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Melanoma: HELP
Articles by Sancy A. Leachman
Based on 78 articles published since 2010
(Why 78 articles?)
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Between 2010 and 2020, S. Leachman wrote the following 78 articles about Melanoma.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Editorial United States Preventive Services Task Force Overstates Cosmetic Harms of Skin Cancer Screening. 2018

Sobanko, Joseph F / Shao, Kimberly / Pearl, Rebecca L / Leachman, Sancy. ·Dr. Sobanko is with the Division of Dermatologic Surgery and Cutaneous Oncology, Department of Dermatology, at the University of Pennsylvania Health System in Philadelphia, Pennsylvania. · Ms. Shao is with the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, Pennsylvania. · Dr. Pearl is with the Department of Psychiatry and Department of Surgery, Perelman School of Medicine at the University of Pennsylvania in Philadelphia, Pennsylvania. · Dr. Leachman is with the Department of Dermatology at Oregon Health & Science University in Portland, Oregon. ·J Clin Aesthet Dermatol · Pubmed #29657674.

ABSTRACT: The United States Preventive Services Task Force (USPSTF) 2016 recommendation for skin cancer screening in asymptomatic healthy adults concluded that current evidence is "insufficient to assess the balance and harms of visual skin examination." One contributing factor leading to the insufficient grade was a concern for cosmetic harms resulting from unnecessary biopsies or excisions. This commentary briefly highlights the pertinent studies and currently accepted methods for pigmented lesion biopsy. Reviewing these data will permit clinicians to more thoroughly analyze the USPSTF statement and might assist in routine assessment and management of suspicious pigmented lesions in adult patients.

2 Editorial Individualizing follow-up for patients with early-stage melanoma. 2011

Sondak, Vernon K / Leachman, Sancy A. · ·J Clin Oncol · Pubmed #22067394.

ABSTRACT: -- No abstract --

3 Review Prognostic gene expression profiling in melanoma: necessary steps to incorporate into clinical practice. 2019

Grossman, Douglas / Kim, Caroline C / Hartman, Rebecca I / Berry, Elizabeth / Nelson, Kelly C / Okwundu, Nwanneka / Curiel-Lewandrowski, Clara / Leachman, Sancy A / Swetter, Susan M. ·Dermatology, Huntsman Cancer Institute & University of Utah Health Sciences Center, Salt Lake City, UT 84112, USA. · Dermatology, Tufts Medical Center, Boston & Newton Wellesley Hospital, Wellesley, MA 02111, USA. · Dermatology, Brigham & Women's Hospital, Harvard Medical School, & Veterans Affairs Boston Healthcare System, Boston, MA 02446, USA. · Dermatology, Oregon Health & Sciences University & Knight Cancer Institute, Portland, OR 97239, USA. · Dermatology, MD Anderson Cancer Center, Houston, TX 77030, USA. · Dermatology, University of Arizona Cancer Center, Tucson, AZ 85719, USA. · Dermatology, Stanford University Medical Center & Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94305, USA. ·Melanoma Manag · Pubmed #31871621.

ABSTRACT: Prognostic gene expression profiling (GEP) tests for cutaneous melanoma (CM) are not recommended in current guidelines outside of a clinical trial. However, their use is becoming more prevalent and some practitioners are using GEP tests to guide patient management. Thus, there is an urgent need to bridge this gap between test usage and clinical guideline recommendations by obtaining high-quality evidence to guide us toward best practice use of GEP testing in CM patients. We focus here on the opportunities and uncertainties associated with prognostic GEP testing in CM, review how GEP testing was incorporated into clinical care guidelines for uveal melanoma and breast cancer and discuss the role of clinical trials to determine best use in patients with CM.

4 Review MoleMapper: an application for crowdsourcing mole images to advance melanoma early-detection research. 2019

Petrie, Tracy / Samatham, Ravikant / Goodyear, Shaun M / Webster, Dan E / Leachman, Sancy A. ·Department of Dermatology, Oregon Health & Science University, Portland, Oregon. · Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon. · Sage Bionetworks, Seattle, Washington. · Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon. leachmas@ohsu.edu. ·Semin Cutan Med Surg · Pubmed #31051024.

ABSTRACT: Advancements in smartphone technologies and the use of specialized health care applications offer an exciting new era to promote melanoma awareness to the public and improve education and prevention strategies. These applications also afford an opportunity to power meaningful research aimed at improving image diagnostics and early melanoma detection. Here, we summarize our experience associated with developing and managing the implementation of MoleMapper™, a research-based application that not only provides an efficient way for users to digitally track images of moles and facilitate skin self-examinations but also provides a platform to crowdsource research participants and the curation of mole images in efforts to advance melanoma research. Obtaining electronic consent, safeguarding participant data, and employing a framework to ensure collection of meaningful data represent a few of the inherent difficulties associated with orchestrating such a wide-scale research enterprise. In this review, we discuss strategies to overcome these and other challenges leading to the implementation of MoleMapper™.

5 Review Melanoma Early Detection: Big Data, Bigger Picture. 2019

Petrie, Tracy / Samatham, Ravikant / Witkowski, Alexander M / Esteva, Andre / Leachman, Sancy A. ·Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA. · Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy; Department of Dermatology, 4 WSK Hospital Wroclaw, Poland. · Department of Computer Science, Stanford University, Stanford, California, USA. · Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA; Melanoma Program, Knight Cancer Institute at Oregon Health & Science University, Portland, Oregon, USA. Electronic address: leachmas@ohsu.edu. ·J Invest Dermatol · Pubmed #30482597.

ABSTRACT: Innovative technologies, including novel communication and imaging tools, are affecting dermatology in profound ways. A burning question for the field is whether we will retrospectively react to innovations or proactively leverage them to benefit precision medicine. Early detection of melanoma is a dermatologic area particularly poised to benefit from such innovation. This session of the Montagna Symposium on Biology of Skin focused on provocative, potentially disruptive advances, including crowdsourcing of patient advocacy efforts, rigorous experimental design of public education campaigns, research with mobile phone applications, advanced skin imaging technologies, and the emergence of artificial intelligence as a diagnostic supplement.

