Skin cancer is common in North America. Incidence rate trends are potentially important in the assessment of the effects of measures to increase sun awareness in the population as well as measures to reduce sun damage.
To determine the incidence of basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and cutaneous malignant melanoma (CMM) in a geographically defined Canadian population over a 40-year period.
Data were obtained from the BC Cancer Registry for the calendar years 1973, 1983, 1993, and 2003.
Age-standardized incidence rates increased significantly from 1973 to 2003 for BCC, SCC, and CMM.
The ethnic makeup of British Columbia has changed over time, and a novel method of accounting for the effect of this on skin cancer rates is presented.
The incidence rate for skin cancers continued to rise in British Columbia, but there appears to have been a decline in the incidence of CMM and BCC in the youngest cohorts.
Actinic keratosis is the most common actinic lesion in fair-skinned populations. It is accepted as an indicator of actinic skin damage and as an occasional precursor of squamous cell carcinoma. The aim of this study was to investigate, in a cohort of patients with a diagnosis of actinic keratosis, the relative risk of developing skin cancer during a follow-up period of 10 years. This registry-based cohort study compared a cohort of 2,893 individuals in south-eastern Sweden, who were diagnosed with actinic keratosis during the period 2000 to 2004, with a matched-control cohort of 14,668 individuals without actinic keratosis during the same inclusion period. The subjects were followed for 10 years to identify skin cancer development in both cohorts. Hazard ratios with 95% confidence intervals (95% CI) were used as risk measures. Individuals in the actinic keratosis cohort had a markedly higher risk for all skin cancer forms compared with the control cohort (hazard ratio (HR) 5.1, 95% CI 4.7-5.6). The relative risk was highest for developing squamous cell carcinoma (SCC) (HR 7.7, 95% CI 6.7-8.8) and somewhat lower for basal cell carcinoma (BCC) (HR 4.4, 95% CI 4.1-5.0) and malignant melanoma (MM) (HR 2.7 (2.1-3.6). Patients with a diagnosis of actinic keratosis were found to be at increased risk of developing SCC, BCC and MM in the 10 years following diagnosis of actinic keratosis. In conclusion, a diagnosis of actinic keratosis, even in the absence of documentation of other features of chronic sun exposure, is a marker of increased risk of skin cancer, which should be addressed with individually directed preventive advice.
The risk of non-melanoma skin cancer in northern Europeans who indulge in sunbathing or use a UVA solarium was estimated using a mathematical model of skin cancer incidence that makes allowance for childhood, occupational and recreational sun exposure. This model demonstrates that the cumulative incidence of skin cancer in indoor workers is about 2-3% by the age of 70, yet this risk can increase 5-fold if they indulge in a two-week sunbathing vacation each summer. The use of a UVA solarium is also shown to increase the risk of skin cancer. Because risk increases with the approximate square of annual solarium exposure, it is not possible to define a 'safe' level of exposure. Instead, it is shown that weekly use of a UVA solarium from age 20 until middle age (40-50) gives a relative cumulative incidence of 1.3 compared with non-users of sun beds and sun canopies. The risk begins to increase rapidly for more frequent use, particularly when solaria are used in combination with sunbathing.
Recent data suggest a reduced risk of malignant melanoma (MM) among atopic dermatitis (AD) patients, but an increased risk of other skin cancers (including basal cell carcinoma [BCC] and squamous cell carcinoma [SCC]).
We examined the association between AD and skin cancers in a large cohort study in Denmark from 1977 through 2006.
Our cohort consisted of 31 330 AD patients recorded in the Danish National Patient Registry, including AD patients admitted to hospitals and specialized outpatient clinics. Linkage to the Danish Cancer Registry allowed ascertainment of skin cancers. We calculated standardized incidence ratios (SIRs) and associated 95% confidence intervals (CIs) by comparing the incidence rate of skin cancers among AD patients with that among the general Danish population.
The overall observed number of MM cases among AD patients was 12, with 21 expected, yielding a SIR of 0.59 (95% CI 0.30, 1.02), with the most pronounced protective effect among AD patients with more than 5 years of follow-up (SIR?=?0.46; 95% CI 0.19, 0.95). The corresponding SIRs for BCC and SCC were increased among AD patients (1.41 [95% CI 1.07, 1.83] and 2.48 [95% CI 1.00, 5.11], respectively).
