Incidence Of Non-melanoma Skin Cancer Research Articles

Wounding Therapies for Prevention of Photocarcinogenesis.

The occurrence of non-melanoma skin cancer (NMSC) is closely linked with advanced age and ultraviolet-B (UVB) exposure. More specifically, the development of NMSC is linked to diminished insulin-like growth factor-1 (IGF-1) signaling from senescent dermal fibroblasts in geriatric skin. Consequently, keratinocyte IGF-1 receptor (IGF-1R) remains inactive, resulting in failure to induce appropriate protective responses including DNA repair and cell cycle checkpoint signaling. This allows UVB-induced DNA damage to proliferate unchecked, which increases the likelihood of malignant transformation. NMSC is estimated to occur in 3.3 million individuals annually. The rising incidence results in increased morbidity and significant healthcare costs, which necessitate identification of effective treatment modalities. In this review, we highlight the pathogenesis of NMSC and discuss the potential of novel preventative therapies. In particular, wounding therapies such as dermabrasion, microneedling, chemical peeling, and fractionated laser resurfacing have been shown to restore IGF-1/IGF-1R signaling in geriatric skin and suppress the propagation of UVB-damaged keratinocytes. This wounding response effectively rejuvenates geriatric skin and decreases the incidence of age-associated NMSC.

Incidence and Prevalence of Skin Cancers in South Korea from 2008 to 2016: A Nation-Wide Population Based Study.

BackgroundIn South Korea, there have been few nationwide epidemiologic studies about premalignant actinic keratosis (AK), squamous cell carcinoma in situ (Bowen’s disease), nonmelanoma skin cancer (NMSC), malignant melanoma of the skin (MM), Kaposi’s sarcoma (KS), connective and soft tissue cancers, or mycosis fungoides (MF).ObjectiveUsing a nationwide population-based study, we attempted to measure the incidence and the prevalence of the above-mentioned tumors in South Korea.MethodsThe database we used included all claims in the Korean National Health Insurance program and the Korean Medical Aid program from 2008 to 2016. The International Classification of Diseases, 10th revision (ICD-10) was used to record diagnoses in this database. This data included AK, Bowen’s disease, NMSC, MM, KS, connective and soft tissue cancers, and MF.ResultsThe age-standardized incidence and prevalence rate of AK, Bowen’s disease, NMSC, MM, KS, connective and soft tissue cancers, as well as MF increased during the periods we investigated. The incidence and prevalence rate of AK and NMSC have increased two- to three-fold. In the case of Bowen’s disease, MM, KS, connective and soft tissue cancers, or MF, we observed no significant tendency in age-standardized incidence or prevalence.ConclusionWe confirmed that the age-standardized incidence and prevalence rates of NMSC and AK tended to increase. These results might contribute to developing preventive and therapeutic strategies for skin cancers and may become a source for further studies.

The Immunogenetics of Non-melanoma Skin Cancer.

Non-melanoma skin cancer (NMSC) is the most common malignancy seen in Caucasians and includes basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The incidence of NMSC is showing an increasing trend which is attributed to the increased use of sunbeds, recreational sun exposure, aging population, and partly to improved screening and reporting. Ultraviolet (UV) radiation plays the most crucial role in the pathogenesis of both BCC and SCC by inducing DNA damage and mutagenic photoproducts. Other risk factors are fair skin, old age, genetic predisposition, immunosuppression, ionizing radiation, organic chemicals, and HPV infection. The role of genomic instability, genetic mutations/aberrations, and host immunity has been fairly illustrated in several studies. This chapter aims to discuss these aspects of NMSC in detail.