6 Review Chemoprevention agents for melanoma: A path forward into phase 3 clinical trials. 2019

Jeter, Joanne M / Bowles, Tawnya L / Curiel-Lewandrowski, Clara / Swetter, Susan M / Filipp, Fabian V / Abdel-Malek, Zalfa A / Geskin, Larisa J / Brewer, Jerry D / Arbiser, Jack L / Gershenwald, Jeffrey E / Chu, Emily Y / Kirkwood, John M / Box, Neil F / Funchain, Pauline / Fisher, David E / Kendra, Kari L / Marghoob, Ashfaq A / Chen, Suephy C / Ming, Michael E / Albertini, Mark R / Vetto, John T / Margolin, Kim A / Pagoto, Sherry L / Hay, Jennifer L / Grossman, Douglas / Ellis, Darrel L / Kashani-Sabet, Mohammed / Mangold, Aaron R / Markovic, Svetomir N / Meyskens, Frank L / Nelson, Kelly C / Powers, Jennifer G / Robinson, June K / Sahni, Debjani / Sekulic, Aleksandar / Sondak, Vernon K / Wei, Maria L / Zager, Jonathan S / Dellavalle, Robert P / Thompson, John A / Weinstock, Martin A / Leachman, Sancy A / Cassidy, Pamela B. ·Department of Medicine, Divisions of Genetics and Oncology, The Ohio State University, Columbus, Ohio. · Department of Surgery, Intermountain Health Care, Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, Utah. · Department of Medicine, The University of Arizona Cancer Center, Tucson, Arizona. · Department of Dermatology, Pigmented Lesion and Melanoma Program, Stanford University Medical Center Cancer Institute, Veterans Affairs Palo Alto Health Care System, Palo Alto, California. · Systems Biology and Cancer Metabolism, Program for Quantitative Systems Biology, University of California Merced, Merced, California. · Department of Dermatology, University of Cincinnati, Cincinnati, Ohio. · Department of Dermatology, Cutaneous Oncology Center, Columbia University Medical Center, New York, New York. · Department of Dermatologic Surgery, Mayo Clinic Minnesota, Rochester, Minnesota. · Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia. · Division of Dermatology, Veterans Affairs Medical Center, Atlanta, Georgia. · Departments of Surgical Oncology and Cancer Biology, Melanoma and Skin Cancer Center, The University of Texas MD Anderson Cancer Center, Houston, Texas. · Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania. · Melanoma and Skin Cancer Program, Department of Medicine, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania. · Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado. · Dermatology Service, U.S. Department of Veterans Affairs, Eastern Colorado Health Care System, Denver, Colorado. · Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado. · Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio. · Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts. · Department of Internal Medicine, Medical Oncology Division, The Ohio State University, Columbus, Ohio. · Memorial Sloan Kettering Skin Cancer Center and Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York, New York. · Department of Medicine, University of Wisconsin, School of Medicine and Public Health, University of Wisconsin Carbone Cancer Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin. · Division of Surgical Oncology, Oregon Health & Science University, Portland, Oregon. · Department of Medical Oncology, City of Hope National Medical Center, Duarte, California. · Department of Allied Health Sciences, UConn Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, Connecticut. · Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York. · Departments of Dermatology and Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah. · Department of Dermatology, Vanderbilt University Medical Center and Division of Dermatology, Vanderbilt Ingram Cancer Center, Nashville, Tennessee. · Department of Medicine, Tennessee Valley Healthcare System, Nashville Veterans Affairs Medical Center, Nashville, Tennessee. · Center for Melanoma Research and Treatment, California Pacific Medical Center, San Francisco, California. · Department of Dermatology, Mayo Clinic, Scottsdale, Arizona. · Department of Hematology and Oncology, Mayo Clinic, Rochester, Minnesota. · Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas. · Department of Dermatology, University of Iowa, Iowa City, Iowa. · Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois. · Department of Dermatology, Boston Medical Center, Boston, Massachusetts. · Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida. · Departments of Oncologic Sciences and Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida. · Department of Dermatology, University of California, San Francisco, San Francisco, California. · Dermatology Service, San Francisco Veterans Affairs Medical Center, San Francisco, California. · Department of Sarcoma, H. Lee Moffitt Cancer Center, Tampa, Florida. · Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington. · Center for Dermatoepidemiology, Veterans Affairs Medical Center, Providence, Rhode Island. · Department of Dermatology, Brown University, Providence, Rhode Island. · Department of Epidemiology, Brown University, Providence, Rhode Island. · Department of Dermatology, Rhode Island Hospital, Providence, Rhode Island. · Department of Dermatology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon. ·Cancer · Pubmed #30281145.

ABSTRACT: Recent progress in the treatment of advanced melanoma has led to unprecedented improvements in overall survival and, as these new melanoma treatments have been developed and deployed in the clinic, much has been learned about the natural history of the disease. Now is the time to apply that knowledge toward the design and clinical evaluation of new chemoprevention agents. Melanoma chemoprevention has the potential to reduce dramatically both the morbidity and the high costs associated with treating patients who have metastatic disease. In this work, scientific and clinical melanoma experts from the national Melanoma Prevention Working Group, composed of National Cancer Trials Network investigators, discuss research aimed at discovering and developing (or repurposing) drugs and natural products for the prevention of melanoma and propose an updated pipeline for translating the most promising agents into the clinic. The mechanism of action, preclinical data, epidemiological evidence, and results from available clinical trials are discussed for each class of compounds. Selected keratinocyte carcinoma chemoprevention studies also are considered, and a rationale for their inclusion is presented. These data are summarized in a table that lists the type and level of evidence available for each class of agents. Also included in the discussion is an assessment of additional research necessary and the likelihood that a given compound may be a suitable candidate for a phase 3 clinical trial within the next 5 years.

7 Review Integrating Skin Cancer-Related Technologies into Clinical Practice. 2017

Winkelmann, Richard R / Farberg, Aaron S / Glazer, Alex M / Cockerell, Clay J / Sober, Arthur J / Siegel, Daniel M / Leachman, Sancy A / High, Whitney A / Markowitz, Orit / Berman, Brian / Pariser, David M / Goldenberg, Gary / Rosen, Theodore / Rigel, Darrell S. ·Department of Dermatology, OhioHealth, 75 Hospital Drive STE 250, Athens, OH 4570, USA. · Department of Dermatology, Icahn School of Medicine at Mt. Sinai, 1425 Madison Avenue, Floor 2, New York, NY 10029, USA. · National Society for Cutaneous Medicine, 35 East 35th Street #208, New York, NY 10016, USA. · Department of Dermatology, The University of Texas Southwestern Medical Center, 5939 Harry Hines Boulevard. 4th Floor, Suite 100, Dallas, TX 75390, USA. · Department of Dermatology, Harvard Medical School, 50 Staniford Street, 2nd Floor, Boston, MA 02114, USA. · Department of Dermatology, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA. · Department of Dermatology, OHSU Knight Cancer Institute, Oregon Health & Science University, 3303 S.W. Bond Avenue, Portland, OR 97239, USA. · Department of Dermatology & Pathology, University of Colorado School of Medicine, 12635 E Montview Boulevard, Bioscience Park, Suite 160, Aurora, CO 80045, USA. · Department of Dermatology, Mount Sinai Medical Center, 5 E 98th Street, FL 5, New York, NY 10029, USA. · Department of Dermatology, University of Miami Miller School of Medicine, 2925 Aventura Boulevard, Suite 205, Aventura, FL 33180, USA. · Department of Dermatology, Eastern Virginia Medical School, 6160 Kempsville Circle, Suite 200A, Norfolk, VA 23502, USA. · Department of Dermatology, Baylor College of Medicine, 1977 Butler Street, Suite E6.200, Houston, Texas 77030, USA. · Department of Dermatology, NYU School of Medicine, 35 East 35th Street #208, New York, NY 10016, USA. Electronic address: dsrigel@prodigy.net. ·Dermatol Clin · Pubmed #28886814.

