Recent trends in incidence of nonmelanoma skin cancers in the East of Scotland, 1992-2003
ABSTRACT Historically, ascertainment of nonmelanoma skin cancer (NMSC) by cancer registries in the U.K. has been shown to be incomplete in several studies. However, recent evidence suggesting that almost all clinically diagnosed NMSCs are verified histologically, coupled with the increasing availability of electronic histopathology data to cancer registries, raises the possibility that this situation may have improved.
To assess recent trends in incidence of the main types of NMSC and carcinoma in situ (CIS) of the skin in Scotland.
The study was restricted to selected health board areas in the East of Scotland for which pathology data have been used routinely to support cancer registration since the early 1990s. Incident cases of squamous cell carcinoma (SCC) of the skin, CIS of the skin, and first ever basal cell carcinoma (BCC) were extracted from the Scottish Cancer Registry covering the period of diagnosis 1992-2003. Sex-specific, age-standardized and age-specific incidence rates were calculated for four consecutive 3-year periods of diagnosis. Estimated annual percentage changes (EAPCs) in incidence were calculated by Poisson regression modelling, with adjustment for age. The percentage distribution of SCC, BCC and CIS of the skin by anatomical site and sex was calculated for the period of diagnosis 1997-2003.
The crude incidence of SCC for the period 1995-97 was 34.7 per 100,000, comparable with the best existing Scottish estimate of 32.2 derived from a prospective survey in Glasgow during March 1995. Age-adjusted rates of SCC, first ever BCC, and CIS of the skin have all increased significantly in both sexes between 1992 and 2003 (all P < 0.001), with EAPCs ranging in magnitude from +1.4% (first ever BCC in males) to +5.1% (CIS in males). The majority of lesions arose on the head and neck area, with the exception of CIS, which in females was more commonly located on the limbs.
Ascertainment of NMSC has probably improved since the advent and use of electronic pathology data. Ongoing increases in age-adjusted incidence, combined with ageing of the population, will have major implications for the clinical workload associated with NMSC for the foreseeable future.
[Show abstract] [Hide abstract]
ABSTRACT: PDT (photodynamic therapy) has been used for the treatment of NMCC (non-melanoma cutaneous cancer) particularly, human SCC (squamous cell carcinoma). However, the nature of the photosensitizer, the activation light source and the mode of cell death induced post-PDT remains elusive. We tried to optimize PDT using the light-activated (320–400 nm) St John's Wort-derived compound, Hyp (hypericin). The work highlights the potential mode of cell death and the increased efficacy of the technique associated with multiple Hyp-PDT treatment. SCC cells were exposed to different concentrations of Hyp and activated with light at 1 J/cm2 for 1 or 2 days. Thereafter with the optimum dose of Hyp proliferation, ROS (reactive oxygen species), and apoptosis were analysed by XTT [2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide] assay, FACS analysis and Fluorescent/Phase contrast microscopy was carried out for morphological studies. Hyp-PDT produces more ROS after 1 day compared with 2 days and the mode of cell death is a necrotic caspase-independent mechanism. We propose a novel ‘double-hit/2-day’ strategy to reduce the viability in SCC using Hyp-based PDT as an adjunctive treatment modality.Cell Biology International 12/2012; 36(12). DOI:10.1042/CBI20120108 · 1.64 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: Background Sigmoidal (S-shaped) dose–cancer incidence relationships are often observed in animal bioassays for carcinogenicity. Ultraviolet (UV) radiation is an established skin carcinogen. The aim of this study is to examine if S-shaped curves describe the relationship between solar UV doses and skin cancer incidences, and if such relationships can be used to estimate threshold levels of non-carcinogenic UV exposure, as well as maximal incidence rates. Methods We studied the incidence rate–annual erythema-effective UV dose relationship for squamous cell carcinoma (SCC), basal cell carcinoma (BCC) and cutaneous melanoma (CM) among different Caucasian populations in Europe, Australia and New Zealand. Results Our analysis indicates that S-shaped associations describe the data well (P < 0.0001). The age-adjusted incidence rates for cases expected to be due to other causes than solar UV exposure (at zero UV dose) were found to be around 0.6, 9.7 and 4.0 per 100,000 for women in 1997–2007 for SCC, BCC and CM, respectively, and around 1.2, 14.3 and 2.6 per 100,000 for men. The analysis indicates that SCC, BCC and CM have maximal incidence of 361 ± 24, 1544 ± 49 and 36 ± 4 per 100,000 for women, and 592 ± 35, 2204 ± 109 and 50 ± 4 per 100,000 for men. Conclusions Between 89 and 95% of the annual CM cases, around 99.8% SCC and 99.4% BCC cases are caused by solar UV exposure. The analysis did not identify any “safe” UV dose below which the risk for skin cancer was absent. Avoidance of UV radiation has a potential to reduce the incidence of skin cancer in fair-skinned population.International Journal of Hygiene and Environmental Health 11/2014; 217(8). DOI:10.1016/j.ijheh.2014.06.002 · 3.28 Impact Factor