Dumont Emmanuel L P, Kaplan Peter D, Do Catherine, Banerjee Shayak, Barrer Melissa, Ezzedine Khaled, Zippin Jonathan H, Varghese George I
Shade, Nutley, NJ, United States.
Hackensack Meridian Center for Discovery and Innovation, Nutley, NJ, United States.
Front Med (Lausanne). 2024 Mar 1;11:1259050. doi: 10.3389/fmed.2024.1259050. eCollection 2024.
Non-melanoma skin cancer (NMSC) is the most prevalent cancer in the United States. Despite guidelines on ultraviolet (UV) avoidance, it remains difficult for people to assess their exposure, as UV is invisible and the onset of UV-induced symptoms is delayed.
In a prospective randomized trial, 97 elderly patients with a history of actinic keratoses (AK) were followed over 6 months. Fifty patients received UV counseling from a dermatologist and a wearable UV dosimeter that provided real-time and cumulative UV exposure. Forty-seven patients received only UV counseling from a dermatologist.
Over 75% of participants recorded UV exposure at least once a week during the summer. After 6 months of intervention, when comparing the device group to the control group, we observed a non-significant 20% lower ratio of incidence rates of AKs (95% CI = [-41, 55%], -value = 0.44) and a significant 95% lower ratio of incidence rates of NMSCs (95% CI = [33, 99.6%], -value = 0.024). Surveys demonstrated that the control group's score in self-perceived ability to participate in social activities significantly increased by 1.2 (-value = 0.04), while in the device group, this score non-significantly decreased by 0.9 (-value = 0.1). We did not observe changes, or between-group differences, in anxiety and depression surveys.
This pilot clinical trial has a short duration and a small sample size. However, device adherence and quality of life questionnaires suggest a smartphone-connected wearable UV dosimeter is well accepted by an elderly population. This trial also indicates that a wearable UV dosimeter may be an effective behavioral change tool to reduce NMSC incidence in an elderly population with a prior history of AKs.: clinicaltrials.gov, identifier NCT03315286.
非黑色素瘤皮肤癌(NMSC)是美国最常见的癌症。尽管有避免紫外线(UV)照射的指南,但由于紫外线不可见且紫外线诱发症状的发作具有延迟性,人们仍难以评估自己的紫外线暴露情况。
在一项前瞻性随机试验中,对97名有光化性角化病(AK)病史的老年患者进行了6个月的随访。50名患者接受了皮肤科医生的紫外线咨询,并使用了可穿戴紫外线剂量计,该剂量计可提供实时和累积紫外线暴露情况。47名患者仅接受了皮肤科医生的紫外线咨询。
超过75%的参与者在夏季每周至少记录一次紫外线暴露情况。经过6个月的干预,将使用设备组与对照组进行比较时,我们观察到光化性角化病发病率的比率降低了20%,差异无统计学意义(95%CI = [-41, 55%],P值 = 0.44),而非黑色素瘤皮肤癌发病率的比率显著降低了95%(95%CI = [33, 99.6%],P值 = 0.024)。调查显示,对照组在自我感知参与社交活动能力方面的得分显著提高了1.2(P值 = 0.04),而在使用设备组中,该得分非显著降低了0.9(P值 = 0.1)。在焦虑和抑郁调查中,我们未观察到变化或组间差异。
这项初步临床试验持续时间短且样本量小。然而,设备依从性和生活质量问卷表明,一款与智能手机相连的可穿戴紫外线剂量计在老年人群中很受欢迎。该试验还表明,可穿戴紫外线剂量计可能是一种有效的行为改变工具,可降低有光化性角化病既往史的老年人群中非黑色素瘤皮肤癌的发病率。:clinicaltrials.gov,标识符NCT03315286