Prognostic and predictive value of thymidylate synthase expression in primary colorectal cancer.

Aim: To investigate thymidylate synthase (TS) expression in primary colorectal cancer (CRC) as a prognostic and predictive marker of benefit for adjuvant chemotherapy.

Patients And Methods: TS expression was immuno0-histochemically (IHC) assessed on tumors from 1,389 patients with stage II and III CRC randomly assigned to either surgery alone or surgery plus 5-fluorouracil (5-FU)-based adjuvant chemotherapy.

Results: In the subgroup treated with surgery alone (n=708), TS expression was prognostic using the classification of TS 0-1 versus 2-3 (p=0.

Factors related to being sunburnt in 7-year-old children in Sweden.

Background: Epidemiologic research shows that being sunburnt as a child is an important risk factor for cutaneous malignant melanoma (CMM). The purpose of this study was to investigate sunburn in relation to tanning habits and complexion among 7-year-old children living at different latitudes in Sweden.

Methods: Two municipalities were chosen at latitudes 65 degrees N and 68 degrees N in the north of Sweden and two at latitude 57 degrees N in the south.

Common melanocytic nevi in 7-year-old schoolchildren residing at different latitudes in Sweden.

Background: Current epidemiologic research shows consistently that increased number of acquired common melanocytic nevi (CMN) is an important risk factor for cutaneous malignant melanoma. The purpose of this study was to investigate the number of CMN in relation to tanning habits and complexion among 7-year-old children residing at different latitudes in Sweden.

Methods: Two municipalities were chosen at latitude 65 degrees N to 68 degrees N in the north of Sweden and two at latitude 57 degrees N in the south.

Risk perception, optimistic bias, and readiness to change sun related behaviour.

Background: The incidence of skin cancer has had a rapid increase in Sweden during the last 20 years. Sun exposure is an important preventable risk factor for skin cancer. It is essential to develop interventions to change people's exposure to the sun.

The importance of assessing the readiness to change sun-protection behaviours: a population-based study.

The purpose of this study was to collect information that may be valuable in developing successful skin cancer prevention programmes. A random sample of 6000 adolescents and 4000 adults answered a questionnaire about sun-related issues. The response rate was 68%.

Attitudes, subjective norms and perception of behavioural control as predictors of sun-related behaviour in Swedish adults.

Background: Exposure to ultraviolet (UV) radiation is the major preventable cause of skin cancer. The aim of this study was to investigate the explanatory value of attitudes, subjective norms and perceived behavioural control on behaviours related to UV exposure.

Method: A random population-based sample (n = 1752, 18-37 years of age) in the Stockholm County, Sweden, answered a questionnaire with items on sun related behaviours and beliefs.

Skin diseases caused by ultraviolet radiation: the cost of illness.

Objectives: To assess the annual direct and indirect costs of skin diseases caused by ultraviolet radiation.

Methods: A model for cost-of-illness, including costs for hospital care, primary care, pharmaceuticals, mortality, and morbidity, for approximately 1.8 million inhabitants in Stockholm.

Reasons to seek medical attention for a skin check-up: the layman's perspective.

Background: The incidence of cutaneous malignant melanoma has increased rapidly in Sweden during the last 20 years. One way of reducing mortality is through early diagnosis. The aim of this study was to explore the reasons why different people seek medical attention for pigmented skin lesions, using a qualitative approach.

Transtheoretical model: investigation of adolescents' sunbathing behaviour.

The incidence of malignant melanoma and non-melanoma skin cancers has increased rapidly in Sweden as well as in other western countries during the last 20 years. Adolescents are an important group in skin cancer prevention. Interventions targeting this group have been reported to affect knowledge and attitudes, but the effect on sun protection behaviour has been slight.

Sunbed use among Swedish adolescents in the 1990s: a decline with an unchanged relationship to health risk behaviors.

Aims: Sunbed use is common among adolescents, and may give an increment to UV exposure and an overall skin cancer risk comparable to that of the sun. Sunbed use was studied among 15- to 19-year-old adolescents in Stockholm County.

Methods: Data from two questionnaire surveys (1252 respondents in 1993, and 2950 respondents in 1999, survey tool partly revised) were analysed.

Sun habits in kidney transplant recipients with skin cancer: a case-control study of possible causative factors.

Organ transplant recipients are frequently affected by skin cancer, which might also be a major cause of long-term mortality. Excessive sun exposure is considered to be a factor in the aetiology, but uncertainty about the importance of this and other proposed risk factors remains. The purpose of this study was to investigate sun behaviour before and/or after the transplantation in kidney transplant recipients with or without cutaneous squamous cell carcinoma.

A randomised population-based intervention to examine the effects of the ultraviolet index on tanning behaviour.

The aim of the following study was to examine the effects of the Ultraviolet (UV) Index and a personal ultraviolet radiation (UVR) intensity indicator on tanning behaviour compared with general, written information about sun protection. A population-based random sample in Sweden was randomly assigned to four groups receiving different information packages (n=3200). Questionnaires were sent before and after the summer of 2001.

