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Round Up Email February 2026

Highlights in this month’s Round up include indoor tanning and melanoma risk, anticholinergic burden (ACB) and cognitive decline and melatonin in paediatric sleep disorders.

Question 1
Indoor tanning and melanoma – the melanoma risk associated with use of indoor tanning is detailed in this page on GPnotebook.: Indoor tanning and melanoma
With respect to indoor tanning and melanoma, which statement is true?
- a study showed that, after adjusting for age, sex, sunburn history, and family history, tanning bed use remained associated with a nearly 3-fold increased risk of melanoma compared to non-tanning bed users
- a study showed that, after adjusting for age, sex, sunburn history, and family history, tanning bed use remained associated with a nearly 1.5-fold increased risk of melanoma compared to non-tanning bed users
- a study showed that, after adjusting for age, sex, sunburn history, and family history, tanning bed use remained associated with a nearly 8-fold increased risk of melanoma compared to non-tanning bed users
Question 2
Kidney stones and kidney cancer risk – there is an increased risk of renal cell carcinoma associated with kidney stones; but is there an increased risk of transitional cell carcinoma associated with kidney stones?: Kidney stones and kidney cancer risk
With respect to risk of kidney cancer and kidney stones, which statement is false?
- evidence shows an an increased risk of RCC (renal cell carcinoma) in patients with a history of prior kidney stones; but no increased risk of TCC (transitional cell carcinoma)
- a meta-analysis demonstrates a significant association between kidney stones and increased risk of kidney cancer, with affected individuals having approximately twice the risk of developing kidney cancer
- transitional cell carcinoma accounts for about 5% of all primary renal tumours, and often presents late
Question 3
Anticholinergic burden (ACB) and cognitive decline – this subject is summarised on GPnotebook.: Anticholinergic burden (ACB) and cognitive decline
With respect to anticholinergic burden (ACB) and cognitive decline, which statement is false?
- long-term use of medications with anticholinergic properties has been associated with cognitive and functional decline among older adults
- a study showed that anticholinergic burden (ACB) was associated with cognitive decline, particularly in the memory and executive function domains
- diazepam has a higher anticholinergic burden (ACB) score than hydroxyzine
Question 4
Semaglutide and non-arteritic anterior ischemic optic neuropathy (NAION) – the risk of NAOIN associated with semaglutide is summarised on GPnotebook.: Semaglutide and non-arteritic anterior ischemic optic neuropathy (NAION)
With respect to semaglutide and non-arteritic anterior ischemic optic neuropathy (NAION), which statement is false?
- non-arteritic anterior ischemic optic neuropathy (NAION) typically causes sudden, painless vision loss, usually in one eye that is often described as a blurring or cloudiness of vision
- the European Medicines Agency (EMA) has reviewed all available data on NAION with semaglutide, including data from non-clinical studies, clinical trials, post-marketing surveillance and the medical literature, and has concluded that NAION is a very rare side effect of semaglutide (meaning it may affect up to 1 in 1,000 people taking semaglutide)
- hypertension, diabetes, and nocturnal hypotension are risk factors for development of non-arteritic anterior ischemic optic neuropathy (NAION)
Question 5
Oxybutynin to reduce hot flashes in men receiving androgen-deprivation therapy (ADT) for prostate cancer - Oxybutynin is an anticholinergic agent available in oral and transdermal formulations that is commonly used for treating overactive bladder symptoms. However, there is also evidence that oxybutynin may be a therapeutic option for the management of hot flashes. This section of GPnotebook describes the use of oxybutynin in men receiving ADT for prostate cancer.: Oxybutynin to reduce hot flashes in men receiving androgen-deprivation therapy (ADT) for prostate cancer
With respect to oxybutynin to reduce hot flashes in men receiving androgen-deprivation therapy (ADT) for prostate cancer, which statement is false?
- a 6 week, double-blind, placebo-controlled trial found that more than 70% of patients taking 5 mg of oxybutynin twice daily experienced at least a 50% reduction in hot flash scores
- study evidence found that 2.5 mg and 5 mg doses of oxybutynin had equivalent effects in terms of reducing hot flashes in men receiving androgen-deprivation therapy (ADT) for prostate cancer
- in patients receiving oxybutynin on this study showed no significant change in IPSS scores related to incomplete emptying or straining
Question 6
Melatonin in paediatric sleep disorders – When does the physiological increase in melatonin secretion during the night reach it’s peak? In general, are night-time melatonin levels 3x, 5x or 10x daytime levels? Is there evidence of long-term effectiveness of melatonin in the management of sleep disorders in children with typical development?: Melatonin in paediatric sleep disorders
With respect to melatonin in paediatric sleep disorders, which statement is false?
- physiological increase in melatonin secretion during the night has a peak around 2 am and night-time values usually at least three times greater than daytime values
- a review concluded that melatonin use was generally effective for sleep outcomes for specific populations in the short term; however, longer-term data in children with typical development were lacking
- pititutary melatonin production is powerfully suppressed by light acting through the retino-hypothalamic tract

Round Up Email February 2026

Question 1

Question 2

Question 3

Question 4

Question 5

Question 6