ABSTRACT: Early diagnosis and treatment of melanoma improve survival. New technologies are emerging that may augment the diagnosis, assessment, and management of melanoma but penetrance into everyday practice is low. In the current health care climate, greater emphasis will be placed on the incorporation of technology for clinically suspicious pigmented lesions to facilitate better, more cost-effective management.

8 Review Assessing Genetic Expression Profiles in Melanoma Diagnosis. 2017

Leachman, Sancy A / Mengden Koon, Stephanie / Korcheva, Veselina B / White, Kevin P. ·Melanoma and Skin Cancer Program, Department of Dermatology, OHSU Knight Cancer Institute, Oregon Health & Science University, 3303 SW Bond Avenue, Portland, OR 97239, USA. Electronic address: leachmas@ohsu.edu. · Department of Dermatology, Oregon Health & Science University, 3303 SW Bond Avenue, Portland, OR 97239, USA. ·Dermatol Clin · Pubmed #28886810.

ABSTRACT: Most melanocytic tumors can be characterized as a benign nevus or a melanoma by a trained pathologist using traditional histopathological methods. However, a minority demonstrates ambiguous features and continues to be a diagnostic challenge. Genetic expression profiling (GEP) assays have been developed in an effort to resolve this dilemma. These assays measure mRNA levels of specified genes using reverse transcription quantitative polymerase chain reaction technology. The development of GEP assays, methodology, challenges associated with GEP validation and testing, and the suitability of a currently available GEP test for clinical use are reviewed.

9 Review Skin cancer screening: recommendations for data-driven screening guidelines and a review of the US Preventive Services Task Force controversy. 2017

Johnson, Mariah M / Leachman, Sancy A / Aspinwall, Lisa G / Cranmer, Lee D / Curiel-Lewandrowski, Clara / Sondak, Vernon K / Stemwedel, Clara E / Swetter, Susan M / Vetto, John / Bowles, Tawnya / Dellavalle, Robert P / Geskin, Larisa J / Grossman, Douglas / Grossmann, Kenneth F / Hawkes, Jason E / Jeter, Joanne M / Kim, Caroline C / Kirkwood, John M / Mangold, Aaron R / Meyskens, Frank / Ming, Michael E / Nelson, Kelly C / Piepkorn, Michael / Pollack, Brian P / Robinson, June K / Sober, Arthur J / Trotter, Shannon / Venna, Suraj S / Agarwala, Sanjiv / Alani, Rhoda / Averbook, Bruce / Bar, Anna / Becevic, Mirna / Box, Neil / E Carson, William / Cassidy, Pamela B / Chen, Suephy C / Chu, Emily Y / Ellis, Darrel L / Ferris, Laura K / Fisher, David E / Kendra, Kari / Lawson, David H / Leming, Philip D / Margolin, Kim A / Markovic, Svetomir / Martini, Mary C / Miller, Debbie / Sahni, Debjani / Sharfman, William H / Stein, Jennifer / Stratigos, Alexander J / Tarhini, Ahmad / Taylor, Matthew H / Wisco, Oliver J / Wong, Michael K. ·Department of Dermatology, Oregon Health & Science University, 3303 SW Bond Ave., Portland, OR, USA. · University of Utah, Salt Lake City, UT, USA. · University of Washington, Seattle, WA, USA. · University of Arizona Cancer Center, Tucson, AZ, USA. · Moffitt Cancer Center, Tampa, FL, USA. · Oregon Health & Science University, Portland, OR, USA. · Stanford University Medical Center & VA Palo Alto Health Care System, Palo Alto, CA, USA. · Intermountain Healthcare & University of Utah, Salt Lake City, UT, USA. · University of Colorado, Aurora, CO, USA. · Columbia University, New York, NY, USA. · The Ohio State University, Columbus, OH, USA. · Harvard Medical School, Boston, MA, USA. · University of Pittsburgh, Pittsburgh, PA, USA. · Mayo Clinic Arizona, Scottsdale, AZ, USA. · University of California, Irvine, Orange, CA, USA. · University of Pennsylvania, Philadelphia, PA, USA. · The University of Texas MD Anderson Cancer Center, Houston, TX, USA. · Emory University & Atlanta VA Medical Center, Atlanta, GA, USA. · Northwestern University Feinberg School of Medicine, Chicago, IL USA. · Inova Medical Group, Fairfax, VA, USA. · St Luke's University Hospital & Temple University, Bethlehem, PA, USA. · Boston University, Boston, MA, USA. · Case Western Reserve University, Cleveland, OH, USA. · University of Missouri, Columbia, MO, USA. · Vanderbilt University, Nashville, TN, USA. · Harvard Medical School & Massachusetts General Hospital, Charlestown, MA, USA. · Winship Cancer Institute of Emory University, Atlanta, GA, USA. · The Christ Hospital, Cincinnati, OH, USA. · City of Hope National Cancer Center, Duarte, CA, USA. · Mayo Clinic Rochester, MN, USA. · Johns Hopkins University, Baltimore, MD. · NYU Langone Medical Center, New York, NY, USA. · Department of Dermatology, University of Athens, Andreas Sygros Hospital, Athens, Greece. · Bend Memorial Clinic, Bend, OR, USA. · University of Texas MD Anderson Cancer Center, Houston, TX, USA. ·Melanoma Manag · Pubmed #28758010.

ABSTRACT: Melanoma is usually apparent on the skin and readily detected by trained medical providers using a routine total body skin examination, yet this malignancy is responsible for the majority of skin cancer-related deaths. Currently, there is no national consensus on skin cancer screening in the USA, but dermatologists and primary care providers are routinely confronted with making the decision about when to recommend total body skin examinations and at what interval. The objectives of this paper are: to propose rational, risk-based, data-driven guidelines commensurate with the US Preventive Services Task Force screening guidelines for other disorders; to compare our proposed guidelines to recommendations made by other national and international organizations; and to review the US Preventive Services Task Force's 2016 Draft Recommendation Statement on skin cancer screening.

10 Review Operable Melanoma: Screening, Prognostication, and Adjuvant and Neoadjuvant Therapy. 2017

Tarhini, Ahmad A / Lorigan, Paul / Leachman, Sancy. ·From the University of Pittsburgh, Pittsburgh, PA; University of Manchester, Manchester, United Kingdom; Oregon Health & Science University, Portland, OR. ·Am Soc Clin Oncol Educ Book · Pubmed #28561661.

