Townes-Brocks syndrome presenting as end stage renal failure.
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Abnormalities, Multiple↗
Biomedical subjects
W G Newman
Publications and source records attributed to W G Newman.
Possible etiologic factors in external root resorption.
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Age Determination by Skeleton↗
Positive predictive value for presumptive diagnoses of skin cancer and compliance with follow-up among patients attending a community screening program.
BACKGROUND: There is an ongoing need for evaluating the effectiveness of skin cancer screening programs and barriers to obtaining definitive diagnoses and treatments among screen-positive patients. METHODS: We studied 132 patients who were given presumptive diagnoses of skin cancer while attending a free skin cancer screening program during May 1994 in San Diego, California (464 screened). We assessed compliance with recommendations to see a physician for definitive diagnostic workup. Logistic regression models included potential determinants of compliance: age, gender, health insurance, educational level, anatomic site, number of suspicious skin lesions, personal and family history of skin cancer, propensity to sunburn, and history of recent change in moles. The positive predictive value (PPV) of skin cancer diagnoses was defined conservatively as a range by inclusion then exclusion of patients not biopsied. RESULTS: Follow-up information was obtained for 115 patients, and 88 (77%) of these reported obtaining a definitive workup. The final regression model controlling for age showed that patients without a family history of skin cancer were less compliant than those with a history [OR for noncompliance 3.29, 95% confidence interval (CI) 1.10-9.83], and patients with only one presumptive skin cancer lesion were less compliant than those with additional cancer lesions (OR 5.31, 95% CI 1.07-26.43). Older patients were more compliant than younger. Among 82 patients under 65 years of age, the above factors were important only among men. Also, noncompliance was significantly higher among younger men without versus with health insurance (OR 5.14, 95% CI 1.23-20.68). Two melanomas, 1 squamous cell carcinoma, and 23 basal cell carcinomas were histopathologically confirmed. The PPV for melanoma was 6-15%, for squamous cell carcinoma 4-12%, and for basal cell carcinoma 32-85%. CONCLUSIONS: This study confirms the ability of skin cancer screening programs to successfully identify individuals with cutaneous malignancies. The significant association of noncompliance to seek recommended follow-up care with lack of health insurance for men too young to participate in Medicare suggests that approaches to definitive workup for uninsured patients be developed alongside free screening programs.
Adult↗
A survey of recreational sun exposure of residents of San Diego, California.
The incidence of skin cancer in San Diego is one of the highest in the nation. Research has documented that excessive unprotected exposure to ultraviolet (UV) radiation over time significantly increases a person's risk for developing various types of skin cancer. Our study investigated the amount of sun exposure and the practice of sun protection among San Diegans and examined factors thought to be associated with these behaviors. In April 1994, a random sample of 864 San Diego residents was surveyed by telephone. Because most survey questions specifically asked about sun exposure and sun protection when tanning versus recreating, the analyses were presented separately for recreators (i.e., those who spent time in the sun during the hours of 8:00 am and 6:00 pm for recreation last summer; n = 786) and tanners (i.e., those who spent at least 10% of their time in the sun to get a tan last summer; n = 464), a subset of recreators. Study results indicated that on average, 27% of the tanners' time in the sun last summer was spent getting a tan, and tanners reported using sunscreen about 50% of the time on both their face and body. In terms of sun protection while recreating, survey respondents reported using sunscreen on their face approximately 40% of the time compared to approximately 30% of the time on their body. Correlates of sun exposure and sun protection for both tanners and recreators included demographic characteristics, susceptibility factors, attitudes, and knowledge. The findings from this study support the need for education on skin cancer prevention. The practical implications of these findings are discussed in terms of appropriate community skin cancer prevention interventions. Medical Subject Headings (MeSH): skin cancer, sunlight, behavior.
Adolescent↗