Alcohol-abuse tool proven effective for Latinos. Not all medical screening methods are created equal. However, a recent investigation by researchers at the schools of Medicine and Public Health has found that a commonly used group of questions designed to screen for alcohol abuse is effective in detecting the problem in Latinos.

The CAGE questionnaire has been widely and successfully used for many years by primary care physicians to screen white Americans for alcohol abuse. However, few alcoholism screening tests have been evaluated for use among Latinos or Spanish-speaking people, and none has been tested in the largest groups of Latinos living in the United States.

CAGE is an acronym for five questions: Have you ever felt that you should Cut down on your drinking? Have people Annoyed you by criticizing you about your drinking? Have you ever felt bad or Guilty about your drinking? Have you ever had an Eye opener -- a drink first thing in the morning to steady your nerves or get rid of a hangover?

"Contrary to our expectations, we've shown the CAGE questionnaire can indeed detect alcohol abuse in a diverse group of Latinos," says Dr. Richard Saitz, MED assistant professor of medicine and associate director of the Clinical Addiction Research Unit at Boston Medical Center.

Their investigation also focused on uncovering the extent of alcohol abuse. "The study results do show a high prevalence of alcohol abuse, particularly among Latino men," says Hortensia Amaro, SPH professor. "Using this information, we can identify those who may need help earlier rather than later and adapt treatment to suit the needs of this unique and growing cultural minority, with a focus on prevention and harm reduction." The study appeared in the April 12 Archives of Internal Medicine.

Understanding skin cancer triggers. With summer around the corner, it's a good time to be reminded that malignant melanoma, the deadliest form of skin cancer, is among the most common causes of cancer fatalities in young adults. But summer isn't the only dangerous season. In an article published in the New England Journal of Medicine April 29, Dr. Barbara Gilchrest, chief of dermatology at the School of Medicine, along with her colleagues, reviews risk factors for the disease, and they find that baking on the beach during an annual winter getaway can actually be more harmful than working in the sun year-round.

Researchers have known for some time that sun exposure is strongly implicated in skin cancer. The risk of developing most forms of skin cancer correlates strongly with total lifetime sun exposure and is greatest in farmers, sailors, and others with outdoor occupations.

However, Gilchrest and colleagues found malignant melanoma to be more a disease of white-collar workers who experience intense, intermittent exposure to the sun -- such as that during a midwinter trip to a tropical climate. This disease is also strongly associated with a history of childhood sunburns.

While these statistics have been known for years, the researchers used work from their own and other laboratories to offer new insights into the biological reasons behind the increased melanoma risk in these individuals. Among other causes, they showed how melanocytes, the pigment-producing cells that can become the site of melanomas, differ from other skin cells that give rise to the more common nonmelanoma skin cancers.

The paper emphasizes that protection from the sun beginning in early childhood is critical to the prevention of both melanoma and nonmelanoma skin cancer. "It's important to protect against the genetic damage caused by sunburn during winter vacation trips and in the early spring, when your skin is unprepared to deal with ultraviolet radiation injury," Gilchrest says.