Localized scleroderma in a woman irradiated at two sites for endometrial and breast carcinoma: a case history and a review of the literature.

Localized scleroderma is an uncommon side-effect of radiotherapy. We report a unique case with multiple asynchronous primary malignant tumors, which developed localized scleroderma after radiotherapy. A 67-year-old healthy woman received external irradiation for endometrial cancer.

'You and your skin': a short-duration presentation of skin cancer prevention for teenagers.

The effectiveness of a short-duration presentation of the educational material 'You and Your Skin' was tested on 184 adolescents (age 13-15) at the Year 7 and 8 levels. A non-equivalent control group design was used with pre-testing and post-testing 3 months after the intervention. The intervention increased the students' knowledge of known risks factors for skin cancers.

Stability of questionnaire items measuring behaviours, attitudes and stages of change related to sun exposure.

The use of questionnaires in epidemiological studies needs more methodological research. The time and effort spent on questionnaire design is often limited. Studies on the construction of questionnaires could lead to a higher quality of data, enhanced comparability and improved credibility of epidemiological findings.

Laypersons' perceptual discrimination of pigmented skin lesions.

Background: Most cutaneous malignant melanomas of the skin are visible and should, at least in theory, be possible to detect with the naked eye.

Objective: This study was conducted to learn more about laypersons' ability to discriminate between benign pigmented lesions and malignant ones.

Methods: Four groups of laypersons (n = 120) were asked to evaluate pictures of different types of pigmented skin lesions, before and after they received information about the ABCD (asymmetry, border irregularity, color variegation, and diameter greater than 6 mm) criteria, with respect to the necessity of action.

Focusing management in implementing a smoking ban in a university hospital in Sweden.

To explore the impact of various steps when introducing a smoking ban at the Karolinska Hospital (1000 beds; 6000 employees) in Stockholm, Sweden, a multiple evaluation strategy was performed over 5 years. All heads of clinical departments (N = 41) and a random sample of employees (n = 517) and a convenience sample of hospital labour managers (n = 17) were separately addressed through questionnaire surveys at different time intervals after the introduction of the ban in 1992. An observational and interview study completed the follow-up.

Tanning habits and sunburn in a Swedish population age 13-50 years.

As part of a skin cancer control programme, we studied the occurrence of self-reported outdoor tanning, sunbed use and ultraviolet (UV)-induced erythema in an urban area. A cross-sectional questionnaire study of 6000 adolescents aged 13-19 years, and 4000 adults aged 20-50 years was applied. Non-response was analysed for outdoor tanning and sunbed use.

Beliefs, knowledge and attitudes as predictors of sunbathing habits and use of sun protection among Swedish adolescents.

In 1996, a random population sample of 2615 adolescents completed a questionnaire concerning habitual sun-related behaviours, attitudes towards sunbathing, and knowledge about skin cancer. Females, older adolescents, those with less sun-sensitive skin, those with higher knowledge and those with a positive attitude towards sunbathing were more likely to be frequent sunbathers. Younger adolescents, those who today sunbathe moderately, and those with sensitive skin were more likely to believe that they would sunbathe more often in the future.

Readiness to change sun-protective behaviour.

The incidence of malignant melanoma and non-melanoma skin cancers has increased rapidly in Sweden during the last 20 years. The best-known way to revert this trend is primary prevention. Matching health messages to readiness to change in the population may enhance the effect of community-based prevention.

Population UV-dose and skin area--do sunbeds rival the sun?

From the perspective of skin cancer risks, sunbed tanning may give the population group of Swedish adolescents a yearly total dose in terms of ultraviolet radiant energy to the skin which is comparable to sunlight. For populations, a dosage scheme is applied, where exposed skin area is estimated to be two to ten times larger in tanning units than in outdoor sunlight. The normal dose fluence rate is multiplied by the exposure time and by the exposed body surface area.

Maintaining a smoke-free policy: an observational and interview study at a university hospital in Sweden.

In the first half of 1992, the Board of Directors at the Karolinska Hospital decided that, as of 1 September 1992, smoking indoors would be prohibited for staff in the hospital. A year later, a new Tobacco Act was introduced in Sweden involving a general ban on smoking in all health care premises, including rooms which patients would have cause to visit or frequent regularly. Four years after the implementation of the policy decision, an evaluation was made based on the principles of data and method triangulation.

Sunbathing and sunbed use related to self-image in a randomized sample of Swedish adolescents.

In 1996 a randomized sample of 4,020 Swedish adolescents from three birth cohorts were sent a questionnaire consisting of 50 items concerning habitual sun-related behaviours and attitudes, knowledge about melanoma, risk perception and self-image. A total of 2,615 questionnaires were returned. Girls sunbathed and used sunbeds more than boys at all ages.