ABSTRACT: The importance of reducing the numbers of patients with late-stage melanoma, identifying which patients are most likely to progress, and treating these patients at the earliest possible stage cannot be overemphasized. Improved screening of patients prior to diagnosis has the advantage of identifying early-stage disease that is for the most part treatable by surgical methods. The process of melanoma screening is rapidly evolving through population-based programs, mobile health technologies, and advanced imaging tools. For patients with newly diagnosed melanoma, accurately estimating disease prognosis has important implications for management and follow-up. Prognostic factors are individual host- or tumor-related factors or molecules that correlate with genetic predisposition and clinical course. These include clinical covariates and host and tumor proteomic/genomic markers that allow the prognostic subclassification of patients. Adjuvant therapy for high-risk surgically resected melanoma targets residual micrometastatic disease with the goal of reducing the risk of relapse and mortality. In the United States, three regimens have achieved regulatory approval for adjuvant therapy, including high-dose interferon alpha, pegylated interferon alpha, and ipilimumab at 10 mg/kg. Phase III trials have reported benefits in relapse-free survival (all regimens) and overall survival (high-dose interferon alpha and ipilimumab). The management of locally/regionally advanced melanoma may benefit from neoadjuvant therapy, which is the subject of several ongoing studies. Recent studies have shown promising clinical activity and yielded important biomarker findings and mechanistic insights.

11 Review A systematic review of interventions to improve adherence to melanoma preventive behaviors for individuals at elevated risk. 2016

Wu, Yelena P / Aspinwall, Lisa G / Conn, Bridgid M / Stump, Tammy / Grahmann, Bridget / Leachman, Sancy A. ·Division of Public Health, Department of Family and Preventive Medicine, University of Utah, USA; Huntsman Cancer Institute, USA. Electronic address: yelena.wu@utah.edu. · Huntsman Cancer Institute, USA; Department of Psychology, University of Utah, USA. · Department of Pediatrics, Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, USA. · Department of Psychology, University of Utah, USA. · Division of Public Health, Department of Family and Preventive Medicine, University of Utah, USA. · Huntsman Cancer Institute, USA; Department of Dermatology, Oregon Health & Science University, USA. ·Prev Med · Pubmed #27090434.

ABSTRACT: BACKGROUND AND OBJECTIVES: To examine the effectiveness of behavioral interventions for melanoma prevention targeted to individuals at elevated risk due to personal and/or family history. METHODS: Through literature searches in 5 search databases (through July 2014), 20 articles describing 14 unique interventions focused on melanoma prevention among individuals at elevated risk for the disease were identified. Interventions targeting only patients undergoing active treatment for melanoma were excluded. RESULTS: The average study quality was moderate. The majority of interventions (6 out of 9, 66% of studies) led to improvements in one or more photoprotective behaviors, particularly for improvements in use of protective clothing (3 out of 5, 60% of studies), and frequency and/or thoroughness of skin self-examinations (9 out of 12, 75%). Fewer interventions (5 out of 14, 36%) targeted uptake of total body skin examinations (60% led to improvements). Also, fewer interventions targeted all three preventive behaviors (5 out of 14, 36%). CONCLUSIONS: Findings suggest that future interventions should aim to improve adherence across multiple preventive behaviors, over a longer time period (past 8months post-intervention), and target high-risk children. Studies should include adequate sample sizes to investigate moderators and mediators of intervention effectiveness. Interventions may be strengthened by new techniques, such as incorporating family members (e.g., to improve thoroughness of skin self-examinations) and eHealth technology.

12 Review Familial skin cancer syndromes: Increased melanoma risk. 2016

Ransohoff, Katherine J / Jaju, Prajakta D / Tang, Jean Y / Carbone, Michele / Leachman, Sancy / Sarin, Kavita Y. ·Department of Dermatology, Stanford University Medical Center, Stanford, California. · Department of Thoracic Oncology, University of Hawaii Cancer Center, Honolulu, Hawaii. · Department of Dermatology, Oregon Health and Science University, Portland, Oregon. · Department of Dermatology, Stanford University Medical Center, Stanford, California. Electronic address: ksarin@stanford.edu. ·J Am Acad Dermatol · Pubmed #26892652.

ABSTRACT: Phenotypic traits, such as red hair and freckling, increase melanoma risk by 2- to 3-fold. In addition, approximately 10% of melanomas are caused by inherited germline mutations that increase melanoma risk from 4- to >1000-fold. This review highlights the key genes responsible for inherited melanoma, with an emphasis on when a patient should undergo genetic testing. Many genetic syndromes associated with increased melanoma risk are also associated with an increased risk of other cancers. Identification of these high-risk patients is essential for preventive behavior reinforcement, genetic counseling, and ensuring other required cancer screenings.

13 Review Methods of Melanoma Detection. 2016

Leachman, Sancy A / Cassidy, Pamela B / Chen, Suephy C / Curiel, Clara / Geller, Alan / Gareau, Daniel / Pellacani, Giovanni / Grichnik, James M / Malvehy, Josep / North, Jeffrey / Jacques, Steven L / Petrie, Tracy / Puig, Susana / Swetter, Susan M / Tofte, Susan / Weinstock, Martin A. ·Department of Dermatology and Knight Cancer Institute, Oregon Health and Science University, 3303 SW Bond Avenue, CH16D, Portland, OR, 97239, USA. leachmas@ohsu.edu. · Department of Dermatology and Knight Cancer Institute, Oregon Health and Science University, 3125 SW Sam Jackson Park Road, L468R, Portland, OR, 97239, USA. cassidyp@ohsu.edu. · Department of Dermatology, Emory University School of Medicine, 1525 Clifton Road NE, 1st Floor, Atlanta, GA, 30322, USA. schen2@emory.edu. · Department of Dermatology and Arizona Cancer Center, University of Arizona, 1515 N Campbell Avenue, Tucson, AZ, 85721, USA. ccuriel@email.arizona.edu. · Department of Dermatology, Harvard School of Public Health and Massachusetts General Hospital, Landmark Center, 401 Park Drive, 3rd Floor East, Boston, MA, 02215, USA. ageller@hsph.harvard.edu. · Laboratory of Investigative Dermatology, The Rockefeller University, 1230 York Avenue, New York, NY, 10065, USA. daniel.gareau@rockefeller.edu. · Department of Dermatology, University of Modena and Reggio Emilia, Via del Pozzo 71, Modena, Italy. giovanni.pellacani@unimore.it. · Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Room 912, BRB (R-125), 1501 NW 10th Avenue, Miami, FL, 33136, USA. grichnik@miami.edu. · Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Villarroel 170, 08036, Barcelona, Spain. jmalvehy@clinic.ub.es. · University of California, San Francisco, 1701 Divisadero Street, Suite 280, San Francisco, CA, 94115, USA. jeffrey.north@ucsf.edu. · Department of Biomedical Engineering and Dermatology, Oregon Health and Science University, 3303 SW Bond Avenue, CH13B, Portland, OR, 97239, USA. jacquess@ohsu.edu. · Department of Biomedical Engineering, Oregon Health and Science University, 3303 SW Bond Avenue, CH13B, Portland, OR, 97239, USA. petrie@ohsu.edu. · Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Villarroel 170, 08036, Barcelona, Spain. spuig@clinic.ub.es. · Department of Dermatology/Cutaneous Oncology, Stanford University, 900 Blake Wilbur Drive, W3045, Stanford, CA, 94305, USA. sswetter@stanford.edu. · Department of Dermatology, Oregon Health and Science University, 3303 SW Bond Avenue, CH16D, Portland, OR, 97239, USA. toftes@ohsu.edu. · Departments of Dermatology and Epidemiology, Brown University, V A Medical Center 111D, 830 Chalkstone Avenue, Providence, RI, 02908, USA. maw@brown.edu. ·Cancer Treat Res · Pubmed #26601859.

