Prevalence Of Nonmelanoma Skin Cancer Research Articles

What does the general population know about nonmelanoma skin cancer? Representative cross-sectional data from Germany

Abstract Aim Nonmelanoma skin cancer (NMSC) is the most common form of cancer in white-skinned populations. However, there is a lack of comprehensive research on the general population’s knowledge about NMSC. Subjects and methods As part of wave 8 of the German National Cancer Aid Monitoring (NCAM), 4000 participants aged 16–65 years (49.3% female) were interviewed by telephone about NMSC. Questions included awareness of (colloquial) terms for NMSC, its signs, consequences, risk factors, prevalence, and severity. Results Colloquial terms for skin cancer were heard of more often than medical terms (60.9–82.1% vs. 22.6–51.5%). In our sample, there was little familiarity with signs (15.8–36.4%), possible consequences (14.7–56.3%), prevalence (27.4%), and severity (29.0%) of NMSC. Most participants knew about UV-related risk factors for NMSC (73.0–78.7%). Women, those with higher education levels, full-time employment, lighter skin type, presence of more than 40 nevi, frequent childhood sunburns, or frequent intentional tanners achieved a higher knowledge score. Concern about NMSC was associated with more NMSC knowledge. Conclusion We found knowledge gaps regarding signs, consequences, and prevalence of NMSC. To ensure early recognition and treatment, the general population should be further educated, specifically targeting male, less educated, and unemployed individuals.

Clinical Application of Artificial Intelligence for Non-melanoma Skin Cancer.

The development and implementation of artificial intelligence is beginning to impact the care of dermatology patients. Although the clinical application of AI in dermatology to date has largely focused on melanoma, the prevalence of non-melanoma skin cancers, including basal cell and squamous cell cancers, is a critical application for this technology. The need for a timely diagnosis and treatment of skin cancers makes finding more time efficient diagnostic methods a top priority, and AI may help improve dermatologists' performance and facilitate care in the absence of dermatology expertise. Beyond diagnosis, for more severe cases, AI may help in predicting therapeutic response and replacing or reinforcing input from multidisciplinary teams. AI may also help in designing novel therapeutics. Despite this potential, enthusiasm in AI must be tempered by realistic expectations regarding performance. AI can only perform as well as the information that is used to train it, and development and implementation of new guidelines to improve transparency around training and performance of algorithms is key for promoting confidence in new systems. Special emphasis should be placed on the role of dermatologists in curating high-quality datasets that reflect a range of skin tones, diagnoses, and clinical scenarios. For ultimate success, dermatologists must not be wary of AI as a potential replacement for their expertise, but as a new tool to complement their diagnostic acumen and extend patient care.

Advanced non-melanoma skin cancer in elderly patients: When surgery says NO, interventional radiotherapy (brachytherapy) says YES.

The prevalence of non-melanoma skin cancer (NMSC) increases, especially in older adults with comorbidities, narrowing radical treatment options. About 5% of skin cancer patients are diagnosed with an advanced stage, which impairs daily functioning. The study was to present a retrospective summary of elderly patients unfit for surgery and treated with various brachytherapy (BT) techniques tailored individually for locally advanced NMSCs in a reference BT department. Clinical case presentations supported the findings. Inoperable patients older than 75 years presenting with advanced pathologically confirmed NMSCs were retrospectively identified. All cases were individually assessed, and the best suiting radical treatment option was chosen, including contact, interstitial, or hybrid high-dose-rate (HDR) or pulsed-dose-rate (PDR) BT. Doses ranging from 45 to 60 Gy were administered to clinical target volume (CTV) in different time schedules. All patients were closely followed-up until complete remission. Ten elderly patients (mean age, 84 years) with differently located locally advanced NMSCs (all staged T3) were treated between 2007 and 2022. Six basal and four squamous cell carcinoma cases showed most painful symptoms as well as bleeding and exudation. Six patients underwent HDR-BT and four PDR-BT. Six patients had superficial, and four interstitial or hybrid applications. All patients completed the intended protocols. Median follow-up was 8.5 months (range, 3-35 months). Six out of ten patients died from other reasons before analysis. All case data were presented in the text and respective figures. Advanced NMSCs in elderly patients are challenging in terms of cure. Inoperable cases may be referred for feasible and locally effective interventional radiotherapy (BT). Individually tailored BT leads to an excellent disease control, function sparing, symptoms release, and quality of life improvement. Large treated volumes are related to prolonged healing. BT should be discussed in a multidisciplinary tumor board regarding older patients with symptomatic functions affecting advanced NMSCs.

