Skin Cancer Incidence Rates Research Articles

Determinants of self-reported sun protection practices among Moroccan population

PurposeTo estimate the prevalence of sunlight exposure and sun protection behaviors and to identify the main determinants of sun protection in a representative sample of the Moroccan population. MethodsCross-sectional survey was carried out during May 2008 among Moroccan adults aged 18 and over, using stratified cluster sampling in origin and sex. ResultsA total of 2896 subjects were included. More than half (52.1%) of the participants were regularly exposed to the sun during midday hours (11–16h) for more than 2h per day. Among those exposed to the sun during midday hours, 16.4% didn't use any means of protection. The subjects who were more protected were women (odds ratio=0.47, 95% confidence interval=[0.35–0.64]), rural residents (odds ratio=2.33, 95% confidence interval=[1.97–2.77]) and worker subjects and students (p<0.0001). ConclusionThis survey has highlighted a high prevalence of sun exposure in the Moroccan population with few protection practices. It is therefore important to promote sun protection in order to maintain the incidence rate of skin cancer at its lower level.

Risk-adjusted melanoma skin cancer incidence rates in Whites (United States)

The objective of this study was to obtain a better population-based measure of risk for melanoma skin cancer. A method has been previously proposed for estimating cancer incidence rates for data collected from the Surveillance, Epidemiology, and End Results (SEER) program. Unlike conventionally reported incidence rates in the USA, this method uses the first primary cancer and adjusts for population-based cancer prevalence to obtain a better measure of cancer risk. The study involves SEER data for white men and women. Conventional melanoma incidence rates overestimate risk for men, increasingly so from 3.3% in the age group of 30-39 years to 11.3% in the age group of 80 years and older. Overestimation in risk for women ranged from 3.3% in the age group of 30-39 years to 8.9% in the age group of 80 years and older. Overestimation of risk was more pronounced when both in-situ and malignant melanomas were considered. Increasing trends in conventional rates were slightly greater than trends in risk-adjusted incidence rates (RAIRs). In 2007, the estimated number of cases with malignant melanoma among the white population based on conventional cancer incidence rates is 37 636 (64 125 including in-situ cases) for men and 28 935 (49 361 including in-situ cases) for women. The estimated number of cases in the USA based on RAIRS is 34 652 [(7.9%); 55 413 (13.6%) including in-situ cases] for male and 27 178 [(6.1%); 44 467 (9.9%) including in-situ cases] for women. We concluded that RAIRs are a better measure of melanoma skin cancer risk and should be used for estimating the number of cancer patients in the USA.

Combined introduction of anti-IL2 receptor antibodies, mycophenolic acid and tacrolimus: effect on malignancies after renal transplantation in a single-centre retrospective cohort study

Several studies suggest that the introduction of tacrolimus (TRL), mycophenolic acid (MPA) and interleukin 2 receptor antibodies (IL2Ra) as single drugs more than a decade ago has not increased the risk of malignancy after renal transplantation. However, only limited data are available on their carcinogenic effects when used in combination as a potent immunosuppressive regimen. A retrospective single-centre cohort study on 929 adult renal transplant recipients. Investigation of the effect of two consecutive immunosuppressive regimens [1993-98, N = 405, anti-lymphocyte antibodies, cyclosporine and azathioprine (AZA); 1999-2007, N = 524, predominantly IL2Ra, TRL and MPA] on the incidence rate of skin cancer, solid tumours and post-transplant lymphoproliferative disease (PTLD). In total, 365 malignancies developed among 113 patients. As compared to the previous cyclosporine and AZA-based immunosuppression, the introduction of the new immunosuppressive regimen did not increase the incidence rate of skin cancer [rate ratio 0.84; 95% confidence interval (CI) 0.48-1.46], solid tumours (0.89; 95% CI 0.46-1.67) and PTLD (0.82; 95% CI 0.28-2.21). Patients treated with the more recent regimens less frequently developed multiple skin cancers and invasive squamous cell cancer. Skin cancer after transplantation was strongly associated with the development of solid tumours (odds ratio 5.2; P < 0.0001). The introduction of the new immunosuppressive drugs reduced the incidence of first year acute rejection from 34.8 to 13.2% (P < 0.0001). Although significantly more efficient in the prevention of acute rejection, the introduction of TRL, MPA and IL2Ra-based immunosuppression after kidney transplantation was not associated with an increased incidence of skin cancer, solid tumours or PTLD.

