Incidence Of SCC Research Articles

The incidence of periocular melanoma: An epidemiologic study in Olmsted County, Minnesota

To the Editor: Melanoma arising in the periocular area presents a unique treatment challenge due to anatomic and functional constraints. To date, most information regarding periocular melanoma is gleaned from extrapolated data from other sites of the body, assuming similar biologic behavior. We aimed to identify the overall incidence, pathologic features, and surgical outcomes of periocular melanoma. Following Institutional Review Board (IRB) approval, using the Rochester Epidemiology Project (a multicenter medical records–linkage system encompassing the Olmsted County population), we identified patients with a first lifetime diagnosis of periocular melanoma between January 1, 1970, and December 31, 2020, while a local resident of Olmsted County, Minnesota. Outside (nonresident) referral cases were excluded. Periocular melanoma was defined as a melanoma arising within the orbital rim – on the upper or lower eyelid, lateral canthus, or eyebrow. A total of 10 patients with primary periocular melanoma were identified. The overall incidence rate of periocular melanoma was 0.2686 per 100,000 patient-years. Among all melanomas diagnosed during that timeframe in Olmsted County, 0.43% were periocular in location. No cases extended onto conjunctiva. The histogenic subtype was lentigo maligna in 8 (80.0%). There was 1 superficial spreading melanoma and 1 case without documentation of histogenic subtype. Incidence of in situ (50.0%) and invasive (50.0%) melanomas was equal. Among invasive melanomas, the average Breslow depth was 0.90 mm (range, 0.2-2.6 mm). Seven (70.0%) were treated with Mohs micrographic surgery (MMS). One (10%) was treated with wide local excision. The 2 cases that did not undergo further surgical treatment were both diagnosed prior to 2000 and were removed entirely via initial excisional biopsy. There was 1 regional metastasis to the parotid gland and lymph node, 2.5 years after diagnosis of a superficial spreading melanoma, Breslow 0.7 mm, status-post treatment with MMS. There were no other local or distant recurrences. There were no melanoma-specific deaths. Mean follow-up time was 7.4 years (range 3.1-13.2). This study demonstrates the relative rarity of periocular melanoma, comprising only 0.43% of all melanomas. Comparatively, basal cell carcinoma (BCC) occurs on the eyelid 16% of the time.1Salomon J. Bieniek A. Baran E. Szepietowski J.C. Basal cell carcinoma on the eyelids: own experience.Dermatol Surg. 2004; 30: 257-263PubMed Google Scholar Our study found an overall periocular melanoma incidence rate of 0.2686 per 100,000 patient-years. A previous Olmsted County cohort reported an incidence of eyelid BCC as 14.35 per 10,000 individuals per year, and an incidence of eyelid SCC as 1.37 cases per 100,000 individuals per year.2Cook Jr., B.E. Bartley G.B. Epidemiologic characteristics and clinical course of patients with malignant eyelid tumors in an incidence cohort in Olmsted County, Minnesota.Ophthalmology. 1999; 106: 746-750Abstract Full Text Full Text PDF PubMed Google Scholar The behavior of melanoma seems to parallel primary cutaneous melanoma of head and neck sites. Most tumors were associated with chronic sun exposure; 80% of cases were lentigo maligna subtype. There was 1 regional recurrence in our study, no distant recurrences, and no deaths due to melanoma. The most significant advantage of our study is in its epidemiologic design. The limitations of this study include the retrospective nature of our analysis and the homogenous demographics of Olmsted County, comprised of mostly Caucasian individuals of higher socioeconomic status.3St Sauver J.L. Grossardt B.R. Leibson C.L. Yawn B.P. Melton 3rd, L.J. Rocca W.A. Generalizability of epidemiological findings and public health decisions: an illustration from the Rochester Epidemiology Project.Mayo Clin Proc. 2012; 87: 151-160Abstract Full Text Full Text PDF PubMed Scopus (487) Google Scholar Additionally, some melanomas may have been missed if the tumor was initially labeled as another anatomic site (cheek, nose, temple, etc.) and had extension onto the lid proper. None disclosed. We would like to acknowledge Austin Todd, MS, for his assistance in statistical analysis.