S105 Association of Inflammatory Bowel Disease With Melanoma and Non-melanoma Skin Cancers- A Nationwide Study

Background: Studies have shown that patients with inflammatory bowel disease (IBD) are at risk for several malignancies. However, the national burden of melanoma (MSC) and non-melanoma skin cancer (NMSC) amongst the IBD population is not widely available. In this study, our aim is to determine the prevalence and association of melanoma and non-melanoma skin cancer (NMSC) in patients with IBD in the United States population. Methods: A retrospective cross-sectional study on Nationwide Inpatient Sample (NIS 2016-2018) was performed in adult US hospitalizations. We identified IBD (Crohn’s Disease-CD and Ulcerative Colitis-UC) using ICD-10 codes. Prevalence MSC and NMSC (squamous cell carcinoma, basal cell carcinoma, and Merkel cell carcinoma) were identified. We performed univariate (unpaired t-test and chi-square) and mixed-effect multivariate regression analyses to identify the prevalence and association of IBD with skin cancers. Results: Out of 87,761,798 USA hospitalizations, 583,765 (0.67%) had CD and 346,515 (0.39%) had UC. Overall prevalence of MSC was 62435 (0.07%), NMSC [squamous cell carcinoma, basal cell carcinoma, and Merkel cell carcinoma] was 4760 (0.01%), 9500 (0.01%) and 4765 (0.01%), respectively. Prevalence of MSC was higher amongst UC (0.13% vs CD: 0.07% vs non-IBD: 0.07%) in comparison without IBD. The prevalence of NMSC was similar (0.01%) in IBD and non-IBD groups. (P < 0.0001) In multivariable regression analysis, we found UC was associated with 51% higher odds (aOR: 1.51, 95%CI 1.22-1.85, P = 0.0001) of having MSC in comparison without IBD. There was no significant association between MSC & CD (0.87, 0.69-1.09, P = 0.2215) and NMSC & IBD (UC: 1.04, 0.58-1.89, P = 0.8867; CD: 1.25, 0.67-2.34, P = 0.4763). Conclusion(s): Our study found an association between melanoma skin cancer with ulcerative colitis. More prospective studies are needed to evaluate this relationship and determine predictors associated with melanoma and non-melanoma skin cancer. Early identification of risk factors will help mitigate the burden of IBD-related skin cancers. The limitation of our study was missing clinical data on the severity of IBD, the establishment of causality between IBD and skin cancer, and the relationship with medication use.

Superficial radiation therapy for nonmelanoma skin cancer: A review

AbstractBackgroundThe high prevalence of nonmelanoma skin cancer (NMSC) has become a global health‐care burden. Various modalities have been established to treat NMSC, with surgery being the mainstay approach. Superficial radiation therapy (SRT) has been in use for over a century to treat various conditions. Recent discussion among the dermatological community has promoted the use of SRT for the treatment of NMSC.Materials and MethodsA literature search was conducted using electronic databases (Medline, Pubmed, Embase, CINAHL, EBSCO) and textbooks, in addition to the authors' clinical experience with SRT.ResultsMultiple retrospective medical record reviews have deemed SRT to be highly effective and associated with minimal side effects. Moreover, SRT yields superior cosmetic results. Over the past decade, SRT has become a mainstay of dermatologist treatment of NMSC due to the new technological advances of the devices. These advances include improved controllability, precision in delivery, additional safety precautions, and have sparked a resurgence in research and clinical evidence on SRT. Most recent data have revealed that the NMSC cure rate is about 93%–100% with excellent 5‐year follow‐up data. Image‐guided SRT using ultrasound guidance may additionally improve cure rates in the future.ConclusionSRT has shown to be an effective option for NMSC. It can also be effectively used in the management of keloids. The limitations across most studies encompass localized patient selection and a predominance of retrospective reviews in the literature. Additional research is warranted to further support SRT's efficacy in clinical practice.

The prevalence of nonmelanoma skin cancer in a population of patients with oculocutaneous albinism in Haiti.