Management of pre-malignant and malignant non-melanoma skin cancers: A study from a Tertiary Care Hospital of North India

Introduction:The incidence of non-melanoma skin cancers (NMSCs) is increasing over the last few decades. This necessitates an early diagnosis which is nowadays aided by dermoscopy. Once diagnosed early, the treatment armamentarium is diverse and includes both topical and surgical modalities.Objective:Our aim was to diagnose pre-malignant and malignant NMSCs at an early stage and treat them as per the standard protocol.Materials and Materials:Out of 136 patients of pre-malignant and malignant tumors enrolled, 100 were taken up for treatment. These were then classified into various subtypes on the basis of clinical examination and dermoscopy. The selected patients were subjected to topical treatment or surgical modalities, wide local excision or flap excision, based on the type of tumor and its size.Results:The pre-malignant group included actinic keratoses, Bowen’s disease, and keratoacanthoma, whereas the malignant group included undifferentiated squamous cell carcinoma (SCC), differentiated SCC, pigmented basal cell carcinoma (BCC), nodulo-ulcerative BCC, and superficial BCC. Actinic keratoses, superficial BCCs, and five cases of keratoacanthoma were treated with topical therapies with a resolution of 90% in 86.8% cases. All the remaining cases (62 in number) were treated with conventional and flap surgery with 88% and 89.1% clearance rates, respectively, with complications in only 7 patients.Conclusion:A prompt identification of NMSCs can enable selection of the appropriate treatment modality for a specific lesion and thus reduce their associated morbidity and mortality.

Incidence of Melanoma and Nonmelanoma Skin Cancer in Colombia: Trends and Projections from 2008 to 2022

Incidence of Melanoma and Nonmelanoma Skin Cancer in Colombia: Trends and Projections from 2008 to 2022

Teledermatology for suspected skin cancer in New Zealand during the COVID-19 pandemic required in-person follow-up in 28% of cases

To the Editor: The New Zealand (NZ) population has one of the highest incidences of nonmelanoma skin cancer in the world.1 Standard face-to-face (FTF) assessment of skin cancer was abruptly halted in early 2020, when the NZ government announced level 4 restrictions due to the COVID-19 pandemic. Educational facilities and businesses closed, and people were instructed to stay home unless accessing essential services. NZ's lockdown imposed strict restrictions by global standards, with only life-preserving health services permitted to proceed in person.

Incidence of Non-Melanoma Skin Cancers in Patients with Chronic Lymphocytic Leukaemia: A Retrospective Study in a Bay of Plenty, New Zealand Population

Background/Aims: Chronic lymphocytic leukaemia (CLL) incurs an increased risk of developing second primary malignancies (SPMs). The pathogenesis underpinning this increased SPM risk is attributable to synergism between genetic aberrations, chronic immune suppression / dysfunction and CLL treatments. Specifically, CLL associated skin cancer is a well-documented phenomenon, with common malignancies such as squamous (SCC) and basal cell (BCC) carcinomas occurring at higher frequencies in CLL patients and are often of a more aggressive phenotype. The incidence of non-melanoma skin cancers (NMSCs) among New Zealand CLL patients is unknown, as NMSCs are not required to be reported to the New Zealand Cancer Registry. Accordingly, this study aimed to analyse the incidence of NMSC in CLL patients from the Bay of Plenty region of New Zealand.Methods: We conducted a retrospective analysis of 213 CLL patients, who were referred to Bay of Plenty District Health Board (BOPDHB) between 2015 and 2020, for the occurrence of SPMs. Clinical notes were reviewed for the demographics of sex, age at time of CLL diagnosis, CLL treatments received and occurrence and type of NMSCs. A control group of 76 patients referred to BOPDHB haematology, for anaemia or thrombocytopenia, of which the cause subsequently remained unknown and was not associated with lymphoproliferative disease, was reviewed for primary malignancy (PM), occurrence and type. NMSC incidence was also compared to a local data, on overall NMSC incidence in the general Bay of Plenty population, in 2015.Results: The predominant SPM types occurring in this CLL patient group were NMSCs. A total of 249 and 170 histological diagnoses of SCC and BCC were made in our group of CLL patients, respectively. Of the 213 CLL patients, 48.8% had a diagnosis of at least one NMSC, with median time between CLL and NMSC diagnosis of 5 years (range, -6 to 19 years). CLL patients that were diagnosed with NMSC developed a mean number of 3.93 ± 2.94 separate lesions, compared to 2.6 ± 1.7 lesions in our control population. Note: comparison of NMSC incidence data between CLL group and Bay of Plenty populationConclusion: Patients with CLL are at increased risk of developing multiple NMSC lesions. Therefore, we believe CLL patients should be assessed by dermatologists or general practitioners for whole-body skin examination, 6 monthly following their CLL diagnosis. This strategy promotes early diagnosis, and patient education on importance of sun protection strategies to reduce NMSC risk. This is essential to the ongoing care of CLL patients in a NZ context, given the increased incidence of NMSC associated with CLL, in combination with the high levels of UV exposure and skin damage among the NZ general population. This study also highlights how NMSC disease burden is likely to be significantly underestimated due to a lack of data collection on these malignancies by the New Zealand Cancer Registry. DisclosuresNo relevant conflicts of interest to declare.