Cytomorphological Variations in Pap Smears amongst Postmenopausal Women Reporting at a Tertiary Care Centre, Tamil Nadu, India

Introduction: In developing countries, cervical cancer is the leading cause of death amongst women. Since women spend one third of their lives in the postmenopausal period, which is most neglected phase, needs a technically simple, non invasive and, cost-effective screening tool for cervical cancer detection and the exact answer is the Pap smear screening test. This simple screening test when performed at regular intervals in post menopausal population, can detect precursor lesions there by reducing cervical cancer morbidity and mortality. Aim: This study was undertaken to evaluate the cytomorphological variations in Pap smears amongst postmenopausal women. Materials and Methods: In this prospective study, a total of 138 satisfactory smears were considered for study amongst 146 postmenopausal women from August 2020 to July 2022 at Bhaarath Medical College and Hospital and then evaluated and categorised based on Bethesda system for reporting cervical cytology 2014. {Reporting elements include specimen type, specimen adequacy, general categorisation, interpretation/result includes general categories of negative for Intraepithelial Lesion or Malignancy (NILM), epithelial cell abnormalities and other malignancies. Results: Out of 138 satisfactory cases, 78.26% (108 cases) 14.5% (20 cases) and 7.24% (10 cases) were diagnosed as of inflammatory/benign conditions, epithelial abnormalities and normal cytology respectively. The mean age for inflammatory/ benign lesions was 57.5 years and majority presenting with postmenopausal bleeding and white discharge. Amongst epithelial abnormalities Atypical Squamous Cells of Undetermined Significance (ASCUS) and Low-grade Squamous Intraepithelial Lesions (LSIL) were commonest. The incidence of ASCUS 7.27% (10 cases), and incidence of LSIL 2.89% (4 cases). The mean age was 57.5 years and majority of patients presented with postmenopausal bleeding and mass per vaginum. Incidence of High grade Squamous Intraepithelial Lesion (HSIL) was 2.17% (3cases), the mean age was 65.5 years and presented with white discharge and postmenopausal bleeding. Incidence of SCC was 2.17% (3 cases) and the mean age was 70.5 years, presented with, postmenopausal bleeding and white discharge. Conclusion: Pap smear is a simple, cheap, safe and gold standard diagnostic tool for screening postmenopausal women for all cervical abnormalities in particular pre-invasive and invasive lesions.

Second Primary Malignancy Incidence in Patients Receiving Lenalidomide at Induction and Maintenance; Long-Term Follow up of 4358 Patients Enrolled to the Myeloma XI Trial

Background Early trials of long-term lenalidomide (len) use reported an increased incidence of second primary malignancies (SPM), including acute myeloid leukaemia and myelodysplastic syndrome. Later, meta-analysis suggested the link to be secondary to len in combination with melphalan. Here we address the impact of len on SPM development when used at induction and maintenance, profiling SPM type and incidence in 4358 patients treated in the UK NCRI Myeloma XI trial, in which len was used at induction and maintenance, in transplant eligible (TE) and non-eligible (TNE) newly diagnosed patients. Methods Myeloma XI was a phase III, randomised, multi-centre, parallel group design, open-label trial comparing cyclophosphamide, thalidomide, len, carfilzomib and bortezomib induction combinations and len as maintenance treatment in newly diagnosed patients. TE patients received high dose melphalan supported by autologous stem cell transplantation. Patients in both pathways were randomised to maintenance with len (+/- vorinostat) or active observation. Within the TE pathway, 701 patients did not receive len at induction or maintenance, 1263 received len at induction or maintenance (single exposure) and 568 received len at induction and maintenance (double exposure). In TNE patients, 677 were not treated with len, 899 were single exposed and 260 double exposed. Median follow-up was 68 months (IQ range 49-83). Results 138 TE patients (IR 5.5%) developed an SPM, with 85 diagnosed following maintenance randomization (IR 5.9%). TE patients receiving len maintenance had an SPM incidence of 12.2% at 7 years, compared to 5.8% in those being observed (Pepe-Mori p=0.003). When profiling the SPM type, the incidence of most cancers was greater in the double exposed patients (non-exposed IR 1.6%, single exposed IR 2.9%, double exposed IR 8.3%). Despite this, the actual incidence was <1% for each SPM type in all groups, except for BCC (1.4%), SCC (1.2%) and MDS (1.1%) noted in >1% of double exposed patients. Haematological SPM were almost all confined to the len treated patients, with most in the double exposed group, Figure 1a. 180 TNE patients (IR 9.9%) developed an SPM, with 110 diagnosed following maintenance randomization (IR 13.2%). TNE patients receiving len maintenance had an SPM incidence of 17.1% at 5 years, compared to 10% in those being observed (p=0.09). There was a greater incidence of most SPM types in the double exposed patients (non-exposed IR 2.8%, single exposed IR 6.7%, double exposed IR 18.1%). Skin cancers were common, particularly in the double exposed patients, with an SCC incidence of 4.6% and BCC incidence of 3.1%. No SPM type was diagnosed in >1% of patients who did not receive len. In the double exposed patients, prostate cancer (1.2%) and melanoma (1.2%) were also noted in >1% of patients, Figure 1b. Haematological SPM were rare in TNE patients, with only 8 patients diagnosed, 7 of whom received len. We also determined the outcome in patients treated with len maintenance. In TE patients, 13 (IR 1.8%) deaths were secondary to an SPM, compared to 121 (IR 16.6%) myeloma related and 18 (IR 2.5%) non-myeloma related deaths. This compared to 2 (IR 0.4%) SPM deaths, 117 (IR 22.6%) myeloma related and 19 (IR 3.7%) non-myeloma related deaths in the observed patients. In TNE len maintenance patients, 25 (IR 6.1%) died due to a SPM, 133 (32.7%) due to progressive myeloma and 44 (IR 10.8%) due to other causes. In the observed TNE patients, 9 (IR 2.8%) died due to an SPM, 131 (IR 41.5%) due to progressive myeloma and 28 (IR 8.9%) secondary to non-myeloma related issues. Conclusions SPM incidence was higher in patients treated with len at both induction and maintenance compared to single exposure or no exposure. This was most marked in the TNE patients suggesting an innate risk of SPM development in older patients, particularly skin cancers, possibly impacted by len. Focusing on the maintenance therapy, there was a significant increase in SPM incidence in TE patients treated with len maintenance compared to observation. In TNE patients there was also a numerical increase in SPM incidence that did not reach statistical significance. Deaths due to SPM were rare but increased with lenalidomide maintenance. However, deaths due to myeloma were lower in patients treated with len. We suggest that clinic review of patients receiving maintenance len should include a history focused on identifying possible SPM, so intervention can be made early. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