Multiple studies have examined the prevalence of nonmelanoma skin cancers (NMSC) in patients with oculocutaneous albinism (OCA). However, to date, no studies have examined this data in Caribbean populations. This study is a cross-sectional study of 106 patients with OCA who were seen at the Oculocutaneous Albinism Clinic in Port-au-Prince and Gros Morne, Haiti, between the dates of February 2017 and June 2018. In our population, 31/106 (29%) patients were found to have NMSC, 10/31 (32%) had BCC, 12/31 (39%) had SCC, and 9/31 (29%) had both types of NMSC. The most common age groups were 31-40 years, with the overall range of ages being 18-63 years. Also, 60/106 (57%) of the patients had actinic keratoses (AK). Our study provides new data examining the prevalence of NMSC within a population of patients with OCA in Haiti. Overall, it shows that patients with albinism develop NMSC at an earlier age compared with the rest of the population. Therefore, appropriate skin cancer screening and surveillance should be implemented within this high-risk population group.

Risk factors for non-melanoma skin cancer development in renal transplant recipients: a 40-year retrospective study in Croatia

AimTo determine the prevalence of non-melanoma skin cancer (NMSC) and disease-specific risk factors in renal transplant recipients (RTRs).MethodsThis retrospective cohort study enrolled 1232 RTRs (736 men) treated in University Hospital Center Zagreb over 40 years. The effect of sex, age at transplantation, geographic residence, dialysis vintage, and the type of immunosuppressive therapy on NMSC occurrence was investigated.ResultsThe prevalence of NMSC was 6.81%. Overall, 60.7% of patients developed basal cell carcinoma (BCC) and 30.9% of patients developed cutaneous squamous cell carcinoma (cSCC). Only 8.3% developed both tumors. The BCC:cSCC ratio was 1.76:1. The risk for NMSC was 50% higher in men. Patients older than 50 years at transplantation were at greater risk for NMSC development. Residence in an area with higher ultraviolet exposure and dialysis vintage before transplantation did not influence NMSC development. Cyclosporine and azathioprine treatment conferred a greater risk for NMSC than tacrolimus or mycophenolate mofetil treatment.ConclusionRTRs are at high risk for NMSC development. Sex, age at transplantation, and type of immunosuppressive therapy play a role in tumor development.

Skin Cancer Excision Analysis in a Single Rural Center in Scotland's Highlands.

Background & AimSkin cancer is the most common cancer around the world. Regional differences have been reported affecting the demographics and the prevalence of non-melanoma skin cancers; furthermore, non-melanoma skin cancers are believed to be underreported. In this study, we aim to identify and highlight any possible significant characteristics of skin cancer in our rural center in Scotland's Highlands.MethodsThis is a retrospective study analyzing and reporting cancerous skin lesions excision rates among all skin lesions excised and their characteristics in our rural center for one year. Clinical and histopathological data for patients attending our services for suspicious skin lesions excision were collected. Data included the patient’s age, gender, lesion’s diagnosis, site, size, color, borders, resection edges, recurrence, and complications. A database was created creating two cohorts: cancer and non-cancerous lesions groups, both cohorts' data was compared using student T-tests and Z-tests. P-values were considered statistically significant if < 0.5, Overall data was analyzed revealing trends and end results.ResultsFrom December 2019 to December 2020, 96 patients underwent skin lesions excision, 30% were cancerous. Basal cell carcinoma was the most common malignant growth standing for 76.7% of all malignant lesions excised. Squamous cell carcinoma and melanoma were found in 20% and 3.3% of patients with malignant lesions, respectively. Out of the total, 76% of cancerous lesions were in males. The most common site was head and neck (58.8%). High-risk lesions were the ones on the head and neck (P= 0.00988), in the elderly over 74.5 years (P= 0.000037), and males (P= 0.001).ConclusionBasal cell carcinoma was the most common malignant lesion. Elderly men with lesions on the head and neck had higher risks for cancer. Further clarification may be required with larger multi-center studies involving general practitioners, which might help identify regional variations.

27479 Does caffeine has positive effect on the prevalence of nonmelanoma skin cancer? Case-control study in Korea

Background: Nonmelanoma skin cancer (NMSC) is one of the most common cancer worldwide, and has also accounted for thousands of cases a year in Korea, and the number is increasing. Dietary factors such as coffee have drawn attention as a possible effective factor in NMSC research, but few studies have been conducted on Asians.

