Joseph Scotto

Non‐melanoma skin cancer among caucasians in four areas of the United States

A survey of the incidence of non‐melanoma skin cancer was undertaken in four areas which included about ten million people. Complete reporting of all newly diagnosed cases of skin cancer which occurred during the survey period of September 1, 1971 to February 29, 1972 was obtained by canvassing dermatologists, radiotherapists, pathologists, and other physicians seeing and treating skin cancer. Rates among Caucasians were found two to three times higher than any ever reported before in these area. An estimate of 300,000 new cases of skin cancer per year would amount to about one‐half the total for all other forms of cancer combined in the United States. In all areas, there was an excess liability in males of about 2 to 1. Highest rates were observed in the Dallas‐Ft. Worth area, where increased solar radiation is suspected as a carcinogenic agent.

The Association of Solar Ultraviolet and Skin Melanoma Incidence Among Caucasians in the United States

Using recent data from cancer incidence surveys and measures of UVB exposure levels at seven geographic locations within the United States, we estimate the dose-response relation between UVB and skin melanoma incidence. Mathematical models used information from general population interview studies conducted in these locations to adjust for potentially confounding factors such as age, skin color, ancestry, eye color, hair color, sunburn sensitivity, prevalence of moles, freckles, and hours spent outdoors, use of sunscreen/lotion, and other variables. The effect of geographic UVB exposure on incidence was found to be statistically significant (p less than 0.01) after adjusting for each variable and certain combinations of these variables. We found that incidence rates for those skin melanomas arising in the face, head, neck, or upper extremities (i.e, the most exposed sites) were more sensitive to UVB increases than the incidence rates for those lesions occurring in the ordinarily less exposed sites of the trunk and lower extremities.

Incidence of nonmelanoma skin cancer in New Hampshire and Vermont

A survey of skin cancer occurrence between June 1979 and May 1980 among residents of New Hampshire and Vermont identified 277 cases of squamous cell carcinoma and 1761 cases of basal cell carcinoma. The age-adjusted incidence rates for squamous cell carcinoma (32 per 100,000 in men, 8 per 100,000 in women) and for basal cell carcinoma (159 per 100,000 in men, 87 per 100,000 in women) were similar to those reported in other populations in the northern United States. Skin cancer incidence was particularly high among men more than 70 years of age and a large proportion (greater than 30%) of patients 55 years or older had a history of at least one previous skin cancer.

Methotrexate compared with placebo in lung cancer

Two hundred thirty‐nine patients with microscopically proven, inoperable bronchogenic carcinoma were allocated at random to receive twice weekly I.M. injections of either methotrexate at “high dose” of 0.6 mg/kg/dose or methotrexate at “low dose” of 0.2 mg/kg or visually indistinguishable placebo in the same volume of 0.1 ml/kg for four months. Twelve patients were invalidated for procedural reasons. Objective response (50% tumor regression) was dose‐related with 21% of 48 patients with measurable disease on high dose, 11% of 37 patients on low dose, and 6% of 32 patients on placebo. Corresponding response rates for epidermoid carcinoma were 35% of 23 patients, 9% of 11 patients, and 0 of 13 patients. Responders in the two treatment groups had a three to four fold increase of median survival (p < .05). Non‐responders on high and low dose methotrexate lived as long as patients on placebo. Leukopenic patients in all three treatment groups lived substantially longer than patients without leukopenia < 4,500/mm3, irrespective of presence or absence of objective response. All three regimens were well tolerated. None of the patients had life‐threatening toxicity. It is concluded that methotrexate at “high dose” is a potentially useful drug for temporary palliation of epidermoid carcinoma of the lung. Cancer 40:4–8, 1977.

Intensity patterns of solar ultraviolet radiation.

Abstract Using field measurements of ultraviolet radiation, intensity patterns by time of day and time of year are examined. Depending on location, 39 to 80% of the half-hourly readings of sufficient intensity to produce minimum erythema occur between 10:00 am and 2:00 pm during the late spring and early summer months of May through August. Most people, particularly those in Northern latitudes, can substantially reduce their exposure to erythema-producing ultraviolet radiation by avoiding sunlight during the noon-day hours. Individuals of light-skin pigmentation, i.e., those who should limit their sunlight exposure, will find this work helpful.