The impact of treatment delay on skin cancer in COVID-19 era: a case-control study

BackgroundThe outbreak of COVID-19 pandemic led to a 2-month lockdown in Europe. Elective surgeries, including skin cancer excisions, were postponed. The purpose of this prospective case-control study was to assess the impact of the treatment delay on patients with non-melanoma skin cancer (NMSC) or melanoma operated in the first post-lockdown period.MethodsA comparative study of skin cancer operations performed in a 4-month period either in 2020 or in 2019 was conducted. All data were collected from a prospectively maintained clinic database and the pathological reports. Continuous variables were compared with t test or Mann-Whitney U test according to their distribution. Categorical variables were compared with Fisher exact test. Odds ratio (OR) with 95% confidence interval (95% CI) was used to assess the risk of excising high-risk NMSC in 2020 compared with 2019.ResultsSkin cancer excision was performed in 158 cases in 2020 compared to 125 cases in 2019 (26.4% increase). Significantly, more SCC were excised in 2020 (p = 0.024). No significant difference for several clinical parameters regarding BCC, SCC, and melanoma was identified. However, the reconstructive method applied, following NMSC excision, was significantly different, requiring frequently either skin grafting or a flap.ConclusionThese results indicate that skin cancer treatment delay, due to COVID-19 pandemic, is related to an increased incidence of SCC and more complicated methods of reconstruction. Considering the relapsing COVID-19 waves, significant skin cancer treatment delays should be avoided.Trial registrationThe study adhered to the STROBE statement for case-control studies.

Effects of 2 intramammary antimicrobial formulations on control of mastitis during the dry-period and performance of dairy cows

Our objective was to evaluate the effects of benzathine cloxacillin (BC) and ceftiofur hydrochloride (CH) treatment at dry-off on prevalence of intramammary infections at calving, incidence of clinical mastitis and SCC and milk yield up to 100 DIM, and removal from the herd and reproductive responses within 100 DIM. At dry-off, cows from 2 herds were assigned randomly to the BC (n = 1,160; Orbenin-DC, Merck Animal Health) and the CH (n = 1,183; Spectramast DC, Zoetis) treatments. Composite milk samples collected at dry-off and at calving were submitted for bacterial culture. Monthly milk samples were used to determine SCC. Days in milk at first insemination and pregnancy outcomes to first and second inseminations were compared between the 2 treatments. Treatments did not differ regarding prevalence of intramammary infections at dry-off (BC = 45.2 ± 1.8% vs. CH = 42.6 ± 1.7%). Treatment did not affect the prevalence of intramammary infections at calving (BC = 39.1 ± 2.3% vs. CH = 40.4 ± 2.3%), incidence of clinical mastitis within 100 DIM (BC = 6.6 ± 1.0% vs. CH = 7.7 ± 1.1%), and milk yield up to 100 DIM (BC = 3.6 ± 0.03 kg × 10 3 vs. CH = 3.6 ± 0.03 kg × 10 3 ). Treatment did not affect reproductive outcomes. Producers may choose between BC and CH at dry-off without being concerned about differences in prevalence of IMI at calving and lactational performance.