ПАЦИЕНТОРИЕНТИРОВАННЫЙ АЛГОРИТМ РАБОТЫ РЕНТГЕНОТЕРАПЕВТИЧЕСКОГО КАБИНЕТА ОНКОЛОГИЧЕСКОГО ДИСПАНСЕРА

Results: IIntroduction: Superficial X-ray therapy is a common treatment of non-melanoma skin cancer with a high incidence worldwide. Interrupting the course of radiation therapy can negatively affect patient survival and treatment results. Low treatment adherence may be associated with a lack of a patient-centered approach and ineffective communications. The original study shows that patients undergoing X-ray therapy for cancer may have different needs. Based on the study results an algorithm for a patient-oriented approach has been developed for the X-ray cabinets.
 Purpose: To develop a patient-oriented algorithm of the X-ray therapy room to address the issues of increasing patient satisfaction and forming their adherence to treatment. The objectives of the study included studying and detailing the needs of the patients who passed the X-ray therapy and to develop the patient-oriented algorithm for the X-ray therapy room.
 Material and methods: The study of the patient's values was carried out from 2019 to 2020 by interviewing using open-ended questions to find out the deep motives and beliefs of patients. The study was based on Milton Rokich’s (2005) model of value orientations, which was adapted to the objectives of the study.
 Results: The study included 116 patients undergoing treatment with the X-ray therapy at the City Clinical Oncology Dispensary. As a result of the study, the following patient needs were identified: clinical outcome of the procedure 111 (96 %), safety of treatment and adverse reactions 106 (91 %), cosmetic outcome 53 (46 %), convenience of the treatment schedule 42 (36 %), painlessness of the procedure 39 (34 %), the ability to lead a normal lifestyle 27 (23 %), comfortable conditions for the procedure 16 (14 %), financial costs associated with treatment 10 (9 %), preservation of organ function 4 (3 %). On the basis of the data obtained, a patient-oriented algorithm for the X-ray therapy was developed, including a communication plan with the patient. The study results clearly demonstrate that even with the same disease and condition, patients may have different priorities hat need to be considered to improve patient experience and adherence to treatment.
 Conclusion: Radiation treatment decision-making based on the patients values is important for the development of the patient-centered management in oncology since this directly affects patients’ adherence to treatment. Exploring the values and needs of patients is an opportunity to influence and improve the metrics of the patient experience. Due to the mass incidence of non-melanoma skin cancer, the introduction of patient-centered approaches is an important part of patient satisfaction and increase of patients adherence to the treatment.

Electronic Cigarette Use and the Diagnosis of Nonmelanoma Skin Cancer Among United States Adults.

IntroductionElectronic cigarette (e-cigarette) use has many potential effects, including damage to the skin. Limited research has assessed e-cigarette use with the incidence of nonmelanoma skin cancer. The current study was conducted to determine if a relationship exists between nonmelanoma skin cancer diagnosis and e-cigarette use among US adults.MethodsData from the National Health Interview Survey (NHIS) were used to assess if a relationship exists between e-cigarette use and the diagnosis of nonmelanoma skin cancer. Data within the sample adult files for years 2014 through 2018, along with the adult cancer file for the year 2015, were analyzed. Participants who reported having a diagnosis of nonmelanoma skin cancer were included. Participants who reported never being diagnosed with any type of cancer were included as a comparison group.ResultsMales and those of older age were significantly more likely to be diagnosed with nonmelanoma skin cancer compared to females and younger adults. Cigarette use was significantly associated with an increased risk of nonmelanoma skin cancer. There was no relationship between e-cigarette use and diagnosis of nonmelanoma skin cancer.ConclusionsAlthough the current study did not find an association between e-cigarette use and nonmelanoma skin cancer diagnosis, a longer study period and larger sample size may more clearly determine if an association exists.

