P49 Epidemiology of skin cancer by ethnicity in England, 2013–2020: a cohort study

Abstract

Abstract Skin cancer rates are increasing worldwide and predominantly affect people of white ethnicity. Although less common, skin cancers in people with skin of colour (SOC) are more likely to experience diagnostic delays and higher mortality. High-quality epidemiological data on skin cancers in SOC are limited. SOC and skin phototype are not recorded in registry data; however, the ethnic group can be used as a somewhat limited proxy. The aim of this retrospective national cancer registry cohort study was to describe skin cancer epidemiology by the ethnic group. We identified a cohort of patients diagnosed with skin cancer in England (2013–2020) from the National Disease Registration Service (NDRS). The ethnic group is routinely recorded as self-reported during hospital visits in Patient Administration System and Hospital Episode Statistics datasets collected by the NDRS. We analysed data by the broad ethnic group [White, Asian (excluding Chinese), Black, Chinese, mixed, other, unknown]. We report counts, incidence, stage at presentation (melanoma only), referral pathway, anatomical location and geographical variation. The first basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) per patient were reported. More cases of skin cancers were diagnosed in Asian ethnicities than in Black and Chinese ethnicities, except for melanoma, which was more frequently diagnosed in Black ethnicities. Of 713 615 BCCs, 571 396 (80.1%) were reported in White, 799 (0.1%) in Asian, 634 (0.1%) in mixed, 413 (0.1%) in Black, 156 (0.02%) in Chinese and 3122 (0.4%) in people of ‘other’ ethnicities; 137 095 (19.2%) were of ‘unknown’ ethnicity. Of 244 072 cSCCs, 225 534 (92.4%) were in White, 609 (0.2%) in Asian, 354 (0.1%) in Black, 279 (0.1%) in mixed, 66 (0.03%) in Chinese and 1137 (0.5%) in people of ‘other’ ethnicity; 16 093 (6.6%) were of ‘unknown’ ethnicity. Of 111 676 melanomas, 102 273 (91.6%) were in White, 199 (0.2%) in Black, 180 (0.2%) in Asian, 125 (0.1%) in mixed, 25 (0.02%) in Chinese and 695 (0.6%) in ‘other’ ethnicities; 8179 (7.3%) were of ‘unknown’ ethnicity. This is the first national study of skin cancer types by ethnicity in England. National datasets allow for the better evaluation of rare subgroups of patients. The main limitation is the high proportion of unknown ethnicity reporting, which is higher for keratinocyte cancers than for other cancers, presumably due to their automated processing and lack of data sources (i.e. inpatient or multidisciplinary team datasets). These data will support a better understanding of unmet clinical needs in underserved populations.