Incidence of nonmelanoma skin cancer on the rise among young adults


Incidence of nonmelanoma skin cancer on the rise among young
adults
August 10, 2005
A new study from Minnesota finds the incidence of nonmelanoma
skin cancer increasing among men and
women under the age of 40,
according to an article in the August 10 issue of JAMA.


The overall incidence of nonmelanoma skin cancer, consisting of
squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), is
increasing, according to background
information in the article. This
increasing incidence is most likely due to a combination of
factors, including increased exposure to UV light, ozone
depletion, and increased surveillance. Long-term exposure to the
sun resulting in photodamage is perhaps the biggest risk factor
for nonmelanoma skin cancer. In the United States, approximately
800,000 new cases of BCC and 200,000 new cases of SCC were
diagnosed in 2000.

Nonmelanoma skin cancer generally occurs in
persons older than 50 years, and in this age group, its
incidence is increasing rapidly. However, little is known about
its incidence in persons younger than 40 years.
Leslie J. Christenson, M.

D., of Mayo Clinic, Rochester, Minn.,
and colleagues conducted a study to estimate the sex- and
age-specific incidence of BCC and SCC in Olmsted County, Minnesota,
in a young population (less than 40 years old) from the beginning
of 1976 through 2003. The patients in this study have comprehensive
medical records captured through the Rochester Epidemiology
Project.


During the study period, 451 incident basal cell carcinomas were
diagnosed in 417 patients, and 70 incident squamous cell carcinomas
were diagnosed in 68 patients. Overall, the age-adjusted incidence
of basal cell carcinoma per 100,000 persons was 25.9 for
women and 20.9 for men.

The
incidence of basal cell carcinoma increased significantly during
the study period among women but not among men. Nodular basal
cell carcinoma was the most common histologic subtype; 43.0
percent of tumors were solely nodular basal cell carcinoma and
11.0 percent had a mixed composition, including the nodular
subtype.

The incidence of squamous cell carcinoma was similar in
men and women, with an average age- and sex-adjusted incidence
of 3.9 per 100,000 persons; the incidence of squamous cell
carcinoma increased significantly over the study period among
both women and men.
Comparing the change in incidence rates for basal cell
carcinoma, per 100,000 persons the rate for 1976-1979 for women was
13.4; for men, 22.

9, and for both sexes, 18.2. For 2000-2003, the
rate for women was 31.6; for men, 26.

7; and for both sexes,
29.1.
For squamous cell carcinoma, per 100,000 persons the rate for
1976-1979 for women was 0.6; for men, 1.

3, and for both sexes, 0.9.
For 2000-2003, the rate for women was 4.1; for men, 4.

2; and for
both sexes, 4.1.
"This increase [in nonmelanoma skin cancer in young adults] may
lead to an exponential increase in the overall occurrence of
nonmelanoma skin cancer over time as the population ages. This may
mean even greater demands for
health care related to
nonmelanoma skin cancer.

Our results also emphasize the need to
focus on the prevention of skin cancer in the very young so that
the increasing incidence of a potentially preventable cancer can
be halted," the authors conclude.
JAMA and Archives Journals

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