Summary
Background
An epidemic of basal cell carcinoma (BCC) has led to a significant healthcare burden in white populations.
Objectives
To provide an update on incidence rates and tumour burden in ...an unselected, geographically isolated population that is exposed to a low level of ultraviolet radiation.
Methods
This was a whole‐population study using a cancer registry containing records of all cases of BCC in 1981–2017. We assessed BCC incidence according to age, residence and multiplicity and assessed trends using join‐point analysis. Age‐standardized and age‐specific incidence rates were calculated along with cumulative and lifetime risks.
Results
During the study period, the age‐standardized incidence rates increased from 25·7 to 59·9 for men, and from 22·2 to 83·1 for women (per 100 000). Compared with the single‐tumour burden, the total tumour burden in the population was 1·72 times higher when accounting for multiplicity. At the beginning of the study period, the world‐standardized rates in men and women were similar, but by the end of the study period the rates were 39% higher in women (83·1 per 100 000, 95% confidence interval 77·9–88·3) than in men (59·9 per 100 000, 95% confidence interval 55·6–64·2). This increase was most prominent in women on sites that are normally not exposed to ultraviolet radiation in Iceland: the trunk and legs.
Conclusions
This is the only reported population in which the incidence of BCC is significantly higher in women than in men. The period of notable increase in BCC lesions correlates with the period of an increase in tanning beds and travel popularity. The high multiplicity rates suggest that the total tumour burden worldwide might be higher than previously thought.
What is already known about this topic?
Basal cell carcinoma (BCC) is becoming an increasing healthcare burden worldwide, especially in white populations.
Recent population studies have reported a rapid increase in incidence among younger individuals, especially women.
What does this study add?
Iceland is the only reported population in which the incidence of BCC is significantly higher in women than in men, and there does not seem to be a clear relationship between latitude and BCC incidence in Europe.
Men might be comparatively protected in the northern low‐ultraviolet environment, with tanning beds and travel abroad likely playing important roles in the observed incidence increase, especially in women.
The high multiplicity rates suggest that the total tumour burden worldwide might be higher than previously thought.
Linked Comment: Pandeya. Br J Dermatol 2020; 183:799–800.
What is already known about this topic?
Basal cell carcinoma (BCC) is becoming an increasing healthcare burden worldwide, especially in white populations.
Recent population studies have reported a rapid increase in incidence among younger individuals, especially women.
What does this study add?
Iceland is the only reported population in which the incidence of BCC is significantly higher in women than in men, and there does not seem to be a clear relationship between latitude and BCC incidence in Europe.
Men might be comparatively protected in the northern low‐ultraviolet environment, with tanning beds and travel abroad likely playing important roles in the observed incidence increase, especially in women.
The high multiplicity rates suggest that the total tumour burden worldwide might be higher than previously thought.
Linked Comment: Pandeya. Br J Dermatol 2020; 183:799–800.
Plain language summary available online
Mucocutaneous reactions to chemotherapy Susser, Wendy S.; Whitaker-Worth, Diane L.; Grant-Kels, Jane M.
Journal of the American Academy of Dermatology,
03/1999, Letnik:
40, Številka:
3
Journal Article
Recenzirano
Chemotherapeutic agents are a widely used treatment modality. Side effects range from common to unusual and may be confused with other cutaneous sequelae of oncologic treatment. The goal of this ...communication is to elaborate on previous descriptions of the cutaneous manifestations of chemotherapeutic treatment and to discuss more recent findings. (J Am Acad Dermatol 1999;40:367-98.)
Learning objective: At the conclusion of this learning activity, participants should be able to generate a differential diagnosis of possible etiologies for varying patterns of cutaneous involvement in patients receiving chemotherapy and identify the various cutaneous side effects of chemotherapeutic treatment. In addition, they should be able to distinguish life-threatening side effects that require immediate management from more benign manifestations of chemotherapeutic treatment.
Dermatologic diseases of the breast and nipple Whitaker-Worth, D.L.; Carlone, V.; Susser, W.S. ...
Journal of the American Academy of Dermatology,
11/2000, Letnik:
43, Številka:
5
Journal Article
Recenzirano
Breast and nipple skin is commonly affected by various inflammatory and neoplastic processes. Despite this fact, many physicians are unaware of the spectrum of diseases that can involve this area. ...Because breast and nipple skin represents a cosmetically, sexually, and functionally important entity to most patients, awareness of these disease entities is invaluable. This article reviews the normal anatomy of the breast, cutaneous manifestations of neoplastic processes that can present in these areas, and common inflammatory diseases of the breast and nipple skin. (J Am Acad Dermatol 2000;43:733-51.) Learning objective: At the conclusion of this learning activity, participants should be familiar with (1) the normal anatomy of the breast, (2) common benign and malignant tumors of the breast, and (3) the spectrum and differential diagnosis of inflammatory and infectious processes involving the breast. Better understanding of dermatologic entities affecting the breast may aid in improved diagnosis of these entities as well as ensuring appropriate intervention.
The misdiagnosis of malignant melanoma Grant-Kels, Jane M.; Bason, Elizabeth T.; Grin, Caron M.
Journal of the American Academy of Dermatology,
04/1999, Letnik:
40, Številka:
4
Journal Article
Recenzirano
Despite the increasing awareness of malignant melanoma over the last 40 years, clinical diagnostic accuracy remains disappointing. Malignant melanoma can masquerade clinically as benign lesions ...(false negatives), and benign pigmented lesions can clinically simulate malignant melanoma (false positives). Histologic examination of pigmented lesions is therefore important to ensure proper diagnosis and treatment. We review many of the published reports of benign lesions mimicking melanoma and melanoma masquerading as other entities as well as present additional cases of clinical misdiagnoses of melanoma. (J Am Acad Dermatol 1999;40:539-48.)
The immune response in halo nevi Zeff, Richard A.; Freitag, Anna; Grin, Caron M. ...
Journal of the American Academy of Dermatology,
10/1997, Letnik:
37, Številka:
4
Journal Article
Recenzirano
The mechanism(s) responsible for halo nevus presents a provocative link with the immune response to melanoma. Although no direct demonstration of melanocyte killing has been observed by the immune ...effector cells found within the halo, the abundance of antigen-presenting cells in the regressing nevus and the presence of T lymphocytes at the site of depigmentation suggest that these cells participate in the halo phenomenon. Within the latter population of cells, evidence points to the involvement of CD8
+ T cells as potential effectors in the destruction of nevomelanocytes. The break in tolerance that triggers migration and the presumed activation of these and other lymphocytes in the nevus in the apparent absence of disease remains unexplained. This brief overview reviews the evidence for the participation of the immune response in the genesis of the halo nevus. (J Am Acad Dermatol 1997;37:620-4.)
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