INCIDENCE OF CERVICAL ADENOCARCINOMA: A RETROSPECTIVE CASE STUDY AT RIMS RANCHI

BACKGROUND:Cervical cancer remains one of the most common causes of death for women globally and ranks 4th of all cancers.Currently,every 2 minutes a life is lost to this disease.Endocervical adenocarcinomas are a heterogeneous group of neoplasms. Screening strategies designed for and effective in detecting squamous cell carcinoma precursors are less effective in detecting endocervical glandular precursor lesions.Because of this and possible other reasons,the real and relative incidence of endocervical adenocarcinoma has increased in recent years from 5% to up to 20-25%, particularly in patients 30yr of age or older.MATERIAL AND METHOD: It was a retrospective record based study, performed in the Department of pathology, RIMS Ranchi. Study population included all cases who were clinically suspected of any cervical pathology, with common clinical presentation of abnormal vaginal bleeding, intermenstrual heavy bleeding,postmenopausal bleeding,postcoital bleeding,whitish discharge per vagina,pain in lower abdomen, from January 2020- july 2021.RESULT:In our study incidence of SCC of cervix is 91.97% and second most common type is adenocarcinoma of cervix with incidence of 8.02%.Striking feature of adenocarcinoma of cervix is its preponderance in younger female as compared to SCC

Survey of somatic cell counts and milk composition in bulk milk of ewes in dairy practice

We evaluated milk quality during the sheep dairy period in the year 2018. The study was performed at fifteen dairy farms with differed breeds and crossbreds under Slovakian usual practical conditions (milking and pasture). At the first and seventh farm purebred Tsigai (TS) ewes were kept, at the eight to twelve farm there were purebred Lacaune ewes (LC) and the thirteen farm were kept crossbred Improved Valachian x Lacaune ewes (IV/LC, with a higher proportion of Improved Valachian), the fourteen farm crossbred Lacaune x East Friesian ewes and the last farm were ewes of the synthetic population of Slovak dairy ewe (SD). The milk yield recording and milk sampling were performed once a month during evening milking as a part of milk recording services. The basic milk composition was determined by MilkoScan FT120 (Foss, Hillerød, Denmark) and somatic cell count was determined using a Fossomatic 90 (Foss Electric, Hillerød, Denmark) after heat treatment at 40 °C for 15 min. We found the highest incidence of SCC on farm 14 with crossbred LC/EF 3.940 x 103 cells.mL-1. Followed by farms 12 and 9 with purebred LC (SCC value of 3.318 and 2.489 x 103 cells.mL-1). Farm 7 with purebred TS reached the lowest value (831 x 103 cells.mL-1). The highest fat content was reached by the purebred TS, with gradual growth from March to July. Crossbreds and the synthetic population of Slovak dairy ewe (SD) had the lowest average fat content, which could be affected by feeding. Similar tendencies were found in protein content.

A study of Human Epidermal Growth factor receptor-2 [HER-2] in Carcinoma Oesophagus [Single Institutional Tertiary cancer centre study from North-East part of India

