Abstract
Background Skin cancer is a growing health concern worldwide. It is the most common malignancy in South Africa and places a large burden on the public healthcare sector. There is a paucity of published scientific data on skin cancer in South Africa. Objectives To report the findings of biopsies performed in patients with suspected skin cancer attending the Tygerberg Academic Hospital (TAH) Dermatology outpatient department (OPD) in the Western Cape Province of South Africa. Methodology: A retrospective chart review identified all patients who underwent a biopsy for a suspected skin cancer diagnosis between September 2015 and August 2016 at the TAH dermatology OPD. Results A total number of 696 biopsies from 390 participants were identified, of which 460 were histologically confirmed as malignant lesions. The proportion of clinically suspected skin cancers that were histologically confirmed as cancer was 68%. The most commonly occurring malignancies were basal cell carcinoma (BCC) (54.8%), squamous cell carcinoma (SCC) (18.9%), squamous cell carcinoma in-situ (SCCI) (8.0%), Kaposi's sarcoma (KS) (6.7%), malignant melanoma (MM) (6.1%), and keratoacanthoma (KA) (4.6%). The number needed to treat (NTT) for all cancers diagnosed and for MM was 1.5 and 4 respectively. BCC (89.3%) and KS (67.7%) was the most common skin cancer in the white and black population respectively. The ratio of BCC to SCC was 2.03. Conclusion This study provides valuable scientific data on the accuracy of skin cancer diagnosis, distribution and patient demographics in the Western Cape Province of South Africa, on which further research can be based. The study highlights the burden of skin cancer on this specific population group and calls for standardised reporting methods and increased surveillance of skin cancers.
Highlights
IntroductionSkin cancer is the most common malignancy worldwide and is typically divided into MM and non-melanoma skin cancer (NMSC) [1]. e term NMSC encompasses basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) and includes rarer types of skin cancer such as Merkel cell carcinoma and Kaposi’s sarcoma (KS) [2]. e worldwide incidence of NMSC and MM has been steadily increasing [3,4,5,6,7].Most of the studies on NMSC have focussed on white populations in Europe, the United States (US), and Australia with limited data for other skin types in regions such as Africa [1].e South African population is at a high risk of skin cancer due to the country’s geographical position and level of ultraviolet radiation (UVR) as well as the increased sun exposure due to occupational and recreational activities [8, 9]
A retrospective study of a descriptive nature was conducted. It consisted of patients who received a biopsy to diagnose skin cancer (MM and non-melanoma skin cancer (NMSC)) at the dermatology outpatient department (OPD) at Tygerberg Academic Hospital (TAH) between 1st September 2015 and 31st August 2016. e exclusion criteria entailed the following: (i) patients under 18 years of age (ii), biopsies done for primary cutaneous T-cell lymphoma
A total number of 1 444 biopsies were performed over a oneyear period (September 2015–August 2016) at the dermatology OPD at TAH, of which 696 biopsies, from 390 unique participants, met the inclusion criteria
Summary
Skin cancer is the most common malignancy worldwide and is typically divided into MM and non-melanoma skin cancer (NMSC) [1]. e term NMSC encompasses BCC and SCC and includes rarer types of skin cancer such as Merkel cell carcinoma and KS [2]. e worldwide incidence of NMSC and MM has been steadily increasing [3,4,5,6,7].Most of the studies on NMSC have focussed on white populations in Europe, the United States (US), and Australia with limited data for other skin types in regions such as Africa [1].e South African population is at a high risk of skin cancer due to the country’s geographical position and level of ultraviolet radiation (UVR) as well as the increased sun exposure due to occupational and recreational activities [8, 9]. Most of the studies on NMSC have focussed on white populations in Europe, the United States (US), and Australia with limited data for other skin types in regions such as Africa [1]. Data on MM incidence on the African continent remain scarce, a recent study showed the overall incidence of MM for South Africa to be 2.7 per 100 000, with the incidence in the white population being. Skin cancer is a growing health concern worldwide It is the most common malignancy in South Africa and places a large burden on the public healthcare sector. To report the findings of biopsies performed in patients with suspected skin cancer attending the Tygerberg Academic Hospital (TAH) Dermatology outpatient department (OPD) in the Western Cape Province of South Africa. BCC (89.3%) and KS (67.7%) was the most common skin cancer in the white and black population respectively
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