309 Does Anaesthetic Type Effect Positive Excision Margin Rate for Non-Melanoma Skin Cancers?

Abstract Aim Australia has the highest incidence of Non-melanoma skin cancers (NMSC) in the world estimated to be 2448/100,000 population with the state of Queensland carrying the highest burden. Surgical excision is the primary treatment and makes up a large proportion of general surgical lists in regional Queensland where they are typically removed using either local anaesthetic (LA) alone, local anaesthetic and sedation (LAS), or general anaesthesia (GA). There is little in the literature to suggest if anaesthetic type effects the rate of involved margins. The purpose of this study is to establish if anaesthetic type impacts the rate of positive excision margins in regional hospitals in Queensland. Method A retrospective audit was performed, incorporating a total of 194 squamous and basal cell carcinoma lesions excised between October 2019 and October 2020 at two hospitals in regional Australia. Data was recorded for the type of anaesthetic used and the histopathology of the lesions including type of lesion and microscopic margin involvement. Results Of the 194 excised lesions 39 of them had involved margins (20.1%). The rate of involved margins under LA, GA and LAS were found to be 19.79%, 18.52% and 22.73% respectively. When comparing these modalities with each other: LA vs GA, LAS vs GA and LA vs LAS no significant difference was found in involved margins for excision of NMSC with p-values (<0.05) of 1, 0.624 and 0.8225 respectively. Conclusions Modality of anaesthetic used for excision of NMSC does not affect the outcome of margin involvement.

Vitamin D serum levels and non-melanoma skin cancer risk.

BackgroundSkin cancer is one of the common malignancies. There is sufficient evidence that sunlight (ultraviolet radiation) contributes to the development of skin cancer, but there is also evidence that relates adequate serum levels of vitamin D produced on the skin by the action of ultraviolet radiation with the decreased risk of various types of cancers, including skin cancer. The aim of this study was to investigate the association of vitamin D serum levels among patients with non-melanoma skin cancers (basal cell carcinoma and squamous cell carcinoma) and controls.MethodsA prospective observational case-control study was conducted in a sample of 84 subjects in Extremadura (Spain). Forty-one patients with histologically diagnosed basal cell carcinomas and squamous cell carcinomas and 43 healthy controls were randomly chosen to assess whether vitamin D (25(OH)D3) serum level, age and sex were related to non-melanoma skin cancer and to determine the possible risk of this type of skin cancer for these variables.ResultsWhen analysing serum vitamin D levels, we ensured that all our subjects, both cases and controls, had normal or low serum vitamin D levels, even though the samples were taken during months with the highest solar irradiance in our region. It is striking in our results that there was a higher percentage of subjects with deficits of vitamin D who did not have skin cancer (66%) than patients with deficits with these types of skin cancers (34%). When adjusting the model for age and sex, vitamin D values above 18 ng/ml increased the risk of suffering from non-melanoma skin cancer by nearly 7-fold (aOR: 6.94, 95% CI [1.55–31.11], p = 0.01).ConclusionsDespite the controversial data obtained in the literature, our results suggest that lower levels of vitamin D may be related to a reduced incidence of non-melanoma skin cancer.

LB752 A cross sectional survey of skin cancer knowledge, attitudes, and sun care practices in an underserved Phoenix population

The incidence of melanoma and non-melanoma skin cancers is on the rise. The Hispanic population is more likely to be diagnosed with melanoma at an advanced stage and have poorer overall survival. The primary aim of our study was to assess the skin cancer knowledge, attitudes, perceived risk, and sun care practices of an underserved, primarily Hispanic, population in the Phoenix area. A cross sectional survey of 208 patients recruited during a skin cancer screening program was performed. Our population was primarily Hispanic (64.9%), from Mexico (87.9%).