Oesophageal cancer both squamous cell [SCC] and adenocarcinoma have poor outcomes with high morbidity and mortality. Our hospital-based registry for year 2017-2018 showed that oesophageal cancer constituted 22.7% of annual case load. The main objective of this study was to determine the presence of HER-2 receptors in patients with oesophageal carcinoma in our region. From September 2018 to September 2019, data regarding expression of HER-2 receptors was analysed in 133 patients of oesophageal carcinoma. Data were statistically described as frequencies (number of cases) and percentages where appropriate. Chi-square and Fischer's exact test was used to find out the association between categorical variables. A P value less than 0.05 was considered as statistical significant at 95% confidence interval. The statistical analysis was performed using SSPS [statistical package for the social sciences] software version 17.0. A total of 133 patients were taken into study. Majority of patients were males (96) with mean age of 52 years. Squamous cell carcinoma was predominant histology. HER-2 receptor positivity was seen in 6.01% of patients. Patients with HER-2 receptor positivity presented in advanced stage with poor functional status and poor grades of differentiation. Statistically significant correlation of Her-2 expression was seen with stage (p = 0.001) and pathology of tumour (p = 0.0001). Squamous cell carcinoma of oesophagus still predominates in North-eastern part of India. For studying the role of effective targeted therapies knowledge of frequency of HER-2 receptor positivity is of utmost importance in our population, and our study aims to answer this question. The present study shows low prevalence of HER-2 neu overexpression in our community, probably due to disproportionately high incidence of SCC compared to adenocarcinoma. Patients with HER-2 receptor positivity presented in advanced stage with poor functional status and poor grades of differentiation.

Factors affecting raw milk quality of dairy cows under practical conditions

Under the practical conditions, it is important to evaluate the factors affecting milk performance. Data from test day yield and milk components should be useful for such evaluation. The aim of the experiment was to study the effect of season, udder health (by somatic cell counts SCC), parity, stage of lactation on milk production, milk components, and SCC under the practical conditions. Also, the frequency of incidence of high SCC during the season was observed. The experiment was realized on one dairy farm in dairy practice. The experiment lasted from December 2015 to October 2017. We examined 481 Holstein dairy cows (6910 milk samples). Milk samples were collected once per month – performed by recording test day. Only cows with 9 – 11 test days were evaluated. The effect of season, parity, stage of lactation, and SCC influenced most of the studied traits. The milk yield was highest at 2nd lactation. In the following lactations, the milk yields were decreasing. The SCC significantly increased with advanced parity. The elevated SCC was found in the beginning and in the final part of lactation. SCC as a factor significantly reduced milk yield, lactose content but increased fat and protein content. In conclusion, under practical conditions, the management should use the data from test days and analyze them for a better understanding of the performance efficiency at the farm level and for implementing more sophisticated decision making in farming.

A study of human epidermal growth factor receptor-2 (HER-2) in carcinoma esophagus (Single Institutional Tertiary Cancer Centre study from Northeast part of India)

Objectives: Esophageal cancer both squamous cell (SCC) and adenocarcinoma have poor outcomes with high morbidity and mortality. Our hospital-based registry for the year 2017–2018 showed that esophageal cancer constituted 22.7% of the annual caseload. The main objective of this study was to determine the presence of HER-2 receptors in patients with esophageal carcinoma in our region. Material and Methods: From September 2018 to September 2019, data regarding the expression of HER-2 receptors was analyzed in 133 patients of esophageal carcinoma. Data were statistically described as frequencies (number of cases) and percentages where appropriate. Chi-square and Fischer’s exact test was used to find out the association between categorical variables. A P &lt; 0.05 was considered as statistical significant at 95% confidence interval. The statistical analysis was performed using SSPS software version 17.0. Results: A total of 133 patients were taken into study. The majority of patients were males (96) with a mean age of 52 years. Squamous cell carcinoma was predominant histology. HER-2 receptor positivity was seen in 6.01% of patients. Patients with HER-2 receptor positivity presented in advanced stage with poor functional status and poor grades of differentiation. Statistically significant correlation of Her-2 expression was seen with stage (P = 0.001) and pathology of tumor (P = 0.0001). Conclusion: Squamous cell carcinoma of esophagus still predominates in Northeast part of India. For studying the role of effective targeted therapies, knowledge of frequency of HER-2 receptor positivity is of utmost importance in our population and our study aims to answer this question. The present study shows a low prevalence of HER-2 neu overexpression in our community, probably due to the disproportionately high incidence of SCC compared to adenocarcinoma. Patients with HER-2 receptor positivity presented in advanced stage with poor functional status and poor grades of differentiation.

The incidence of squamous cell carcinoma of the oral tongue is rising in young non-smoking women: An international multi-institutional analysis.

