% of the time residual NMSC is not found at the time of excision following shave biopsy.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
Nonmelanoma skin cancer represents the most common malignancy in the United States, and the incidence is increasing. In the United States alone, average annual treatment costs are in the billions. Although basal cell carcinoma (BCC) is considered the most common skin cancer, recent studies suggest the incidence of squamous cell carcinoma (SCC) has increased creating a SCC:BCC ratio of 1.0. Many treatment modalities are used for SCC including Mohs micrographic surgery, but there are currently no FDA-approved topical therapies for SCCs.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
Background: Incidence of nonmelanoma skin cancer (NMSC), specifically, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), has been increasing for decades. This increase is multifactorial: better skin cancer detection, increased sun exposure, and increased life expectancy. In addition, biopsy rates (number of biopsies/number of patient visits) are increasing in the U.S. Utah has one of the highest rates of both NMSCs and melanoma in the U.S. Historic figures for BCC:SCC ratio in the U.S.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
Introduction: Actinic keratosis (AK) may be considered by some to be an incipient form of squamous cell carcinoma (SCC) as the rate of SCC in individuals with AK has been estimated at 0.025%-16%. There is much less reported evidence for AK association with basal cell carcinoma (BCC) and melanoma (MM). The aim of this study is to determine if an association exists between AK and nonmelanoma skin cancer (NMSC; SCC and BCC) and between AK and MM in a large midwestern U.S. patient population.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
Background: Reflectance confocal microscopy (RCM) is a noninvasive diagnostic (830 nm laser based) technique to visualize different layers of skin. Various published literature has proven the efficacy of RCM for the diagnosis of benign and malignant melanocytic and nonmelanocytic skin tumors such as basal cell carcinoma, squamous cell carcinoma, lentigo maligna and melanoma. The aim of this study is to present the diagnostic RCM features of different types of lentigo.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
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