Incidencia de cáncer de piel en Colombia, años 2003-2007

Objective To establish the incidence of skin cancer in Colombia from 2003 to 2007. Methods We performed an ecological study, using health services’ records collected by the Colombian Ministry of Social Protection 2003-2007, the results of the National Demography and Health Survey of 2005, and the population predictions for Colombia of the National Department of Statistics. Results The incidence rate of skin cancer in 2003 was 23 cases per 100 000 people, increasing to 41 cases per 100 000 people in 2007. The male:female ratio was 1.2:1. The incidence of skin cancer doubled in people over 60 years old. The departments with the highest incidence of skin cancer in the country were Bogota, Cundinamarca, Antioquia and Boyaca. The expected incidence of skin cancer in Colombia for 2020 is approximately 102 cases per 100 000 people. Conclusions As in other countries, the incidence of skin cancer in Colombia is increasing. Preventive strategies are required to control this phenomenon in our setting.

Abstract PL05-05: The Australian skin cancer prevention experience: Lessons learned and global challenges ahead

Abstract Australia has one of the highest skin cancer incidence and mortality rates in the world. The reason for these high rates is due in part to the high ambient UV radiation levels, combined with a predominantly susceptible fair-skinned population. To address this problem, since 1980, Australians have been exposed to social marketing campaigns like SunSmart to raise awareness of skin cancer prevention. These campaigns have used advocacy to influence legislative reforms and mass media alongside interventions in schools, workplaces, and in the community to motivate sun protective behavior. As a result of these interventions it can be demonstrated that social marketing campaigns can be a very effective method to not only motivate behavior change, reduce sunburn, and increase awareness but more importantly, reduce melanoma rates. In addition to this, we have been able to demonstrate that for every $1 the government invests in skin cancer prevention over a 20-year period, it will yield a $2.30 return. This makes skin cancer control a remarkably good investment in public health. However, long-term investment in this area is required otherwise any population gains in behavior are very likely to be quickly eroded. In more recent years, skin cancer prevention programs worldwide have faced significant challenges in particular from the sunbed industry as well as increased awareness by the general population of vitamin D and its potential positive health benefits. To address these issues, Australia now has a comprehensive approach to manage sunbed operations that include legislative requirements to restrict under 18 access, ban people with skin type 1, and the licensing of operators. Due to these intervention and increased awareness, there has been a decrease of up to 50% in the number of sunbed operators in Australian cities, a downturn not seen anywhere else in the world. In addition to this, considerable effort has gone into managing the issues associated with vitamin D to the point now where the SunSmart program is an authoritative voice to advise people when they should use sun protection, but also when they should not. Citation Information: Cancer Prev Res 2010;3(12 Suppl):PL05-05.

Hautkrebsvorsorge

The skin is the most affected organ by cancer. The incidence rates of skin cancer are steadily increasing, both for melanoma and non-melanoma skin cancers (squamous cell carcinoma, basal cell carcinoma). Over 90 % of the death cases from skin cancers attribute to melanoma. Survival from melanoma is strongly related to tumour thickness. Therefore early detection is the most important step to improve prognosis. In the last years a number of new non invasive techniques for the early diagnosis of melanoma have been developed which are superior to the naked eye examination. In this overview article we present some non-invasive diagnostic techniques like total body photography, digital dermoscopy and confocal microscopy which in addition to dermoscopy assist the dermatologist in differentiating nevi from early melanomas.Non-melanoma skin cancer can be prevented by accurate sun protection. Early squamous cell carcinomas and basal cell carcinomas can be treated either invasively or non-invasively with excellent prognosis.