ABSTRACT: Detection and removal of melanoma, before it has metastasized, dramatically improves prognosis and survival. The purpose of this chapter is to (1) summarize current methods of melanoma detection and (2) review state-of-the-art detection methods and technologies that have the potential to reduce melanoma mortality. Current strategies for the detection of melanoma range from population-based educational campaigns and screening to the use of algorithm-driven imaging technologies and performance of assays that identify markers of transformation. This chapter will begin by describing state-of-the-art methods for educating and increasing awareness of at-risk individuals and for performing comprehensive screening examinations. Standard and advanced photographic methods designed to improve reliability and reproducibility of the clinical examination will also be reviewed. Devices that magnify and/or enhance malignant features of individual melanocytic lesions (and algorithms that are available to interpret the results obtained from these devices) will be compared and contrasted. In vivo confocal microscopy and other cellular-level in vivo technologies will be compared to traditional tissue biopsy, and the role of a noninvasive "optical biopsy" in the clinical setting will be discussed. Finally, cellular and molecular methods that have been applied to the diagnosis of melanoma, such as comparative genomic hybridization (CGH), fluorescent in situ hybridization (FISH), and quantitative reverse transcriptase polymerase chain reaction (qRT-PCR), will be discussed.

14 Review Addressing the knowledge gap in clinical recommendations for management and complete excision of clinically atypical nevi/dysplastic nevi: Pigmented Lesion Subcommittee consensus statement. 2015

Kim, Caroline C / Swetter, Susan M / Curiel-Lewandrowski, Clara / Grichnik, James M / Grossman, Douglas / Halpern, Allan C / Kirkwood, John M / Leachman, Sancy A / Marghoob, Ashfaq A / Ming, Michael E / Nelson, Kelly C / Veledar, Emir / Venna, Suraj S / Chen, Suephy C. ·Pigmented Lesion Clinic and Cutaneous Oncology Program, Department of Dermatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts. · Pigmented Lesion and Melanoma Program, Department of Dermatology, Stanford University Medical Center, Palo Alto, California3Dermatology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California. · Pigmented Lesion Clinic and Multidisciplinary Cutaneous Oncology Program, Division of Dermatology, Department of Medicine, University of Arizona, Tucson. · Melanoma Program, Department of Dermatology, Miller School of Medicine, University of Miami, Miami, Florida. · Pigmented Lesion Clinic, Departments of Dermatology and Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City. · Pigmented Lesion Clinic, Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. · Melanoma Program, University of Pittsburgh Cancer Institute, Department of Medicine, Dermatology and Translational Science, University of Pittsburgh, Pittsburgh, Pennsylvania. · Melanoma and Cutaneous Oncology Program, Department of Dermatology, Oregon Health and Science University, Portland. · Pigmented Lesion Clinic, Department of Dermatology, University of Pennsylvania, Philadelphia. · Pigmented Lesion Clinic, Department of Dermatology, Duke University Medical Center, Durham, North Carolina. · Center for Research and Grants, Baptist Health South Florida, Miami. · Skin Oncology and Melanoma Center, Department of Medicine, MedStar Washington Cancer Institute and Georgetown University Medical Center, Washington, DC. · Melanoma and Pigmented Lesion Clinic, Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia15Division of Dermatology, Atlanta Veterans Administration Medical Center, Decatur, Georgia. ·JAMA Dermatol · Pubmed #25409291.

ABSTRACT: IMPORTANCE: The management of clinically atypical nevi/dysplastic nevi (CAN/DN) is controversial, with few data to guide the process. Management recommendations for DN with positive histologic margins were developed by the Delphi method to achieve consensus among members of the Pigmented Lesion Subcommittee (PLS) of the Melanoma Prevention Working Group (MPWG) after reviewing the current evidence. OBJECTIVES: To outline key issues related to the management of CAN/DN: (1) biopsies of CAN and how positive margins arise, (2) whether incompletely excised DN evolve into melanoma, (3) current data on the outcomes of DN with positive histologic margins, (4) consensus recommendations, and (5) a proposal for future studies, including a large-scale study to help guide the management of DN with positive margins. EVIDENCE REVIEW: The literature, including recent studies examining management and outcomes of DN with positive margins between 2009 to 2014, was reviewed. FINDINGS: A consensus statement by the PLS of the MPWG following review of the literature, group discussions, and a structured Delphi method consensus. CONCLUSIONS AND RELEVANCE: This consensus statement reviews the complexities of management of CAN/DN. A review of the literature and 2 rounds of a structured Delphi consensus resulted in the following recommendations: (1) mildly and moderately DN with clear margins do not need to be reexcised, (2) mildly DN biopsied with positive histologic margins without clinical residual pigmentation may be safely observed rather than reexcised, and (3) observation may be a reasonable option for management of moderately DN with positive histologic margins without clinically apparent residual pigmentation; however, more data are needed to make definitive recommendations in this clinical scenario.

15 Review Melanocortins and the melanocortin 1 receptor, moving translationally towards melanoma prevention. 2014

Abdel-Malek, Zalfa A / Swope, Viki B / Starner, Renny J / Koikov, Leonid / Cassidy, Pamela / Leachman, Sancy. ·Department of Dermatology, University of Cincinnati, United States. Electronic address: abdelmza@uc.edu. · Department of Dermatology, University of Cincinnati, United States. · Department of Dermatology, Oregon Health Sciences University, United States. ·Arch Biochem Biophys · Pubmed #25017567.