Increasing evidence is accumulating for an alarming rising incidence of oral tongue SCC in a younger cohort, particularly in developed countries. The aim of this study is to analyse the change in incidence of OSCC in patients under the age of 45 in developed nations in the Asia-Pacific region. Population data was extracted from the Australian Cancer Incidence and Mortality 2017 database and National Registry of Diseases Office, Singapore to allow calculation of the incidence in the Australian and Singaporean populations. This was compared to multi-institutional data from four tertiary Australian institutions. The inclusion criteria were as follows: a) diagnosis of primary SCC of the mobile tongue; b) treatment with curative intent; c) complete histopathologic data; d) complete adjuvant treatment data; e) follow up data. Analysis of ACIM data demonstrated that there was a significant increase in the incidence of tongue SCC in those under the age of 45 in the Australian and Singaporean populations (p<0.001). When analysed for gender, the incidence of tongue SCC increased at a significantly higher rate in females than males (p<0.001). Similarly, in the multi-institutional analysis including 1814 patients, the number of females under the age of 45 with tongue SCC significantly increased over time (p<0.001), with the proportion of smokers in this cohort decreasing over time. The incidence of tongue SCC is rising in young females in developed nations in the Asia Pacific region, in keeping with observed epidemiological trends worldwide.

Arguments to Support a Viral Origin of Oral Squamous Cell Carcinoma in Non-Smoker and Non-Drinker Patients.

In some western countries, an increasing incidence of oral squamous cell carcinoma (OSCC) has been observed in non-smoker non-drinker patients (NSND), mostly in women with HPV-negative OSCC. In the context of the unknown etiology and mechanisms of tumorigenesis of OSCC in NSND, we discuss data supporting the hypothesis of a viral origin not related to HPV. OSCC from NSND are characterized by an antiviral DNA methylation and gene expression signature. Based on the similar increasing incidence of oral tongue SCC (OTSCC) and oropharyngeal SCC (OPSCC) in young women and men respectively, we hypothesize that changes in sexual behaviors may lead to an increasing incidence of herpesvirus in the oral cavity, especially HSV-2, similarly to what has already been described in HPV-positive OPSCC. Because viral genome integration has not been detected in OSCC from NSND, a “hit and run” viral mechanism involving epigenome deregulation could therefore play a key role at early steps of oral carcinogenesis in this population of patients. In conclusion, epidemiological, clinical and molecular data supports a “hit and run” viral origin of OSCC from NSND.

Treatment approaches in immunosuppressed patients with advanced cutaneous squamous cell carcinoma.

Immunosuppression, both iatrogenic and disease-related, is associated with a greatly increased incidence of cutaneous SCC (cSCC) and with aggressive cSCC and worse disease outcomes. Consequently, rapid access to skin cancer services and prudent surgical choices, such as circumferential margin assessment, is essential when treating advanced cSCC in an immunosuppressed patient. For high-risk cancers and control of cSCC multiplicity, additional strategies should be actively considered within the multidisciplinary clinical care team. These include minimization or revision of immunosuppressive medications, systemic chemoprevention (including retinoids, nicotinamide, capecitabine) and adjuvant therapies such as radiotherapy. Unfortunately, there is a relative paucity of good evidence for many of these treatments in the immunosuppressed. Systemic treatments for metastatic cSCC are often contraindicated in organ transplant recipients, notably checkpoint inhibitor immunotherapy. There are also toxicity concerns with some conventional chemotherapies and EGFR inhibitors. Until recently, clinical trials have largely excluded immunosuppressed individuals. Development of more effective treatment for advanced cSCC in this high-risk group and prospective clinical trials are now research priorities.

Squamous cell carcinoma of the tongue in patients older than 45 years.

This study aims to evaluate the clinicopathological features, TNM status, AJCC staging and behavior of squamous cell carcinoma of the tongue (SCCT) in patients older than 45 years. The files of the Department of Pathology of the Hospital General de México were reviewed and all cases of SCCT in patients older than 45 years were selected. Clinicopathological features, treatment, follow-up, microscopic diagnosis, and IJCC and TNM staging were retrieved. Complete data from 60 cases were evaluated. They were more common in males (mean age = 63.9 years). Unexpectedly a high rate of tumors (38.3%) were in the base of the tongue (BT). Moderately and poorly differentiated SCCT were the most common. 16.7% presented lymph node invasion, 15% were recurrent tumors and BT carcinomas recurred more frequently. A high rate (81.7%) were stage II and 48.3% were low-risk patients. SCCTs in the studied population displayed different clinico-pathological and behavioral features compared with worldwide data. Our results suggest that BT tumors should be treated more aggressively than those in the mobile tongue. BT located tumors were more frequent than previously published. Additional frequency studies will define outcomes in age cohorts with a consensus cut-off for young and elderly populations. More population-based studies should be performed in Latin American regions to acquire accurate data on SCC incidence in elder subpopulations and to identify precisely the etiological factors in these patients.