Review: Ultraviolet radiation and skin cancer

AbstractSkin cancer is the most common type of cancer in fair‐skinned populations in many parts of the world. The incidence, morbidity and mortality rates of skin cancers are increasing and, therefore, pose a significant public health concern. Ultraviolet radiation (UVR) is the major etiologic agent in the development of skin cancers. UVR causes DNA damage and genetic mutations, which subsequently lead to skin cancer. A clearer understanding of UVR is crucial in the prevention of skin cancer. This article reviews UVR, its damaging effects on the skin and its relationship to UV immunosuppression and skin cancer. Several factors influence the amount of UVR reaching the earth’s surface, including ozone depletion, UV light elevation, latitude, altitude, and weather conditions. The current treatment modalities utilizing UVR (i.e. phototherapy) can also predispose to skin cancers. Unnecessary exposure to the sun and artificial UVR (tanning lamps) are important personal attributable risks. This article aims to provide a comprehensive overview of skin cancer with an emphasis on carefully evaluated statistics, the epidemiology of UVR‐induced skin cancers, incidence rates, risk factors, and preventative behaviors &amp; strategies, including personal behavioral modifications and public educational initiatives.

Skin cancer prevention in Australia

Australia has one of the highest skin cancer incidence and mortality rates in the world. The reason for these high rates is due in part to the high ambient UV radiation levels, combined with a predominantly susceptible fair-skinned population. To address this problem, since 1980 Australians have been exposed to social marketing campaigns to raise awareness of skin cancer prevention. These campaigns have used mass media alongside interventions in schools, workplaces, and in community and leisure settings to motivate sun protective behaviour. As a result of these interventions it can be demonstrated that social marketing campaigns can be a very effective method to not only motivate behaviour change, reduce sunburn, and increase awareness but more importantly, reduce melanoma rates and bring positive economic returns to government. However long term investment in this area is required otherwise any population gains in behaviour are very likely to be quickly eroded.

Skin cancer trends among Asians living in Singapore from 1968 to 2006

The incidence rates of skin cancers in Caucasian populations are increasing. There is little information on skin cancer trends in Asians, who have distinctly different skin types. We sought to study skin cancer incidence rates and time trends among the 3 Asian ethnic groups in Singapore. We analyzed skin cancer data from the Singapore Cancer Registry from 1968 to 2006 using the Poisson regression model. There were 4044 reported cases of basal cell carcinoma, 2064 of squamous cell carcinoma, and 415 of melanoma. Overall skin cancer incidence rates increased from 2.9/100,000 in 1968 to 1972 to 8.4/100,000 in 1998 to 2002, declining to 7.4/100,000 in 2003 to 2006. Among older persons (> or = 60 years), basal cell carcinoma rates increased the most, by 18.9/100,000 in Chinese, 6.0/100,000 in Malays, and 4.1/100,000 in Indians from 1968 to 1972 to 2003 to 2006. Squamous cell carcinoma rates among those aged 60 years and older increased by 2.3/100,000 in Chinese and by 1/100,000 in Malays and Indians. Melanoma rates were constant for all 3 races. Skin cancer rates among the fairer-skinned Chinese were approximately 3 times higher than in Malays and Indians, who generally have darker complexions. Although appropriate population denominators were used, lack of data from 2007 could have affected the results for the last time period, which comprised 4 instead of 5 years. Incidence rates of skin cancer in Singapore increased from 1968 to 2006, especially among older Chinese.

Solar ultraviolet radiation and skin cancer

Incidence rates of skin cancer, both non-melanoma skin cancer and (malignant/cutaneous) melanoma, are rising in Great Britain. It is widely accepted that solar ultraviolet radiation (UVR) is the main causal factor for these neoplasms. Many people are occupationally exposed to solar UVR, including farmers, construction workers and some public service workers. The aim of this article is to review the key epidemiologic papers on occupational solar exposure and skin cancer and discuss the relationships found. A literature search was conducted using online databases and article bibliographies. A full review of all available studies was not carried out, as only key studies on occupational exposure were required. There is a clear association between solar radiation and skin cancer. The mechanisms for induction vary between the types of skin cancer and these cannot be solely attributed to occupational exposures. There is great difficulty in separating the effects of occupational and recreational solar UVR exposure; therefore, any results discussed in this review should be interpreted with caution. However, it is clear that solar UVR exposure does induce skin cancer and protective measures should be taken in an attempt to reduce the burden of occupational skin cancer in Great Britain.