ABSTRACT: Beginning in the last decade of the twentieth century, the fields of pigment cell research and melanoma have witnessed major breakthroughs in the understanding of the role of melanocortins in human pigmentation and the DNA damage response of human melanocytes to solar ultraviolet radiation (UV). This began with the cloning of the melanocortin 1 receptor (MC1R) gene from human melanocytes and the demonstration that the encoded receptor is functional. Subsequently, population studies found that the MC1R gene is highly polymorphic, and that some of its variants are associated with red hair phenotype, fair skin and poor tanning ability. Using human melanocytes cultured from donors with different MC1R genotypes revealed that the alleles associated with red hair color encode for a non-functional receptor. Epidemiological studies linked the MC1R red hair color variants to increased melanoma risk. Investigating the impact of different MC1R variants on the response of human melanocytes to UV led to the important discovery that the MC1R signaling activates antioxidant, DNA repair and survival pathways, in addition to stimulation of eumelanin synthesis. These effects of MC1R were absent in melanocytes expressing 2 MC1R red hair color variants that result in loss of function of the receptor. The importance of the MC1R in reducing UV-induced genotoxicity in melanocytes led us to design small peptide analogs of the physiological MC1R agonist α-melanocortin (α-melanocyte stimulating hormone; α-MSH) for the goal of utilizing them for melanoma chemoprevention.

16 Review Melanocytes as instigators and victims of oxidative stress. 2014

Denat, Laurence / Kadekaro, Ana L / Marrot, Laurent / Leachman, Sancy A / Abdel-Malek, Zalfa A. ·L'OREAL Research and Innovation, Aulnay-sous-Bois, France. · Department of Dermatology, University of Cincinnati, Cincinnati, Ohio, USA. · Department of Dermatology, Oregon Health Sciences University, Portland, Oregon, USA. · Department of Dermatology, University of Cincinnati, Cincinnati, Ohio, USA. Electronic address: abdelmza@uc.edu. ·J Invest Dermatol · Pubmed #24573173.

ABSTRACT: Epidermal melanocytes are particularly vulnerable to oxidative stress owing to the pro-oxidant state generated during melanin synthesis, and to the intrinsic antioxidant defenses that are compromised in pathologic conditions. Melanoma is thought to be oxidative stress driven, and melanocyte death in vitiligo is thought to be instigated by a highly pro-oxidant state in the epidermis. We review the current knowledge about melanin and the redox state of melanocytes, how paracrine factors help counteract oxidative stress, the role of oxidative stress in melanoma initiation and progression and in melanocyte death in vitiligo, and how this knowledge can be harnessed for melanoma and vitiligo treatment.

17 Review Survival is not the only valuable end point in melanoma screening. 2012

Curiel-Lewandrowski, Clara / Kim, Caroline C / Swetter, Susan M / Chen, Suephy C / Halpern, Allan C / Kirkwood, John M / Leachman, Sancy A / Marghoob, Ashfaq A / Ming, Michael E / Grichnik, James M / Anonymous2280718. ·Division of Dermatology, Department of Medicine, University of Arizona, Tucson, Arizona, USA. ·J Invest Dermatol · Pubmed #22336950.

ABSTRACT: -- No abstract --

18 Review Genetics of pigmentation and melanoma predisposition. 2010

Pho, L N / Leachman, S A. ·Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, UT 84112, USA. ·G Ital Dermatol Venereol · Pubmed #20197744.

ABSTRACT: About 5-10% of human cutaneous malignant melanoma is hereditary and known to involve rare germline mutations in highly penetrant, autosomal dominant genes. These genes are important in cell cycle control but are not responsible for all familial cases of melanoma. Epidemiologic studies have linked specific phenotypic traits including fair skin, light-colored eyes, and poor tanning ability to melanoma risks. The ability to visually discern and define pigmentary phenotypes in humans and in animal models has permitted elucidation of many genes involved in pigmentation and melanin biosynthesis. Additional genetic epidemiological studies have recently identified a subset of these pigmentation genes that are associated with risk for melanoma and other cutaneous malignancies as well as photosensitivity. Genome-wide association studies (GWAS) have unveiled single nucleotide polymorphisms (SNPs) or genetic variants in MC1R, TPCN2, ASIP, KITLG, NCKX5, TYR, IRF4, OCA2, and TYRP1 pigmentation genes. These findings emphasize the contribution of pigmentation pathways to melanoma predisposition and tumorigenesis through gene-environment interactions. Since pigmentation genes in the melanin synthesis pathway also confer risk for cutaneous malignancy, a better understanding of the operative molecular mechanisms involved in this relationship has the potential to impact individual risk assessment for cutaneous malignant melanoma in the future. This paper is an overview of our current understanding of pigmentation gene modifications that have been associated with melanoma risk and how these genes can enrich clinical management, prevention, and early detection of malignant melanoma.

19 Clinical Trial A Phase II Randomized Placebo-Controlled Trial of Oral N-acetylcysteine for Protection of Melanocytic Nevi against UV-Induced Oxidative Stress In Vivo. 2017

Cassidy, Pamela B / Liu, Tong / Florell, Scott R / Honeggar, Matthew / Leachman, Sancy A / Boucher, Kenneth M / Grossman, Douglas. ·Department of Dermatology, Oregon Health & Science University, Portland, Oregon. doug.grossman@hci.utah.edu cassidyp@ohsu.edu. · Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon. · Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, Utah. · Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, Utah. · Department of Dermatology, Oregon Health & Science University, Portland, Oregon. · Department of Internal Medicine, University of Utah Health Sciences Center, Salt Lake City, Utah. · Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, Utah. doug.grossman@hci.utah.edu cassidyp@ohsu.edu. · Department of Oncological Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah. ·Cancer Prev Res (Phila) · Pubmed #27920018.

ABSTRACT: Oxidative stress plays a role in UV-induced melanoma, which may arise from melanocytic nevi. We investigated whether oral administration of the antioxidant N-acetylcysteine (NAC) could protect nevi from oxidative stress in vivo in the setting of acute UV exposure. The minimal erythemal dose (MED) was determined for 100 patients at increased risk for melanoma. Patients were randomized to receive a single dose (1,200 mg) of NAC or placebo, in double-blind fashion, and then one nevus was irradiated (1-2 MED) using a solar simulator. One day later, the MED was redetermined and the irradiated nevus and a control unirradiated nevus were removed for histologic analysis and examination of biomarkers of NAC metabolism and UV-induced oxidative stress. Increased expression of 8-oxoguanine, thioredoxin reductase-1, and γ-glutamylcysteine synthase modifier subunit were consistently seen in UV-treated compared with unirradiated nevi. However, no significant differences were observed in these UV-induced changes or in the pre- and postintervention MED between those patients receiving NAC versus placebo. Similarly, no significant differences were observed in UV-induced changes between subjects with germline wild-type versus loss-of-function mutations in the melanocortin-1 receptor. Nevi showed similar changes of UV-induced oxidative stress in an open-label post-trial study in 10 patients who received NAC 3 hours before nevus irradiation. Thus, a single oral dose of NAC did not effectively protect nevi from UV-induced oxidative stress under the conditions examined. Cancer Prev Res; 10(1); 36-44. ©2016 AACR.

