Современные мысли о меланоме....

[FRSM]

Bad medicine: melanoma

Sunlight is relaxing. Our body rewards us for being in the
sun, and evolution dictates that everything happens for a
reason. Pale skin was positively selected for as our ancestors
ventured north, like economic migrants of 100 000 years ago,
to aid synthesis of vitamin D in a temperate climate. It is no
mere chance that the Celts who live in the perpetual rain of
the west of the United Kingdom are porcelain pale. Sunlight
is fundamental to human survival. Today, however, pressure
groups call for a so called enforceable sun protection policy
for children, involving sunscreen, hats, and active avoidance
of the sun. But does this police state approach make sense
in Britain?
The baton of policy enforcement is the near tripling of
melanoma incidence since 1980. But the evidence presented
for the campaign has the whiff of propaganda and is riddled
with contradictions. Melanoma most commonly occurs in
areas that are less sun exposed. It is 50% more common in
social class one, despite the fact that manual workers are
more likely to work outside and use sun beds. And women
have a 20% greater incidence of melanoma yet a 20% lower
death rate compared with men.
There is no dose-response gradient. The most conflicting
evidence, however, is that despite a reported tripling of
incidence, the actual death rate under 65 has remained
unchanged. This observation cannot be explained by better
treatment, because melanoma remains resistant to chemotherapy.
Nor indeed can it reflect a recent increase in sunlight
exposure
because melanoma is a disease of the old, so the
potential risk from sunlight has a long lag time. Logically
this would have been in 1920 onwards, not a period
associated
with cheap foreign travel. Is there a more rational
explanation?
Campaigns against the sun started in the early 80s, fuelling
anxiety and referrals, especially in the health conscious
middle class. Dermatologists opened public and private so
called pigmented lesions clinics. Removal rates took off. But
melanoma incidence is directly linked to rates of biopsy.
So, because deaths from melanoma are unchanged, the
only logical conclusion is that the rapid and steep rise in
melanoma is not real but an artefact of overdiagnosis. Dermatologists
are removing lesions that will never progress.
Further, there is scant evidence for the beneficial effects of
sun block or avoidance of the sun on incidence of melanoma,
and no evidence that they reduce mortality.
What we do know is that vitamin D deficiency is
increasingly
common, and sunscreen blocks the synthesis
of vitamin D. Deficiency causes bone diseases and is linked
to cardiovascular disease and a range of cancers. I pale at the
potential consequences of the current sun policy on the long
term health of our children. We should trust evolution: the
current policy is counterintuitive, and bad medicine.
BMJ 2011;343:

[nastassia]

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[FRSM]

Где наши коллеги из Австралии?

[nastassia]

во-во)) думаю, до них еще не "дошло"))) у них же там все вверх тормашками дойдет-будут бузить