Comorbidity in multiple sclerosis patients from Nordland County, Norway – validated data from the Norwegian Patient Registry

Background: Knowledge of comorbid disorders is important to optimize therapy for multiple sclerosis (MS), but data are limited. The aim of this study was to assess comorbidity in persons with MS living in Nordland County on January 1, 2017. Methods: Data were retrieved from the Norwegian Patient Registry (2008-2017) and validated through review of electronic hospital charts (1970-2017). Comorbidity was defined as any distinct disorder, classified in the International Classification of Diseases (ICD-10), that had existed or occurred after the diagnosis of MS was established. Results: Data from 637 subjects were reviewed, and 97.5% were registered with at least one comorbid condition. Malignant melanoma was found in 0.5%, and non-melanoma skin cancers in 1.9%. In female subjects, breast cancer was found in 3.3%. Hypothyroidism was confirmed in 3.1%, type-1 diabetes in 0.3%, type-2 diabetes in 3.9%, psychosis in 0.6%, epilepsy in 2.8%, myocardial infarction in 1.7%, subarachnoid hemorrhage in 0.2%, cerebral infarction in 0.6%, pulmonary embolism in 0.9%, inflammatory bowel disease in 1.3%, and rheumatoid arthritis in 0.6%. Conclusion: Compared to reports from other Norwegian epidemiological studies, a higher proportion of inflammatory bowel disease and epilepsy was found. This is in accordance with findings from other studies. The prevalence of non-melanoma skin cancers was significantly higher than in the general Norwegian population as they were reported by The Cancer Registry of Norway.

Association of blood mercury levels with non-melanoma skin cancer in the United States using NHANES data from 2003-2016

PDS 63: Chemicals and metals: health effects, Exhibition Hall (PDS), Ground floor, August 27, 2019, 10:30 AM - 12:00 PM Background/Aim: Some studies have reported that mercury is associated with an increased risk of lung and esophageal cancers. However, few epidemiological studies investigated mercury exposure in relation to skin cancer risk. Mercury inactivates glutathione peroxidase (GPX) and lower GPX activity is associated with increased risk of skin cancer. Therefore, we investigated the association between blood mercury levels and skin cancer. Methods: We used National Health and Nutrition Examination Survey (NHANES) data from 2003 through 2016. Our exposures of interest were blood total (tHg), inorganic (iHg), and methyl mercury (MeHg). The main outcome was a reported diagnosis of non-melanoma skin cancer. We included participants aged ≥18 having information on exposures, outcome, and covariates (age, sex, race, BMI, smoking history, and income). We conducted logistic regression analysis adjusting for above covariates and survey year. Results: Among 30,103 participants, the median age was 48, 52% were female, 46% Non-Hispanic White, and 21% Non-Hispanic Black. A total of 477 subjects reported diagnosis of non-melanoma skin cancer; 95% of whom were Non-Hispanic White. Median levels of tHg and MeHg were 0.9 µg/L and 0.6 µg/L, respectively. A 1 µg/L increase in blood tHg was associated with 6% increased odds of non-melanoma skin cancer (OR: 1.06; 95% CI: 1.02, 1.09). Compared to subjects with tHg ≤ 0.46 µg/L, subjects with tHg >1.72 µg/L had approximately double the odds of non-melanoma skin cancer (OR: 1.93, 95% CI: 1.31, 2.84). Similarly, subjects with MeHg > 1.43 µg/L had 1.8 times greater odds of non-melanoma skin cancer (OR: 1.82, 95% CI: 1.18, 2.79) compared to subjects with MeHg ≤ 0.21 µg/L. Conclusions: We found that higher blood tHg and MeHg levels were associated with higher prevalence of non-melanoma skin cancer. Our findings add to the limited evidence from epidemiologic studies supporting the role of mercury exposures in skin cancer.

Evaluation of Post Wide Excision Non-Melanoma Skin Cancer at DR Cipto Mangunkusumo Hospital in 2012-2015: Recurrence and Prognostic Factors