Fractionated 5-aminolaevulinic acid-photodynamic therapy vs. surgical excision in the treatment of nodular basal cell carcinoma: results of a randomized controlled trial

Skin cancer incidence rates have been increasing for decades and this increase is expected to continue. Surgical excision (SE) is the treatment of first choice for nodular basal cell carcinoma (nBCC). Photodynamic therapy (PDT) has proven to be an effective treatment for superficial basal cell carcinoma. Its long-term efficacy in nBCC has not yet been established. Prospectively compare the efficacy of 5-aminolaevulinic acid (ALA)-PDT and SE in terms of failure rates with long-term follow-up. Determinants of failure in the study population, such as the effect of tumour depth, were analysed retrospectively. A randomized controlled trial in 173 primary nBCCs in 149 patients. Primary nBCCs were randomly assigned either to PDT (n = 85) or to SE (n = 88). Tumours treated with PDT were illuminated twice on the same day, 4 h after application of ALA cream, 3 weeks after debulking. SE was performed under local anaesthesia with a 3-mm margin, followed by histological examination. An intention-to-treat analysis was performed. In total, 171 primary nBCCs in 149 patients were treated. A 3-year interim analysis revealed that the cumulative incidence of failure was 2.3% for SE and 30.3% for PDT (P < 0.001). Tumour depth and other analysed determinants of failure were not significantly related to treatment failure. SE proved to be significantly more effective than treatment with fractionated illumination ALA-PDT. Therefore, in the treatment of primary nBCC, SE is preferred over PDT following this treatment regimen.

Skin cancer incidence rates in Krasnoyarsk Region

Skin cancer is one of the most common malignancies and its increasing rates are found all over the world and in the Russian Federation in particular. The paper presents statistical analysis of the data on skin cancer morbidity and mortality rates in Krasnoyarsk Region summarized for the period since 1999 until 2005. Peculiarities of occurrence of this pathology among male and female persons are evaluated, tendencies of epidemiology of these tumors are analyzed, and comparative analysis of skin cancer morbidity in Krasnoyarsk Region with the Russian Federation as a whole and with foreign countries is carried out.

Ultraviolet Emission Spectra of Sunbeds¶

It is well known that UV radiation contributes to the development of skin cancer. Exposure to solar radiation is predominantly responsible for the high incidence rate of skin cancer, but there are also indications that sunbeds are involved. The aim of the present investigation was to determine the UV emission spectra of sunbeds. It included the most common sunbed models, which cover more than 50% of the Swiss market. The UV emission spectra of sunbeds have special characteristics and are different from the sun spectrum, which can be seen in high-resolution spectral measurements. Sunbed emission spectra are similar to the sun spectrum in the UVB (280–320 nm) range but reach values 10 to 15 times higher in the UVA (320–400 nm) range. An average erythema-effective irradiance of 0.33 W/m2 was determined for sunbeds. This corresponds to a UV index of 13, which is significantly higher than the UV index of 8.5 of the high summer sun at noon at intermediate latitudes. The measurements were spread over the whole effective area of the sunbeds, and an inhomogeneous distribution of the irradiances with variations of up to 30% from the average value was found.

