Accuracy of skin cancer incidence data in the United Kingdom

A thorough survey was undertaken of all new patients with skin cancer resident in Avon who were treated in Bristol in 1974. These results were then compared with the official skin cancer incidence figures from the Cancer Registry of the South-Western Regional Health Authority. Our survey suggests that the Cancer Registry figures underestimated the incidence of malignant melanoma by at least 8–19% and for non-melanoma cancer the underestimate was at least 14–28%.     

Predictions of skin cancer incidence in the Netherlands up to 2015

BACKGROUND: Skin cancer is an important, growing public health problem among white caucasians, causing a heavy burden on dermatologists and general practitioners. OBJECTIVES: To predict the future incidence of skin cancer in the Netherlands up to 2015. METHODS: Expected numbers of skin cancer cases in the Netherlands up to 2015 were calculated by trend modelling of observed rates for melanoma and squamous cell carcinoma (SCC) between 1989 and 2000 obtained from the Netherlands Cancer Registry and for basal cell carcinoma (BCC) obtained from the Eindhoven Cancer Registry; these rates were then multiplied by the predicted age distributions. Incidence rates were fitted to four different models, and predictions were based on the best fitting model. RESULTS: An increase of 80% in the total number of skin cancer patients is expected in the Netherlands: from 20 654 in 2000 to 37 342 in 2015. The total number of melanoma cases is expected to increase by 99%, with the largest increase for males (males aged 35-64, 111%; males aged > or = 65, 139%). Numbers of patients with SCC will increase overall by 80%, mainly among older males and females (increase of 79%) and females aged 35-64 (increase of 93%). The number of cases of BCC will increase by 78%, with the largest increase for the combined groups, those aged 15-64 (males, 66% increase; females, 94% increase), especially for sites other than the head and neck. The contribution of demographic changes (ageing effect) was largest for males with BCC and SCC (35-44%). CONCLUSIONS: If incidence rates for skin cancers in the Netherlands continue to increase and population growth and ageing remain unabated, a rise in annual demand for care of more than 5% could occur, putting a heavy burden on general practitioners and dermatologists. In the absence of marked changes in current ultraviolet radiation exposure, these increases will probably continue after 2015.     

A systematic review of worldwide incidence of nonmelanoma skin cancer

Background Nonmelanoma skin cancer (NMSC) is the most common cancer affecting white‐skinned individuals and the incidence is increasing worldwide. Objectives This systematic review brings together 75 studies conducted over the past half century to look at geographical variations and trends worldwide in NMSC, and specifically incidence data are compared with recent U.K. cancer registry data. Methods Following the development of a comprehensive search strategy, an assessment tool was adapted to look at the methodological quality of the eligible studies. Results Most of the studies focused on white populations in Europe, the U.S.A. and Australia; however, limited data were available for other skin types in regions such as Africa. Worldwide the incidence for NMSC varies widely with the highest rates in Australia [> 1000/100 000 person‐years for basal cell carcinoma (BCC)] and the lowest rates in parts of Africa (< 1/100 000 person‐years for BCC). The average incidence rates in England were 76·21/100 000 person‐years and 22·65/100 000 person‐years for BCC and squamous cell carcinoma (SCC), respectively, with highest rates in the South‐West of England (121·29/100 000 person‐years for BCC and 33·02/100 000 person‐years for SCC) and lowest rates by far in London (0·24/100 000 person‐years for BCC and 14·98/100 000 person‐years for SCC). The incidence rates in the U.K. appear to be increasing at a greater rate when compared with the rest of Europe. Conclusions NMSC is an increasing problem for health care services worldwide. This review highlights a requirement for prevention studies in this area and the issues surrounding incomplete NMSC registration. Registration standards of NMSC should be improved to the level of other invasive disease.     

A population-based study of skin cancer incidence and prevalence in renal transplant recipients

BACKGROUND: Cancers occurring following solid organ transplantation are a rapidly growing public health concern. Defining the extent of the problem has been limited by surveillance systems with incomplete registration of cases and the paucity of reliable national incidence data. OBJECTIVES: To determine the incidence of all cancers following renal transplantation and to make a detailed examination of trends and patterns associated with postrenal transplant skin cancers. METHODS: Integration of data from the national renal transplant database and the national cancer registry in Ireland enabled accurate determination of the number of renal transplant recipients (RTRs) with skin cancers and other malignancies in the time period 1 January 1994 to 31 December 2001. RESULTS: We demonstrated a biphasic increase in skin cancer incidence following renal transplantation, determined by the age at transplantation. There was a steady increase in risk for older RTRs (age 50+ years) from year 2 post-transplant, whereas the increased risk in younger RTRs (age < 50 years) occurred later but much more significantly, reaching 200 times the risk for an age-matched nontransplanted population by year 6 post-transplant. The number of nonmelanoma skin cancers (NMSCs) registered in RTRs accounted for 1% of all NMSCs registered nationally over the study period. The standardized incidence rates for invasive NMSC (33-fold increase) and in situ carcinoma of the skin (65-fold increase) were significantly increased (P < 0.05). The risk for invasive squamous cell carcinoma (SCC) was increased 82-fold compared with the nontransplanted population. Male RTRs were at particular risk of invasive SCC at sun-exposed sites such as the scalp and the external ear. Risk of malignant melanoma and Kaposi sarcoma were also increased relative to the nontransplanted population. CONCLUSIONS: This comprehensive national study illustrates how rates of skin cancer in Irish RTRs have influenced the national incidence of skin cancer. The high incidence of SCC, basal cell carcinoma and Bowen's disease in the early post-transplant period for older patients and the cumulative risk in younger patients with increased duration of transplantation highlight the importance of implementing early and continued cancer surveillance regimens post-transplant.     

Trends in the incidence of non-melanoma skin cancer in the SE Netherlands 1975–1988: a registry-based study

The trends in the incidence and the sites of primary basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) of the skin were examined in a defined population of 650,000 persons in the SE Netherlands during the period 1975-88. The data was obtained from the Cancer Registry in Eindhoven and was from the dermatological and surgical clinics of 12 community hospitals. The incidence rates for BCC during this period rose from 42 to 53/100,000 person years for males and 24 to 38/100,000 person years for females. The rate of incidence for SCC varied with an increase mainly among males. In about 80% of the cases BCC and SCC occurred on the head and neck. Allowing for some detection bias a rise in the true incidence of BCC and SCC was observed, with an increase in SCC only since 1982. There was a marked decline in the incidence of SCC on the lips of males. These rates and trends fit into a pattern observed in other parts of Europe.