Department of Health, Medicine and Caring Sciences Linköping University, Linköping, Sweden.
Department of Health, Medicine and Caring Sciences Linköping University, Linköping, Sweden
Anticancer Res. 2020 Jun;40(6):3325-3331. doi: 10.21873/anticanres.14315.
BACKGROUND/AIM: A variety of self-tests addressing individual skin cancer risk are available online. These are generally based on self-estimated measures, such as self-rated skin sensitivity to sun exposure, affecting its reliability. The aim of this study was to investigate whether the addition of objective variables, by means of ultraviolet (UV) sensitivity phototesting and nevi count, could be of contributory value for the composition of a comprehensive risk score for skin cancer, and whether the use of such a score could contribute to change of behavior in the sun after assessment of individual risk.
A sample of 70 voluntary participants, all university students, were recruited for the study. The participants rated their sun exposure habits by filling out the Sun Exposure and Protection Index (SEPI) questionnaire, and their skin UV-sensitivity was decided both by self-estimation, using Fitzpatricks's skin type scale, and objectively, by the performance of a UV-sensitivity phototest. Finally, the number of pigmented nevi on the lower arm was counted both by the participants themselves and by a trained observer. A cumulated skin cancer risk score was calculated on the basis on these three variables (sun habits, UV-sensitivity and nevi count), and the outcome compared whether based on the participants' self-assessments or on the objective assessment. The individual risk score, based on objective measures, along with a tailored sun protection advice, was communicated to the participants, and after three weeks they once again filled-out the SEPI part addressing propensity to increase sun protection.
The results showed good correlation between the self-assessed and trained observer performed nevi count, but poor agreement between self-estimated and objectively measured skin UV-sensitivity. For the cumulative risk score, the self-performed score was on average slightly lower than its reference, but no systematic difference could be observed. At follow-up, high-risk individuals showed a significant decrease in total SEPI score (p<0.05).
Objective assessment of nevi count and skin UV-sensitivity might be of significant value when estimating individual skin cancer risk, in order to communicate tailored sun protection advice.
背景/目的：目前有多种针对个体皮肤癌风险的自测方法可在网上获得。这些方法通常基于自我估计的指标，例如自我评估的皮肤对阳光暴露的敏感性，这会影响其可靠性。本研究旨在探讨通过紫外线（UV）敏感性光测试和痣计数等客观变量的添加是否对综合皮肤癌风险评分的组成具有贡献价值，以及在评估个体风险后，使用这种评分是否有助于改变个体在阳光下的行为。
本研究招募了 70 名自愿参加的大学生作为研究对象。参与者通过填写阳光暴露和保护指数（SEPI）问卷来评估他们的阳光暴露习惯，通过使用 Fitzpatricks 皮肤类型量表进行自我评估和客观的 UV 敏感性光测试来确定他们的皮肤 UV 敏感性。最后，参与者本人和一名受过训练的观察者分别计数前臂上的色素痣数量。根据这三个变量（阳光习惯、UV 敏感性和痣计数）计算累积皮肤癌风险评分，并比较基于参与者自我评估和客观评估的结果。基于客观测量的个体风险评分以及个性化的防晒建议传达给参与者，三周后他们再次填写针对增加防晒倾向的 SEPI 部分。
结果显示，自我评估和经过训练的观察者计数的痣数量之间存在良好的相关性，但自我估计的皮肤 UV 敏感性与客观测量之间的一致性较差。对于累积风险评分，自我评估的评分平均略低于参考值，但未观察到系统差异。在随访时，高风险个体的总 SEPI 评分显著降低（p<0.05）。
客观评估痣计数和皮肤 UV 敏感性可能在评估个体皮肤癌风险时具有重要价值，以便传达个性化的防晒建议。