SunSmart? Skin cancer knowledge and preventive behaviour in a British population representative sample

The incidence of skin cancer has risen rapidly in the UK over the last 20 years, prompting public health organizations to try and raise awareness of the dangers of sun exposure and the need to practice sun-safe behaviour. This study aimed to assess baseline levels of sun-safe knowledge and behaviour in a British population-representative sample, prior to the launch of Cancer Research UK's ‘SunSmart’ campaign. A face-to-face survey was conducted through the Office for National Statistics as part of their Omnibus survey. In total, 1848 men and women aged 18 and over were interviewed. Knowledge of what to do to reduce skin cancer risk was modest. Two-thirds mentioned avoiding the sun by seeking shade, 50% mentioned covering up and only 43% said to use high factor sunscreen. Practice of sun-safe behaviours was also poor, with only one-third saying they sought shade, covered up or used high factor sunscreen to protect themselves from the sun. Men and those from lower socioeconomic groups were least informed and least likely to report using sun-protective behaviours. Increases in both knowledge and use of appropriate sun-protective behaviours are needed if skin cancer incidence rates are to decrease.

The causes of skin cancer: A comprehensive review

Skin cancer is the most common type of cancer in fair-skinned populations around the world. The incidence and mortality rates of skin cancers are dramatically increasing and thus pose a threat to public health. Understanding the etiology and pathogenesis of skin cancer remains a goal for healthcare systems. A clearer understanding of causative factors is an essential step in the prevention of skin cancer. This article comprehensively reviews the causative agents which play a role in the development of skin cancer. Ultraviolet radiation (UV) from sun exposure is the most important cause of skin cancer. Sunburns and excessive exposures cause cumulative damage which induces immunosuppression and skin cancers. Ozone depletion, the level of UV light, elevation, latitude, altitude and weather conditions influence the emission of UV radiation reaching the earth's surface. Organ transplant recipients and AIDS patients have an increased incidence of skin cancers. Some treatment modalities, including radiation therapy, phototherapy and psoralen and long-wave ultraviolet radiation (PUVA) can also predispose to skin cancers. Viral infections such as the human papilloma virus can cause squamous cell carcinomas. Individuals with familial genetic syndromes are susceptible to specific types of skin cancers. Ionizing radiation, environmental pollutants, chemical carcinogens and work-related exposures have been associated with skin cancers. Exposure to artificial UV radiation (tanning beds and lamps), aging, skin color, diet and smoking are attributable risks. Skin cancers have been found in dermatoses and various types of keratoses, chronically injured or nonhealing wounds, and scars. This article provides a comprehensive and thorough overview of skin cancer, with an emphasis on understanding its epidemiology, incidence, etiology and related risk factors.

Asertividad en el diagnóstico clínico de los tumores cutáneos

There is an increase in the incidence rates of skin cancer in Chile. To study the clinical diagnostic accuracy (CDA) for skin cancer. CDA was defined as the percentage of agreement between clinical and pathological diagnosis. Approximately 600,000 pathological reports from five hospitals in Santiago were reviewed. A total of 2,593 skin tumours; 230 Malignant Melanoma (MM); 412 Squamous Cell Carcinoma (SCC) and 1,951 Basal Cell Carcinoma (BCC) were studied. These tumours were clinically diagnosed and surgically treated by dermatologists. The CDA was studied for each tumour, by the anatomical localization of the tumour, Breslow Index in MM, by age and sex of the patient. The highest CDA was observed for BCC (76.2%); followed by MM (64.3%) and SCC (34.7%). By anatomical localization, for MM the highest CDA was observed in the soles (p < 0.05); for BCC, the highest CDA was in the face (p < 0.05). No significant differences were observed in SCC. By age, for MM, the CDA was higher in patients aged less than 50 years. No differences in CDA by age were observed in the other two tumours. By sex, no differences were found. A higher CDA was found in MM with Breslow indexes III and IV than for MM with Breslow indexes I and II. CDA is affected by the clinical variables analyzed in this study. A more accurate clinical diagnosis of skin cancer could be obtained taking into account these variables.

Basal cell carcinoma, squamous cell carcinoma and melanoma of the skin: analysis of the Singapore Cancer Registry data 1968-97.