An updated report on the incidence and epidemiological trends of keratinocyte cancers in the United Kingdom 2013-2018.

IntroductionThe most common cancers in the UK are keratinocyte cancers (KCs): the combined term for basal cell carcinomas (BCCs) and cutaneous squamous cell carcinomas (cSCCs). Registration of KC is challenging due to high numbers and multiplicity of tumours per person.MethodsWe provide an updated report on the descriptive epidemiology of trends in KC incidence for the resident populations of UK countries (England, Northern Ireland, Scotland and Wales) using population‐based cancer registry and pathology report data, 2013–18.ResultsSubstantial increases in cSCC incidence in England, Scotland and Northern Ireland can be detected for the period of 2013–18, and the incidence of cSCC also increased in Wales from 2016 to 2018. In contrast, however, the pattern of annual change in the incidence of BCC across the nations differs. In England, the incidence of BCC declined slightly from 2016 to 2018, however, the overall trend across 2013–18 is not statistically significant. In Scotland, the incidence of BCC shows some variability, declining in 2017 before increasing in 2018, and the overall trend across 2013–18 was also not statistically significant. In Northern Ireland, the incidence of BCC increased significantly over the study period, and in Wales, the incidence of BCC increased from 2016 to 2018. One in five people will develop non‐melanoma skin cancers (NMSC) in their lifetime in England. This estimate is much higher than the lifetime risk of melanoma (1 in 36 males and 1 in 47 females born after 1960 in the UK), which further highlights the burden of the disease and importance of early prevention strategies.ConclusionsWe highlight how common these tumours are by publishing the first ever lifetime incidence of NMSC. Additionally, the first time reporting of the age standardised incidence of KC in Wales further confirms the scale of the disease burden posed by these cancers in the UK. With approximately one in five people developing NMSC in their lifetime, optimisation of skin cancer prevention, management and research are essential.

Subsequent Cancers in Patients Affected with Moderate or Severe Chronic Graft-versus-Host Disease

Subsequent cancer (SC) is a significant cause of morbidity and mortality in long-term survivors after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Chronic graft-versus-host disease (cGVHD) and treatment-related immunosuppression have been recognized as risk factors for SC. This study sought to investigate the incidence and risk factors for SC in patients with established cGVHD, assessed separately for onset of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)-categorized into nonmelanoma skin cancer (NMSC)-and all cancers other than NMSC. Two hundred and four patients were enrolled in the prospective cross-sectional cGVHD Natural History Study and underwent comprehensive clinical evaluation. Patients were followed-up with an annual survey. The cumulative incidences of NMSC and cancers other than NMSC with competing risks were estimated separately, and transplantation- and cGVHD-related factors were assessed for association with outcomes using Gray's test and multivariable Cox models. The time period for all analyses began at 2 years postevaluation to restrict analyses to patients presumed to not have had SC present at evaluation. Nineteen patients were diagnosed with NMSC and 19 were diagnosed with cancers other than NMSC, with 10-year cumulative incidences of 15.5% (95% confidence interval, 9.0% to 27.6%) and 13.8% (95% CI, 8.2% to 20.8%), respectively. Age at transplantation (hazard ratio [HR], 1.94; 95% CI, 1.23 to 3.06) and higher C-reactive protein level at evaluation (HR, 9.49; 95% CI, 1.26 to 71.58) were jointly associated with NMSC, and gastrointestinal cGVHD at evaluation (HR, 0.26; 95% CI, 0.09 to 0.78) was associated with reduced risk of NMSC. T cell depletion at transplantation (HR, 3.09; 95% CI, 1.17 to 8.20), lymphoma as an indication for transplantation (HR, 3.96; 95% CI, 1.56 to 10.05), and oral cGVHD severity at evaluation (HR, 4.36; 95% CI, 1.52 to 12.46) were jointly associated with cancers other than NMSC. This study estimates the incidence of SC in a population of allo-HSCT recipients with severe cGVHD and identifies correlations with the subsequent development of SC. These factors seem to differ between NMSC and cancers other than NMSC. Further longitudinal investigations accounting for dynamic and cumulative processes are needed to improve our understanding and management of SC.