Our findings support an inverse association between AD and MM, but an increased risk of BCC and SCC among AD patients.
BACKGROUND. The incidence of basal cell carcinoma (BCC) in a defined population is unknown. METHODS. The incidence of histologically diagnosed cases of BCC in a defined population of a city in southern Sweden was studied. Four 2-year periods were examined from 1970 to 1986. Cases from 1970 and 1980 were reexamined microscopically. RESULTS. From 1970 to 1986, the age-standardized incidence of BCC was doubled. BCC was equally common in male and female patients. It was possible to trace another BCC in the medical history of 41% of the patients. The risk of development of BCC increased rapidly with age greater than 55 years. Approximately two-thirds of the tumors were found in the head and neck region. There was a possible increase in superficial multicentric tumors on the trunk but otherwise an essentially unchanged pattern in type and distribution. CONCLUSIONS. The age-standardized incidence of histologically diagnosed BCC was doubled from 1970 to 1986. The rapid increase should be taken into consideration when planning allocation of medical resources.
Reliable estimates of disease incidence are fundamental to planning future healthcare services. However, in many countries registration of basal cell carcinoma (BCC) is often non-existent. This study examines how many BCC treatments were carried out in Denmark in 2013. The Danish Cancer Registry and the Danish Pathology Registry were used to examine how many BCC treatments were registered, and a test sample was taken from Bispebjerg Hospital to examine the number treated but not registered. The study showed that 21.7% of BCC treatments were performed solely on a clinical diagnosis. Furthermore, some records are inadequate in relation to BCC registration, as BCCs treated are 3 times the number of individuals in the Danish Cancer Registry, and there are nearly as many BCCs as the sum of all other cancers. The increasing BCC incidence will result in difficulties in ensuring treatment capacity.
To study the incidence of basal cell carcinoma (BCC) of the eyelid in Finland.
We studied 6241 cases of BCC of the eyelid reported to the nationwide Finnish Cancer Registry during 1953-97. We determined the age- and sex- specific incidence rates and overall rates adjusted for age to the world standard population, and social class- and occupation-specific standardized incidence ratios, with the total Finnish population as reference.
The incidence rates of BCC of the eyelid varied between 0.7 and 3.0 per 100 000 person-years in men and between 0.5 and 2.8 per 100 000 person-years in women during the study period. The age-adjusted incidence rates of BCC of the eyelid increased during 1953-87 (p
PURPOSE: To examine all basal cell carcinomas of the eyelid diagnosed in Iceland during a 25-year period, paying special attention to the surgical margins of excision in relation to recurrence. Based on the results a simple, clinically relevant method of classifying the surgical margin is proposed. METHODS: All histologically proven basal cell cancer specimens from eyelids were reviewed retrospectively. The surgical excision margins were classified as radical, marginal or intralesional. RESULTS: Recurrence risk was low when the tumor had a surgical margin described as radical or marginal. The recurrence rate was 38% when the margin was intralesional. CONCLUSION: By assessing the surgical margins by this method, which is easy to apply, better understanding between the pathologist and the surgeon may be achieved.
To review our experience and that in the recent literature regarding basal cell carcinoma of the vulva to see whether current management guidelines are appropriate.
Twenty-eight women with basal cell carcinoma of the vulva were seen over 25 years at the BC Cancer Agency. The clinical-pathologic features were tabulated and the outcome was analyzed.
The mean age was 74 years, and almost two-thirds were over the age of 70 at diagnosis. Patients typically presented with an irritation or soreness, with a symptom duration ranging from a few months to several years. Most lesions were confined to the anterior half of the vulva, and 23 of the 28 patients had T1 lesions. Wide local excision was the treatment method used most commonly. Only one patient was known to have died from disease metastasis. Ten women had other basal cell carcinomas, either before or after the diagnosis of their vulvar lesions, and in ten patients 11 other malignancies were diagnosed.
Basal cell carcinoma of the vulva is an extremely uncommon tumor that rarely metastasizes or spreads. Primary treatment should consist of wide local excision and continued follow-up.