Background Skin cancer is one of many kinds of cancer which incidence increases globally. Basal cell carcinoma (BSC) and squamous cell carcinoma (SCC) are the most common prevalence of non-melanoma skin cancer, and also are the most common cancer among skin cancer. The main therapy for such skin cancer is wide excision within its safety margin added by adjuvant therapy. Despite of adequate therapy, people with skin cancer still have risk of recurrence. This study assesses the prognostic factors of recurrence among people with non-melanoma skin cancer who underwent wide excision surgery. Method This study was a retrospective cohort with survival analysis. The patients data who underwent wide excision surgery were from Perhimpunan Ahli Bedah Onkologi Indonesia (PERABOI) registry and medical record from Oncology Surgery Division in RSCM from January 2012-December 2015. Data selection was done based on inclusion and exclusion criterias. Result There were 187 patients with non-melanoma skin cancer who underwent wide excision surgery; the recurrence was detected on 15% of the case. Most of the patients were ≥45 years old with the most common histopathological feature of the skin cancer was basal cell carcinoma. We did survival analysis with cox regression and the result was previous history of skin cancer (RR 6,903; 95% CI 2,925-16,292), perineural invasion (HR 3,818; 95%CI 1,561-9,340), location of the lesion (HR 0,071; 95% CI 0,022-0,228), andsize of the tumour (HR 1,842; 95%CI 1,244-2,729) was the factors that increased recurrence. Conclusion Previous history of skin cancer, perineural invasion, location of the lesion, and size of the tumour were the prognostic factors for recurrence among patients with non-melanoma skin cancer who underwent wide excision surgery.

Immunotherapy in non-melanoma skin cancer: updates and new perspectives.

The term ‘non-melanoma skin cancer (NMSC)’ includes a wide range of cutaneous tumors, including cutaneous squamous cell carcinoma (CSCC) and basal cell carcinoma (BCC), which represent the largest portion of cutaneous lymphomas. CSCC and BCC are numerically the most common human cancers in Caucasians. Their incidence and prevalence have increased constantly since 1960, from 3 to 8% worldwide, despite increased awareness of the harmful effects of sunlight.1 Distinct from other cancers, the incidence and prevalence of NMSC are not documented in a standardized manner; however, in almost all countries, the evaluation is based on small subsegments or estimates. In the United States, the annual number of cases of NMSC is, approximately, more than one million.2 In Europe, there are some regional differences, due to registration modalities, genetic background, and/or variability in public awareness and prevention measures, with a trend for an increased incidence in Northern European countries.3 In Italy, the updated AIRTUM data showed that BCC represents 15% of all neoplasms, with an annual incidence of 31.9/100,000 in males and 22.8/100,000 in females. BCC represents 80% of all NMSCs, while the remaining cases are usually CSCC. CSCC is cured by surgical measures in most cases but, in 3–5% of patients, they can progress into locoregionally advanced or, even, metastatic stages. The low percentages for advanced disease translate into an incidence for males of 4.2 out of 100,000 and for females of 2.4 out of 100,000 – numbers that indicate a ‘rare tumor-like’ occurrence.1 Currently, there is no standard therapy for patients who develop locally advanced or metastatic CSCC.4,5 As per the European Association of Dermatol-Oncology guidelines, curing tumor and preserving function with addition of cosmetics are the main goals of the primary treatment.3 Surgical resection or biopsy followed by histology should always confirm the diagnosis of precancerous lesions, before using any therapeutic modality different from surgery. Radiotherapy is a fair alternative to surgery for small CSCCs in low-risk areas, for inoperable CSCC or in the adjuvant setting.3 It may be the first option when complete resection is technically difficult or refused by the patient. Of note, radiotherapy is not curative in the advanced phase of disease.6 Platinum-based chemotherapy may be used as second-line treatment of CSCC – the response to treatment usually lasts 4–6 months and the toxicity profile precludes its use in many patients because of their pre-existing comorbidities.5 Epidermal growth factor receptor (EGFR) inhibitors can be used as subsequent line treatment when chemotherapy is unfeasible or there is a progressive disease. Cetuximab is the first chimeric monoclonal antibody anti-EGFR that showed encouraging results in the treatment of CSCC in anecdotal clinical cases5,7 and achieved a median time to treatment failure of around 4 months.7 The limitations of current treatments and their failure to achieve therapeutic targets highlight an unmet medical need for advanced CSCC treatment. In this report, we provide background on NMSC and describe the updates and new perspectives that were discussed during the symposium ‘CSCC It Bridge’ held in Naples, Italy, 28–29 November 2018.

The Importance of Dedicated Dermatology Clinics in the Care of Organ Transplant Recipients.