Non-melanoma Skin Cancers in Patients on Hydroxyurea for Philadelphia Chromosome-Negative Myeloproliferative Neoplasms: A Systematic Review.

Hydroxyurea (HU) or hydroxycarbamide is a cytotoxic antimetabolite widely used to treat Philadelphia chromosome-negative Myeloproliferative Neoplasms (Ph-MPN) like Polycythemia Vera (PV), Essential Thrombocythemia (ET), and Primary Myelofibrosis (PMF). Patients with Ph-MPN are at an increased risk of Non-melanoma skin cancers (NMSC). The cause of this finding remains uncertain. In this systematic review, we would like to know if chronic use of HU in this population is responsible for the sudden onset of NMSC. The results obtained will help the patients and clinicians with early diagnosis of cutaneous lesions and in optimizing the current treatment options for MPN. We conducted a multi-database literature search, applied eligibility criteria and quality assessment tools to the studies extracted, with an intention to include only fair to high-quality articles. We analyzed six observational studies and four traditional reviews. Two out of 10 studies concluded that no relationship exists between the incidence of NMSC and HU. The remaining eight studies indicated the association. According to these studies, the possible risk factors include old age, excessive exposure to sunlight, higher doses, and prolonged HU therapy duration. Ultraviolet (UV) radiation and HU play a combined role in carcinogenesis. Periodic dermatologic screening is essential in these patients. Prompt biopsy and accurate diagnosis can prevent the progression of cancer and decrease the associated morbidity and mortality. True incidence and causation cannot be ascertained due to the scarcity of research on this topic. Multi-center prospective studies in large groups of Ph-MPN patients are recommended to determine the temporal relationship between NMSC and HU treatment.

Non-Melanoma Skin Cancer in People Living With HIV: From Epidemiology to Clinical Management.

Skin cancers represent the most common human tumors with a worldwide increasing incidence. They can be divided into melanoma and non-melanoma skin cancers (NMSCs). NMSCs include mainly squamous cell (SCC) and basal cell carcinoma (BCC) with the latest representing the 80% of the diagnosed NMSCs. The pathogenesis of NMSCs is clearly multifactorial. A growing body of literature underlies a crucial correlation between skin cancer, chronic inflammation and immunodeficiency. Intensity and duration of immunodeficiency plays an important role. In immunocompromised patients the incidence of more malignant forms or the development of multiple tumors seems to be higher than among immunocompetent patients. With regards to people living with HIV (PLWH), since the advent of combined antiretroviral therapy (cART), the incidence of non-AIDS-defining cancers (NADCs), such as NMSCs, have been increasing and now these neoplasms represent a leading cause of illness in this particular population. PLWH with NMSCs tend to be younger, to have a higher risk of local recurrence and to have an overall poorer outcome. NMSCs show an indolent clinical course if diagnosed and treated in an early stage. BCC rarely metastasizes, while SCC presents a 4% annual incidence of metastasis. Nevertheless, metastatic forms lead to poor patient outcome. NMSCs are often treated with full thickness treatments (surgical excision, Mohs micro-graphic surgery and radiotherapy) or superficial ablative techniques (such as cryotherapy, electrodesiccation and curettage). Advances in genetic landscape understanding of NMSCs have favored the establishment of novel therapeutic strategies. Concerning the therapeutic evaluation of PLWH, it’s mandatory to evaluate the risk of interactions between cART and other treatments, particularly antiblastic chemotherapy, targeted therapy and immunotherapy. Development of further treatment options for NMSCs in PLWH seems needed. We reviewed the literature after searching for clinical trials, case series, clinical cases and available databases in Embase and Pubmed. We review the incidence of NMSCs among PLWH, focusing our attention on any differences in clinicopathological features of BCC and SCC between PLWH and HIV negative persons, as well as on any differences in efficacy and safety of treatments and response to immunomodulators and finally on any differences in rates of metastatic disease and outcomes.