Climate change and its relationship with non-melanoma skin cancers.

Climate change is affecting both the environment and human behaviour. One significant impact is related to health, as detailed in the IPCC 2014 report. In the present work, and as a contribution to this commemorative special issue to Prof. Dr Jan van der Leun, we present the results of the squamous (SCC) and basal-cell carcinoma (BCC) incidence change in relation to the ambient temperature increase. This increase is produced by global warming, mainly induced by anthropogenic atmospheric emissions of greenhouse gases. We have broadened a previous study conducted by van der Leun et al. (Photochem. Photobiol. Sci., 2008, 7, 730-733), by analysing the effective carcinogenicity of UV dose, for the period 2000-2200 and four climate change scenarios (called RCP2.6, RCP4.5, RCP6.0 and RCP8.5). The corresponding percentage increases of the incidence of SCC for 2100 are 5.8, 10.4, 13.8 and 21.4%, and for 2200 they are 4.3, 12.1, 19.0 and 40.5%. In a similar way, the percentage increases of the incidence of BCC for 2100 are 2.8, 4.9, 6.5 and 9.9% and for 2200 they are 2.0, 5.8, 8.9 and 18.2%. We report the SCC and BCC percentage effective incidence results as a function of time, for the whole 21st century and we extended the analysis to the 22nd century, since people possibly affected (like the Z and T generations, born at the beginning of this century) will have a life expectancy extending up to the final decades of the present century and even to the first ones of the next century.

Anal cancer in high-income countries: Increasing burden of disease.

BackgroundPrevious studies have reported that anal cancer incidence has increased in individual countries; however, age-specific trends were not examined in detail. This study describes pooled and country-specific anal cancer incidence trends by sex, age (all ages, <60 and 60+ years) and histological subtype (all subtypes, squamous cell carcinoma [SCC] and adenocarcinoma [ADC]).MethodsFive-year incidence and population-at-risk data were obtained from IARC’s Cancer Incidence in Five Continents for the years 1988–1992 to 2008–2012. The standardised rate ratios (SRRs) for 2008–2012 vs 1988–1992 and the 5-year average percent change (AvPC) during the period were used to assess changes in the age-standardised incidence rates.ResultsDuring the study period, there were significant increases in the incidence of SCC in both men and women of all age groups with significant increasing trend, and these increases were highest in those aged <60 years (SRR = 2.34 [95% CI:2.11–2.58] in men and SRR = 2.76 [95% CI:2.54–3.00] in women). By contrast, there were significant decreases in the incidence of ADC in men and women of all ages (SRR = 0.60 [95% CI:0.54–0.67]) and (SRR = 0.63 [95% CI:0.56–0.71], respectively), with similar decreases in those aged <60 years and 60+ years. These competing trends still resulted in significant increases in the overall incidence of anal cancer in men and women of all ages groups with significant increasing trend. The SRRs in men of all ages, <60 years and 60+ years were 1.35 (95% CI:1.28–1.42), 1.77 (95% CI:1.62–1.92) and 1.08 (95% CI:1.00–1.15), respectively. The corresponding SRRs in women were 1.75 (95% CI:1.67–1.83), 2.31 (95% CI:2.14–2.48) and 1.38 (95% CI 1.31–1.46), respectively.ConclusionIncreases in the incidence of anal SCC has driven an overall increase in anal cancer incidence; this may be associated with changing sexual behaviours and increasing levels of HPV exposure in younger cohorts. The findings further reinforce the importance of HPV vaccination.

Temporal Trends and Geographic Patterns of Lung Cancer Incidence by Histology in Thailand, 1990 to 2014.