There has been an alarming recent increase in skin cancer incidence among fair-skinned populations. Information from Asian populations is less readily available. This study examines time trends and ethnic differences of skin cancers among Asians in Singapore. Data from 1968 to 1997 was obtained from the Singapore Cancer Registry, a population-based registry. Age-standardized incidence rates (ASRs) and age-adjusted average annual percentage change, using the Poisson regression model, were calculated. A total of 2650 basal cell carcinomas (BCCs), 1407 squamous cell carcinomas (SCCs) and 281 melanomas were reported. There was an overall increase of skin cancer from 6.0 per 100000 person years (1968-72) to 8.9 per 100000 person years (1993-97). BCC incidence increased 3% annually, melanoma remained constant, and SCC decreased 0.9% annually. BCC ASRs were highest among Chinese, then Malays and Indians. A similar pattern was noted for SCC and melanomas. The incidence rates of skin cancer increased in Singapore during the period 1968-97. Fairer-skinned Chinese had a higher incidence of skin cancer.

Ultraviolet emission spectra of sunbeds.

It is well known that UV radiation contributes to the development of skin cancer. Exposure to solar radiation is predominantly responsible for the high incidence rate of skin cancer, but there are also indications that sunbeds are involved. The aim of the present investigation was to determine the UV emission spectra of sunbeds. It included the most common sunbed models, which cover more than 50% of the Swiss market. The UV emission spectra of sunbeds have special characteristics and are different from the sun spectrum, which can be seen in high-resolution spectral measurements. Sunbed emission spectra are similar to the sun spectrum in the UVB (280-320 nm) range but reach values 10 to 15 times higher in the UVA (320-400 nm) range. An average erythema-effective irradiance of 0.33 W/m2 was determined for sunbeds. This corresponds to a UV index of 13, which is significantly higher than the UV index of 8.5 of the high summer sun at noon at intermediate latitudes. The measurements were spread over the whole effective area of the sunbeds, and an inhomogeneous distribution of the irradiances with variations of up to 30% from the average value was found.

Risk of nonmelanoma skin cancer in Italian organ transplant recipients. A registry-based study.

Organ transplant recipients are at an increased risk of nonmelanoma skin cancer. Few data concern heart transplantation and populations from southern Europe. A total of 1,329 patients who received their first kidney (1,062 subjects) or heart allograft (267 subjects) were included in a partly retrospective cohort study to evaluate the risk of skin cancer. The incidence rate per 1,000 person-years and the cumulative incidence were computed. Standardized morbidity ratio was estimated by comparison with Italian cancer registry data. To analyze the role of potential prognostic factors, Cox's regression method was used. The overall incidence rate of nonmelanoma skin cancer was 10.0 cases per 1,000 posttransplant person-years (95% confidence interval 8.2-11.7). This estimate was far higher than expected in the general population. The overall risk of developing skin cancer increased from a cumulative incidence of 5.8% after 5 posttransplant years to an incidence of 10.8% after 10 years of graft survival. In a Cox proportional hazard risk model, the most important factors that appeared to favor the development of skin cancer were age at transplantation and sex. After adjustment for age at transplantation and sex, no definite increased risk was documented among heart as compared with kindney transplant recipients. Our study confirms the increased risk of nonmelanoma skin cancer among organ transplant recipients in a southern European population.

Skin Cancer Control Western Australia: Is it Working and What Have we Learned?

Australia has the highest rates of skin cancer in the world, with malignant melanoma rates in Western Australia second only to the state of Queensland. The Cancer Foundation of Western Australia has been actively involved in skin cancer control programmes for almost 20 years. The evaluation of skin cancer campaigns run by the Foundation over the past 5 years, including evaluation data from the summer 1998/99 campaign, is reported. Secondly, the reduction of age standardised rates of melanoma now being witnessed in Western Australia are reported. From these data arises the question - is it too early to claim that public health measures have contributed to this recent reduction in melanoma rates in Western Australia? Finally, a summary is presented of lessons learned about the historical process of conducting skin cancer control programmes. While there is debate about the specific impact in terms of skin cancer incidence rates, there is no doubt our programmes have changed the way Australians perceive, and behave, in the sun.