Reducingnon‐melanomaskin cancer risk in renal transplant recipients

With an increasing number of renal transplant recipients (RTRs) and improving patient survival, a higher incidence of non-melanoma skin cancer (NMSC) has been observed. NMSC in RTRs are often more numerous and biologically more aggressive than the general population, thus contributing towards an increase in morbidity and to a lesser degree, mortality. The resultant cumulative health and financial burden is a recognized concern. Proposed strategies in mitigating risks of developing NMSC and early therapeutic options thereof include tailored modification of immunosuppressants in conjunction with sun protection in all transplant patients. This review highlights the clinical and financial burden of transplant-associated skin cancers, carcinogenic mechanisms in association with immunosuppression, importance of skin cancer awareness campaign and integrated transplant skin clinic, and the potential role of chemoprotective agents. A scheme is proposed for primary and secondary prevention of NMSC based on the available evidence.

Incidence of melanoma and nonmelanoma skin cancers in Indian and the global regions.

Incidence of common types of skin cancers in India is not reported and its comparison with global load would be helpful statistics. The aim of this study is to summarize and report recent skin cancer incidence in India and to compare it with the incidence globally. Age-specific rates and age-adjusted rates (AARs) of the incidence of skin cancer for all ages (0-75 years) were collected from India and the world, respectively, from the National Cancer Registry Programme and GLOBOCAN 2018. The AAR per 100,000 of melanoma of the skin was highest in the North region of India for both males and females with 1.62 and with 1.21, respectively. The incidence of nonmelanoma of the skin or other skin cancers for males was highest in the East region with 6.2 and for females in Northeast with 3.49. Among nonmelanoma, northeast region showed the maximum incidence for both male (75.6) and female (43.6) sexes. Globally, AAR of melanoma of skin for males was highest in the Western Pacific region with 36.9 and for the females; AAR was highest in the European region with 31.7. The incidence of nonmelanoma of the skin or other skin cancers for males was highest in the Western pacific region with 225.4 and 68.6 for females. Summary of the incidence rates of melanoma and nonmelanoma skin cancers which shows that though there are regional variations of incidence in India is lower than that of in the West.

Factors Associated with Non-Melanoma Skin Cancer (NMSC) Among Chronic Lymphocytic Leukemia (CLL) Patients

