Basal cell carcinoma on the rise in Europe
MedWire News: The incidence of basal cell carcinoma (BCC) in Europe has increased by 7% annually between 1991 and 2007, with incidence of the superficial and infiltrative subtypes showing the largest increases, study results show.
Since superficial (s)BCC was common in younger patients and frequently found on the trunk rather than head, lead researcher A Arits (Maastricht University Medical Centre, The Netherlands) and colleagues speculate that its marked rise may be due to recreational sun exposure.
BCC is the most common type of skin cancer in the White population, and while it rarely metastasizes or causes death, it can cause significant destruction and disfigurement by invading surrounding tissues.
"As a result of the high prevalence, BCC is starting to represent a large and expensive healthcare problem," the researchers comment in the Journal of the European Academy of Dermatology and Venereology.
Clinical experience suggests an increase in BCC and a shift to infiltrative (i)BCC, but tangible data are somewhat lacking, they add.
In the current study, Arits and team retrospectively reviewed all primary histologically confirmed BCCs diagnosed in the Maastricht University Medical Centre in the years 1991, 1999, and 2007.
A total of 1205 BCCs were diagnosed in 862 patients during the study period. The numbers of BCCs diagnosed at the three respective time points were 153, 372, and 680.
The age-standardized incidence rates for BCC increased between 1991 and 2007 from 54.2 to 162.1 per 100,000 men and from 61.7 to 189.8 per 100,000 women, corresponding to a year-on-year average increase of around 7% for both genders.
The nodular BCC subtype was the most common, although the proportion of BCC represented by nodular BCC decreased from 60.8% in 1991 to 40.6% in 2007.
By contrast, there was a significant increase in the proportion of sBCCs, from 17.6% in 1991 to 30.7% in 2007, and also of iBCCs, which increased from 11.1% in 1991 to 28.7% in 2007.
The mean age of patients with sBCC was significantly lower, at 65 years, than that of patients with other histologic subtypes, at 69.5 years.
The percentage of BCCs located in the head and neck region decreased from 73.9% in 1991 to 44.3% in 2007, while the percentage of BCCs located on the trunk increased during this time, from 17.6% to 45.3%, respectively.
The researchers say these trends could be explained by recreational sun exposure during vacation. Alternatively BCC may progress from superficial to nodular to infiltrative subtype, which would explain why the mean age of patients differed with the histological subtype.
In any case, "the increase in incidence of BCC confronts specialists and governments worldwide with higher costs and increasing demands for capacity to treat BCC," Arits et al conclude.
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By Andrew Czyzewski