Organ transplant recipients have a high risk of skin cancer associated with immunosuppressive therapy and ultraviolet radiation. The incidence of non-melanoma skin cancer, in particular is up to 65-times higher than for the normal population. Field cancerization of sun- exposed skin is also a major health issue in these patients1.In Portugal there were 895 solid organ transplants in 2017, with the majority being kidney (529) and liver (259)2. There are already several publications concerning skin cancer in Portuguese organ transplant recipients, reporting a prevalence of non-melanoma skin cancer ranging from 15% to 25% in renal transplant recipients3,4,5and 8% in one series6that included more liver transplant recipients with relatively less immunosuppression.The sunny geographical location and sun exposure habits, namely the poor knowledge and adherence to photoprotective measures, such as hats, long-sleeved clothes or sunscreen while on outdoor work or leisure activities, pose serious difficulties for skin cancer prevention in this population. In one study concerning knowledge of sun protective measures in a population of Portuguese transplant recipients7, 29% did not know that their risk of skin cancer was increased, and 25% of those who went to the beach stayed there between 11.30 and 16:00 pm. Not surprisingly, only 8% consulted a dermatologist in the first year after transplant7.Different organizations like the Skin Care in Organ Transplant Recipients - Europe (SCOPE) or the International Transplant Skin Cancer Collaborative (ITSCC) together with institutions such as the British National Institute for Health and Clinical Excellence (NICE)8,9,10, recommend initial assessment of these patients by a dermatologist and providing them with education on photoprotection and self-examination of the skin. These patients also need regular follow-up with time intervals defined by their previous history of skin cancer and the presence of field cancerization of their sun-exposed skin. In such patients with previous skin cancer and detectable field cancerization, some authors11propose three months as time interval between appointments. Dedicated or specialist dermatology clinics for organ transplantation are recommended11,12,and have also been shown to improve compliance with photoprotection13. Their introduction in the main Portuguese referral hospitals for transplantation would allow earlier dermatological care, inclusion of dermatology among the specialties that collaborate in the transplant teams and reduction of the burden of skin cancer in these patients, saving lives and costs.

Photocarcinogenic Risk Associated With Narrowband UV-B Phototherapy: An Epidemiologic Study in a Tertiary Care Hospital

BackgroundThe risk of skin cancer in patients treated with narrowband (NB) UV-B phototherapy is not well understood. Although experimental studies have shown that there is a risk, clinical studies have not detected an increased incidence of cancer following treatment. The aim of this study was to determine the incidence of nonmelanoma skin cancer (NMSC) in patients treated with NB UV-B phototherapy at a tertiary care hospital in the Mediterranean area. Material and methodsWe conducted a retrospective chart review of 474 patients who received whole-body NB UV-B phototherapy at our hospital between 2002 and 2016 and identified those diagnosed with NMSC during follow-up. We calculated the corresponding crude and standardized incidence rates and compared these with rates in the general population in a similar geographic area. ResultsOf the 474 patients, 193 (40.7%) were men and 281 (59.3%) were women. The mean (SD) follow-up period was 5.8 (3) years. The prevalence of NMSC at the end of the study period was 1.9% and the standardized incidence was 108.3 cases per 100 000 patient-years. The SIR of 1.9 in the study group was not significantly different from that of the general population. The number of patients who needed to be treated with NB UV-B phototherapy for 1 case of NMSC to occur was 1900. ConclusionNB UV-B phototherapy does not appear to be associated with an increased risk of NMSC

Riesgo de fotocarcinogénesis asociado a la fototerapia UVB-BE. Estudio epidemiológico de un hospital terciario

BackgroundThe risk of skin cancer in patients treated with narrowband (NB) UV-B phototherapy is not well understood. Although experimental studies have shown that there is a risk, clinical studies have not detected an increased incidence of cancer following treatment. The aim of this study was to determine the incidence of nonmelanoma skin cancer (NMSC) in patients treated with NB UV-B phototherapy at a tertiary care hospital in the Mediterranean area. Material and methodsWe conducted a retrospective chart review of 474 patients who received whole-body NB UV-B phototherapy at our hospital between 2002 and 2016 and identified those diagnosed with NMSC during follow-up. We calculated the corresponding crude and standardized incidence rates and compared these with rates in the general population in a similar geographic area. ResultsOf the 474 patients, 193 (40.7%) were men and 281 (59.3%) were women. The mean (SD) follow-up period was 5.8 (3) years. The prevalence of NMSC at the end of the study period was 1.9% and the standardized incidence was 108.3 cases per 100 000 patient-years. The SIR of 1.9 in the study group was not significantly different from that of the general population. The number of patients who needed to be treated with NB UV-B phototherapy for 1 case of NMSC to occur was 1900. ConclusionNB UV-B phototherapy does not appear to be associated with an increased risk of NMSC

