American Journal of Epidemiology Vol. 147, No. 8: 722-726
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health
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Incidence of Invasive Cancers following Basal Cell Skin Cancer
1 Registre Vaudols des Tumeurs, Institut Universitaire de Medecine Sociale et Préventive, Centre Hospitaller Universitaire Vaudois Falaises 1, 1011 Lausanne, Switzerland
2 Registre Neuchåtelois des Tumeurs, Les Cadolles 2000 Neuchåtel, Switzerland
3 Istituto di Ricerche Farmacologiche "Mario Negri" e Istituto di Statistica Medica e Biometria, Università degli Studi di Milano Via Venezian 1, 20133 Milano, ltaly
To obtain quantitative information on the risk of invasive cancers following a diagnosis of basal cell carcinoma (BCC) of the skin, patients with incident BCC cases listed in the cancer registries of the Swiss cantons of Vaud and Neuchatel between 1974 and 1994 were actively followed up through December 31, 1994, for the occurrence of subsequent invasive neoplasms. Among 11,878 persons with incident BCC who were followed for a total of 76,510 person-years at risk, 1,543 metachronous cancers were observed versus 1,397.9 expected, corresponding to a standardized incidence ratio (SIR) of 1.1 (95% confidence interval (Cl) 1.0–1.2). However, after exclusion of skin cancers (mostly squamous cell carcinoma and melanoma), 975 second primary cancers were observed versus 1,059 expected (SIR = 0.9, 95% Cl 0.8–1.0). Significant excesses were registered for cancer of the lip (SIR = 2.2), for squamous cell skin cancer (SIR = 4.5) and melanoma of the skin (SIR = 2.5), and for non-Hodgkin's lymphoma (SIR = 1.9). The SIRs were also above unity, though not significantly, for cancers of the salivary glands (SIR = 2.8) and the small intestine (SIR = 2.1) and for soft-tissue sarcomas (SIR = 1.7). The SIR for lung cancer was 0.9. The SIRs for salivary gland and skin cancer were appreciably greater below age 70 years. For most sites, particularly for squamous cell cancer and melanoma of the skin, the SIRs remained elevated 5 or more years after BCC diagnosis. The cumulative incidence of squamous cell skin cancer was 13% at 19 years; this stresses the importance of carefully monitoring skin lesions among persons previously diagnosed with BCC. Am J Epidemiol 1998;147:722–6.
carcinoma, basal cell; neoplasms; skin neoplasms
Reprint requests to Dr. Fabio Levl, Registre Vaudois des Tumeurs, Institut Universitaire de Médecine Sociale et Préventive, Centre Hospitalier Universitaire Vaudols, Falalses 1, Casier 15 CH-1011 Lausanne, Switzerland.
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