20 Clinical Trial A phase I study of intratumoral ipilimumab and interleukin-2 in patients with advanced melanoma. 2016

Ray, Abhijit / Williams, Matthew A / Meek, Stephanie M / Bowen, Randy C / Grossmann, Kenneth F / Andtbacka, Robert H I / Bowles, Tawnya L / Hyngstrom, John R / Leachman, Sancy A / Grossman, Douglas / Bowen, Glen M / Holmen, Sheri L / VanBrocklin, Matthew W / Suneja, Gita / Khong, Hung T. ·Division of Oncology, Huntsman Cancer Institute-University of Utah, Salt Lake City, UT, USA. · Department of Pathology, University of Utah, Salt Lake City, UT, USA. · School of Medicine, University of Utah, Salt Lake City, UT, USA. · Section of Surgical Oncology, Division of General Surgery Huntsman Cancer Institute-University of Utah, Salt Lake City, UT, USA. · Department of General Surgery, Intermountain Medical Center, Murray, UT, USA. · Department of Dermatology, Oregon Health & Science University-Knight Cancer Institute, Portland, OR, USA. · Department of Radiation Oncology, University of Utah, Salt Lake City, UT, USA. ·Oncotarget · Pubmed #27391442.

ABSTRACT: PURPOSE: Intratumoral interleukin-2 (IL-2) is effective but does not generate systemic immunity. Intravenous ipilimumab produces durable clinical response in a minority of patients, with potentially severe toxicities. Circulating anti-tumor T cells activated by ipilimumab may differ greatly from tumor-infiltrating lymphocytes activated by intratumoral ipilimumab in phenotypes and functionality. The objective of this study was to primarily assess the safety of intratumoral ipilimumab/IL-2 combination and to obtain data on clinical efficacy. RESULTS: There was no dose limiting toxicity. While local response of injected lesions was observed in 67% patients (95% CI, 40%-93%), an abscopal response was seen in 89% (95% CI, 68%-100%). The overall response rate and clinical benefit rate by immune-related response criteria (irRC) was 40% (95% CI, 10%-70%) and 50% (95% CI, 19%-81%), respectively. Enhanced systemic immune response was observed in most patients and correlated with clinical responses. EXPERIMENTAL DESIGN: Twelve patients with unresectable stages III/IV melanoma were enrolled. A standard 3+3 design was employed to assess highest tolerable intratumoral dose of ipilimumab and IL-2 based on toxicity during the first three weeks. Escalated doses of ipilimumab was injected into only one lesion weekly for eight weeks in cohorts of three patients. A fixed dose of IL-2 was injected three times a week into the same lesion for two weeks, followed by two times a week for six weeks. CONCLUSIONS: Intratumoral injection with the combination of ipilimumab/IL-2 is well tolerated and generates responses in both injected and non-injected lesions in the majority of patients.

21 Clinical Trial A randomized, double-blind, placebo-controlled phase II clinical trial of lovastatin for various endpoints of melanoma pathobiology. 2014

Linden, Kenneth G / Leachman, Sancy A / Zager, Jonathan S / Jakowatz, James G / Viner, Jaye L / McLaren, Christine E / Barr, Ronald J / Carpenter, Philip M / Chen, Wen-Pin / Elmets, Craig A / Tangrea, Joseph A / Lim, Sung-Jig / Cochran, Alistair J / Meyskens, Frank L. ·Department of Dermatology and The Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, 101 The City Drive, Orange, CA 92868. kglinden@uci.edu. ·Cancer Prev Res (Phila) · Pubmed #24614012.

ABSTRACT: On the basis of large cardiovascular clinical trials of lipid-lowering agents that showed a considerable decrease in the incidence of primary melanomas in the active agent arm, we have carried out a randomized, double-blind clinical trial examining the impact of lovastatin on various biomarkers of melanoma pathogenesis. Subjects with at least two clinically atypical nevi were randomized to receive oral lovastatin or placebo for a 6-month period. Clinical, histopathologic, and molecular biomarkers were evaluated for change in the two groups. Eighty subjects were randomized, evaluable, and included in the analyses. Lovastatin showed no benefit in comparison with placebo in the primary endpoint of decreasing the level of histopathologic atypia, nor in any of the secondary endpoints of decreasing clinical atypia, impact on nevus number, nor in showing significant changes in any of the molecular biomarkers. There were no significant differences in adverse event profiles for lovastatin compared with placebo. The lovastatin arm did show a significant and considerable decrease in total serum cholesterol and serum low-density lipoprotein (LDL) levels compared with placebo, an expected result. This finding bolsters confidence in subject compliance. Given the results of this trial, it is concluded that if lovastatin were to lower the incidence of melanoma, it would appear not to be doing so by reversing atypia of precursor atypical nevi over the 6-month time frame studied. Further research into the pathogenesis of melanoma and in other potential chemopreventive agents is needed.

22 Article Priority of Risk (But Not Perceived Magnitude of Risk) Predicts Improved Sun-Protection Behavior Following Genetic Counseling for Familial Melanoma. 2020

Taber, Jennifer M / Aspinwall, Lisa G / Drummond, Danielle M / Stump, Tammy K / Kohlmann, Wendy / Champine, Marjan / Cassidy, Pamela / Leachman, Sancy A. ·Department of Psychological Sciences, Kent State University, Kent, OH. · Department of Psychology, University of Utah, Salt Lake City, UT. · Department of Preventive Medicine, Northwestern University, Evanston, IL. · Huntsman Cancer Institute, University of Utah, Salt Lake City, UT. · Oregon Health & Science University, Portland, OR. ·Ann Behav Med · Pubmed #32415830.

ABSTRACT: BACKGROUND: Understanding multiple components of risk perceptions is important because perceived risk predicts engagement in prevention behaviors. PURPOSE: To examine how multiple components of risk perceptions (perceived magnitude of and worry about risk, prioritization of the management of one's risk) changed following genetic counseling with or without test reporting, and to examine which of these components prospectively predicted improvements in sun-protection behavior 1 year later. METHODS: A prospective, nonrandomized study design was used. Participants were 114 unaffected members of melanoma-prone families who (i) underwent genetic testing for a CDKN2A/p16 mutation (n = 69) or (ii) were at comparably elevated risk based on family history and underwent genetic counseling but not testing (no-test controls, n = 45). Participants reported risk perception components and sun-protection behavior at baseline, immediately following counseling, and 1 month and 1 year after counseling. RESULTS: Factor analysis indicated three risk components. Carriers reported increased perceived magnitude and priority of risk, but not cancer worry. No-test controls showed no changes in any risk perception. Among noncarriers, priority of risk remained high at all assessments, whereas magnitude of risk and cancer worry decreased. Of the three risk components, greater priority of risk uniquely predicted improved self-reported sun protection 1 year post-counseling. CONCLUSIONS: Priority of risk (i) seems to be a component of risk perceptions distinguishable from magnitude of risk and cancer worry, (ii) may be an important predictor of daily prevention behavior, and (iii) remained elevated 1 year following genetic counseling only for participants who received a positive melanoma genetic test result.