Update on Noninvasive Diagnostic Imaging and Management of Nonmelanoma Skin Cancer

The focus of this review is to present some of the new noninvasive diagnostic imaging tools and their use in conjunction with nonsurgical modalities that have been demonstrated to be effective for the treatment and prevention of nonmelanoma skin cancer (NMSC). Given the vast prevalence of NMSC and substantial associated morbidity, clinicians are working toward effective nonsurgical therapeutic options, including topical treatments, laser and photodynamic therapy, radiation as well as newer systemic treatment modalities. With this shift toward increasingly nonsurgical therapies comes the need to find new noninvasive ways to assess treatment efficacy, monitor treatment response, and detect subclinical residual disease. Recent developments in imaging modalities, including dermoscopy, optical coherence tomography, and reflectance confocal microscopy, are emerging as useful tools for diagnosis and treatment management of NMSC.

Increasing incidence of melanoma after solid organ transplantation: a retrospective epidemiological study

The risk of melanoma in organ transplant recipients (OTR) is increased compared with the general population. This retrospective study registered all cases of post-transplant melanoma in kidney, heart, lung, and liver transplant recipients followed in our specialized post-transplant Dermatology Clinic since 1991. The yearly prevalence of melanoma and skin carcinoma between 2000 and 2015 was computed and compared in this population. Based on another cohort of kidney transplant recipients grafted since 2005, adjusted age- and sex-standardized incidence ratio (SIR) was calculated using a renal transplantation registry. In our overall OTR cohort, between 1991 and 2000, five melanomas occurred in 1800 OTRs (0.28%), whereas between 1991 and 2015, 53 melanomas were diagnosed in 49 of 4510 OTR (1.09%), representing a 3.9-fold increase in prevalence after 2000. Remarkably, the prevalence of nonmelanoma skin cancers remained unchanged over this period. Two deaths related to melanoma were recorded with an overall follow-up of 62 months. In our cohort of 1102 renal transplant recipients, the SIR of melanoma was 4.52. Our data suggest that contrasting with nonmelanoma skin cancer, the risk of post-transplant melanoma has considerably increased over the last decade.

Molecular signaling cascades involved in nonmelanoma skin carcinogenesis.

Nonmelanoma skin cancer (NMSC) is the most common cancer worldwide and the incidence continues to rise, in part due to increasing numbers in high-risk groups such as organ transplant recipients and those taking photosensitizing medications. The most significant risk factor for NMSC is ultraviolet radiation (UVR) from sunlight, specifically UVB, which is the leading cause of DNA damage, photoaging, and malignant transformation in the skin. Activation of apoptosis following UVR exposure allows the elimination of irreversibly damaged cells that may harbor oncogenic mutations. However, UVR also activates signaling cascades that promote the survival of these potentially cancerous cells, resulting in tumor initiation. Thus, the UVR-induced stress response in the skin is multifaceted and requires coordinated activation of numerous pathways controlling DNA damage repair, inflammation, and kinase-mediated signal transduction that lead to either cell survival or cell death. This review focuses on the central signaling mechanisms that respond to UVR and the subsequent cellular changes. Given the prevalence of NMSC and the resulting health care burden, many of these pathways provide promising targets for continued study aimed at both chemoprevention and chemotherapy.

Histopathological evaluation of parotid gland neoplasms in Queensland, Australia

Parotid gland tumours are complex neoplasms with a broad histological range. The parotid gland is also a common site of face and scalp skin cancer metastases. Parotidectomies performed by ENT department in the Gold Coast health district from 2006 to 2013. A total of 158 specimens were examined. Of these, 53.80 per cent were benign and 46.20 per cent were malignant. Pleomorphic adenoma was the most common tumour (29.11 per cent), followed by cutaneous squamous cell carcinoma (23.42 per cent) and Warthin's tumour (12.03 per cent). Metastatic squamous cell carcinoma accounted for a large proportion of parotid masses in our case series, reflecting the high prevalence of non-melanoma skin cancer in Australia. Primary parotid neoplasms had similar incidence rates to other studies.