PurposeLung cancer is one of the most common cancers worldwide and in Thailand. We characterize and forecast region-specific patterns of lung cancer incidence by histology and sex.MethodsWe analyzed lung cancer incidence trends in Thailand by histology (adenocarcinoma [AdC]; squamous cell carcinoma [SCC]; and large-cell, small-cell, and other carcinomas) from 1990 to 2014 in four cancer registries in three regions (north, Chiang Mai Province and Lampang Province; northeast: Khon Kaen Province; south: Songkhla Province). Annual percent change (APC) was calculated to quantify the incidence rate trends using joinpoint regression. Age-period-cohort models were used to examine the temporal trends of AdC and SCC by age, calendar year, and birth cohort. We projected the incidence of AdC and SCC up to 2030 using three independent approaches: joinpoint, age-period-cohort, and Nordpred models.ResultsAdC incidence significantly increased from 1990 to 2012 in Chiang Mai males (APC, 1.3%), Songkhla males from 2004 to 2014 (APC, 2.5%), Songkhla females from 1990 to 2014 (APC, 5.9%), and Khon Kaen females from 2005 to 2014 (APC, 3.1%). Conversely, SCC incidence significantly decreased from 1990 to 2012 in Chiang Mai males and females (APC, −1.2% and −4.8%, respectively), Lampang males and females from 1993 to 2014 (APC, −5.4% and −5.2%, respectively), and Songkhla females from 1990 to 2014 (APC, −2.1%). In general, trends of AdC and SCC correlated more with birth cohort than with calendar year. Three projection models suggested that incidence rates of AdC in Songkhla may continue to increase until 2030.ConclusionTemporal trends of lung cancer by histology varied among regions in Thailand. Reduction of lung cancer incidence in Thailand likely will require prevention strategies tailored to each specific region.

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for Anal Squamous Cell Cancers (Revised 2018).

The American Society of Colon and Rectal Surgeons is dedicated to ensuring high-quality patient care by advancing the science, prevention, and management of disorders and diseases of the colon, rectum, and anus. The Clinical Practice Guidelines Committee is composed of society members who are chosen

The incidence and body site of skin cancers in the population groups of Astana, Kazakhstan.

Background and aimsData on cutaneous malignant melanoma (CMM), squamous cell carcinoma of the skin (SCC), and basal cell carcinoma (BCC) in populations consisting of multi‐racial groups in the Commonwealth of Independent States are limited. Here, the main aim was to analyse the incidence and body site of these cancers in the population groups of Astana, Kazakhstan (2007‐2016).MethodsAnnual age standardised incidences and body sites of BCC, SCC, and CMM in Astana's population, divided into “Kazakhs and other Turkic/Asian” and “Russian and other European/Caucasian” groups, were calculated from histologically confirmed cases reported to Astana Oncology Centre.ResultsDuring the period January 2007 to October 2016, 647 skin cancers were diagnosed. The age and sex standardised incidence of BCC, SCC, and CMM increased significantly between 2007 to 2011 and 2012 to 2016. Higher incidences occurred in the Russian and other European/Caucasian group compared with the Kazakh and other Turkic/Asian group for the 3 skin cancers. BCC was the most common type of skin tumour, followed by SCC, and then CMM, in both population groups and sexes. The head/neck was the commonest site for BCC and SCC in all groups. For CMM, the most frequent site was the trunk in the Russian group and the head/neck in the Kazakh group.ConclusionThe incidence of skin tumours in Astana rose over the past 10 years. Differences in skin phototypes and sun exposure/ protection behaviours may account for the more frequent occurrence of skin tumours in the Russian population group compared with the Kazakh population group.

Estimated differences in economic and environmental performance of forage‐based dairy herds across the UK

AbstractDifferences in performance among the areas of England, Scotland, Wales, and Northern Ireland can provide some insight into the resilience of UK milk supplies from forage‐based dairy herds. This study used a Markov Chain approach to model the average herd in each region between the years 2010 and 2015. The effect of a single unit change in milk production (milk volume, fat yield, and protein yield), fitness (survival, somatic cell count, mastitis, and calving interval) and efficiency (methane) traits on the economic value and GHG emissions intensity (expressed as carbon dioxide equivalents per cow and per kg milk solids) were assessed. Production data were obtained from a total of about half a million milk recorded dairy cows in the UK and the Farm Business Surveys for each region. Across the UK improving the health, somatic cell counts (SCC and mastitis), fertility (calving intervals) and survival of cows will increase profitability and reduce emissions intensity of milk production. In Scotland, herds had higher milk yields but poorer survival, which potentially could be due to poor fertility indicated by a longer calving interval compared to other regions. Herds in Northern Ireland had the shortest average calving interval but the highest SCC, and thus greater estimated mastitis incidence and wasted milk. Notably, England had considerably higher economic values (between 10% and 30%) and emission intensity values (between 11% and 37%) for SCC and mastitis incidence than other regions, due to lost milk production and the higher gross margin. This study provides a framework that can be customized for individual herds to allow assessment of resilience and resource efficiency of milk production not only in the UK but for comparison with international dairy systems.