23 Article Parent and child perspectives on family interactions related to melanoma risk and prevention after CDKN2A/p16 testing of minor children. 2020

Wu, Yelena P / Aspinwall, Lisa G / Parsons, Bridget / Stump, Tammy K / Nottingham, Katy / Kohlmann, Wendy / Champine, Marjan / Cassidy, Pamela / Leachman, Sancy A. ·Department of Dermatology, University of Utah, Salt Lake City, USA. Yelena.Wu@utah.edu. · Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4509, Salt Lake City, UT, 84112, USA. Yelena.Wu@utah.edu. · Department of Psychology, University of Utah, Salt Lake City, USA. · Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4509, Salt Lake City, UT, 84112, USA. · Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, USA. · Population Health Sciences, University of Utah, Salt Lake City, USA. · Ancestry DNA, Lehi, USA. · Department of Dermatology, Oregon Health & Science University, Portland, USA. · Knight Cancer Institute, Oregon Health & Science University, Portland, USA. ·J Community Genet · Pubmed #31955387.

ABSTRACT: Predispositional genetic testing of children for adult-onset health risks is typically only used when prevention and screening measures have utility during childhood. Little is known about how children and their parents may use predispositional risk information, including whether it changes their interactions around risk-reducing prevention and screening behaviors. The current study examined perspectives on family interactions around skin cancer prevention and control practices through 1 year after test reporting and counseling among children who received melanoma predispositional genetic testing and their parents. Eighteen children (50% carriers, 56% male, mean age = 12.4 years) and 11 parents from 11 families participated in semi-structured interviews 1 month and 1 year after receiving the child's test result. Both parents (73%) and children (50%) reported making changes to family skin cancer prevention and control practices after receiving the test result. Parent- and child-reported discussions about melanoma prevention increased over time (36% parents and 61% children at 1 month, 73% parents and 67% at 1 year). One-quarter (27%) of parents and no children reported having conflicts about sun protection or screening 1 year after test reporting. A majority of parents (63%) reported treating their child differently at the 1-year follow-up, especially among carriers. Predispositional genetic testing for melanoma was associated with reported changes to plans for and discussions about sun protection, and high levels of parent-child collaboration to implement child sun protection. Future work could seek to identify child and parent factors and interactions that predict improved prevention and screening behaviors following pediatric predispositional genetic testing.

24 Article A pilot study of a telehealth family-focused melanoma preventive intervention for children with a family history of melanoma. 2020

Wu, Yelena P / Boucher, Kenneth / Hu, Nan / Hay, Jennifer / Kohlmann, Wendy / Aspinwall, Lisa G / Bowen, Deborah J / Parsons, Bridget G / Nagelhout, Elizabeth S / Grossman, Douglas / Mooney, Kathi / Leachman, Sancy A / Tercyak, Kenneth P. ·Department of Dermatology, University of Utah, Salt Lake City, Utah. · Huntsman Cancer Institute, Salt Lake City, Utah. · Internal Medicine, University of Utah, Salt Lake City, Utah. · Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York. · Department of Psychology, University of Utah, Salt Lake City, Utah. · Department of Bioethics and Humanities, University of Washington, Seattle, Washington. · Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah. · College of Nursing, University of Utah, Salt Lake City, Utah. · Department of Dermatology & Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon. · Cancer Control Program, Georgetown Lombardi Comprehensive Cancer Center, Washington, D.C. ·Psychooncology · Pubmed #31520429.

ABSTRACT: OBJECTIVE: Melanoma preventive interventions for children with familial risk are critically needed because ultraviolet radiation (UVR) exposure and sunburn occurrence early in life are the primary modifiable risk factors for melanoma. The current study examined the feasibility and acceptability of a new, family-focused telehealth intervention for children with familial risk for melanoma and their parents. The study also explored changes in child sun protection and risk behaviors, sunburn occurrence, and objectively measured UVR exposure. METHODS: This was a prospective study with a single-group design (n = 21 parent-child dyads, children ages 8-17). Dyads were asked to participate in three in-person assessments and three live video teleconference intervention sessions. RESULTS: The intervention was feasibly delivered, and the intervention content was acceptable to parents and children. The intervention was associated with improvements in child use of certain sun protection strategies over time and declines in child UVR exposure. CONCLUSIONS: A telehealth-delivered,family-focused melanoma preventive intervention was feasibly delivered and was acceptable to parent-child dyads. Future melanoma preventive interventions for this at-risk population could incorporate eHealth technologies to facilitate improvements in use of sun protection and monitoring of UVR exposure. This trial was registered with Clinicaltrials.gov, number NCT02846714.

25 Article CDKN2A testing and genetic counseling promote reductions in objectively measured sun exposure one year later. 2020

Stump, Tammy K / Aspinwall, Lisa G / Drummond, Danielle M / Taber, Jennifer M / Kohlmann, Wendy / Champine, Marjan / Cassidy, Pamela B / Petrie, Tracy / Liley, Ben / Leachman, Sancy A. ·Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. tammy.stump@northwestern.edu. · Department of Psychology, University of Utah, Salt Lake City, UT, USA. · Department of Psychology, Kent State University, Kent, OH, USA. · Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, USA. · Oregon Health and Science University, Portland, OR, USA. · National Institute of Water & Atmospheric Research, Lauder, New Zealand. ·Genet Med · Pubmed #31371819.

ABSTRACT: PURPOSE: This study investigated whether genetic counseling and test reporting for the highly penetrant CDKN2A melanoma predisposition gene promoted decreases in sun exposure. METHODS: A prospective, nonequivalent control group design compared unaffected participants (N = 128, M RESULTS: Both carriers and no-test control participants exhibited a decrease one year later in daily UVR dose (B = -0.52, -0.33, p < 0.01). Only carriers exhibited a significant decrease in skin pigmentation at the wrist one year later (B = -0.11, p < 0.001), and both carriers and no-test control participants reported fewer sunburns than noncarriers (p < 0.05). Facial pigmentation did not change for any group. Noncarriers did not change on any measure of UVR exposure. CONCLUSIONS: These findings support the clinical utility of disclosing CDKN2A test results and providing risk management education to high-risk individuals.

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