Background: The incidence of NMSC in patients with CLL is significantly higher compared to age- and sex- matched controls. Herein, we evaluate factors associated with risk of NMSC post-CLL diagnosis, including CLL clinical and prognostic characteristics, history of UV radiation exposure, severe sunburn, and combined genetic score of single nucleotide polymorphisms (SNPs) associated with NMSC.Methods: CLL patients newly diagnosed from 2002-2015 were enrolled and systematically followed by the Mayo Clinic/University of Iowa Lymphoma SPORE. Clinical and prognostic CLL data were obtained from the Mayo Clinic CLL database. NMSCs were abstracted both from medical records and from patient self-report. Self-reported history of the extent of mid-day sun exposure (h/week) at various ages (<13, 13-21, 22-40, >40 yrs) and severe sunburn were obtained from a risk factor questionnaire. The CLL International Prognostic Index (CLL-IPI) was computed as established using a weighted average of five independent CLL prognostic factors (IGHV mutational status, serum b2-microglobulin, Rai stage, age at CLL diagnosis and FISH 17p deletion/ TP53 status). CLL treatment was classified as positive if a person received T-cell immunosuppressive treatments that are purine analogue and/or alemtuzumab based treatments. All other therapies were combined into an “other category”. We computed a polygenetic risk score (PRS), a weighted average of the number of risk alleles across 13 SNPs that are known to be associated with NMSC, with the weights being the log of the odds ratio reported for each SNP. To evaluate associations with risk of NMSC post-CLL diagnosis we used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). CLL treatment was considered a time-dependent covariate in the analysis.Results: Among 1269 CLL patients, the median age at diagnosis was 63 years (range 24-91), 68% were male, and 6% had Rai stage III-IV at diagnosis. Based on the CLL-IPI, 44% were low risk, 34% intermediate risk, and 22% high/very-high risk. 9% of the CLL cases had prior history of NMSC and 44% reported history of severe sun burn. At a median follow-up of 7 years from CLL diagnosis, 196 patients had ≥1 NMSCs post-CLL diagnosis. Among these patients, 45 also had NMSC before CLL diagnosis. The most frequent NMSC was squamous cell carcinoma (63%), followed by basal cell (55%), and Merkel cell (1%). 264 patients received T-cell immunosuppressive treatments prior to NMSC diagnosis or prior to last follow up. Significant associations of clinical and prognostic characteristics with risk of NMSC post-CLL diagnosis were observed for age (HR=1.42 per 10 year increase, CI=1.24-1.62), male sex (HR=1.43, CI=1.04-1.97), prior history of NMSC (HR=3.85, CI=2.75-5.39), and CLL-IPI (HR=1.36, CI=1.13-1.64, adjusted for sex and prior NMSC). Mid-day sun exposures for each of the age groups considered showed no evidence of association with risk of NMSC post-CLL diagnosis; however, history of severe sunburn was significantly associated (HR=1.58, CI=1.06-2.36, adjusted for sex, CLL-IPI and prior NMSC). We observed an association between T-cell immunosuppressive treatments with risk of NMSC post-CLL diagnosis (HR=1.65, CI=1.14-2.40, adjusted for age, sex and prior NMSC). PRS was also associated with the risk of NMSC post-CLL diagnosis (HR=1.82, CI=1.21-2.72, adjusted for sex, CLL-IPI and prior NMSC).Conclusion: Screening for NMSC is important in CLL patients, and our data suggest that it is particularly important among patients with aggressive CLL according to CLL-IPI score, those receiving T-cell immunosuppressive treatments that are purine analogue and/or alemtuzumab based treatments, those who have a prior history of NMSC, or history of severe sunburn. PRS was also a significant factor in the risk of NMSC among CLL patients. Future studies should develop prediction models that include these factors. [Display omitted] DisclosuresKay:Tolero Corporation: Research Funding; Gilead: Research Funding; Agios: Membership on an entity's Board of Directors or advisory committees; Pharmacyclics: Research Funding. Shanafelt:Genentech, Celgene, Pharamacyclics, Jansen, GlaxoSmithKline, AbbVie, Hospira, and Cephalon: Research Funding. Cerhan:Janssen: Other: Multiple Myeloma Registry Steering ; Janssen: Other: Scientific Advisory Board (REMICADELYM4001).

Increased Risk of Skin Cancer in 1,851 Long-Term Retinoblastoma Survivors

Patients with hereditary retinoblastoma are at risk for developing cutaneous melanoma, but little is known about the role of sun exposure or other factors, and the incidence of nonmelanoma skin cancer (NMSC) is poorly understood. We investigated the incidence of melanoma and NMSC in a cohort of 1,851 White, long-term retinoblastoma survivors (1,020 hereditary and 831 nonhereditary) diagnosed during 1914‒2006. During follow-up through 2016, 33 hereditary and 7 nonhereditary survivors developed melanoma, and 26 hereditary and 9 nonhereditary survivors developed NMSC. Most NMSCs were on the head/neck, whereas melanomas were more broadly distributed with patterns similar to melanoma-prone families. For both outcomes, the median age at diagnosis was ~20 years younger among hereditary survivors than among nonhereditary survivors. At 50 years after retinoblastoma diagnosis, the cumulative incidence in hereditary survivors was 4.5% for melanoma and 3.7% for NMSC; for nonhereditary survivors, it was 0.7% and 1.5%, respectively. Sun sensitivity and phenotypic characteristics generally did not vary by skin cancer status. Hereditary retinoblastoma survivors have an increased risk for melanoma and NMSC that occurred earlier than that observed among nonhereditary survivors, likely reflecting genetic factors. These findings among White retinoblastoma survivors support consensus-based recommendations for skin cancer screening and sun protection starting at young ages and continuing long term.