Basal cell carcinomas on sun‐protected vs. sun‐exposed body sites: a comparison of phenotypic and environmental risk factors

Khalesi, Mohammad; Whiteman, David C.; Rosendahl, Cliff; Johns, Richard J.; Hackett, Timothy; Cameron, Alan; Waterhouse, Mary; Lucas, Robyn; Kimlin, Michael G.; Neale, Rachel E.

doi:10.1111/phpp.12170

Cited by 11 publications

(11 citation statements)

References 48 publications

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“…Nevi have an uncertain relationship with heavy sun damage . The body site associations of adult nevi with BCC on the head and neck, but not the trunk, and any solar keratoses with BCC on all body sites support similar Queensland findings . Childhood freckling too was a risk factor at all body sites.…”

Section: Discussionsupporting

confidence: 58%

Early Life UV and Risk of Basal and Squamous Cell Carcinoma in New South Wales, Australia

Kricker

Weber

Sitas

et al. 2017

Photochem & Photobiology

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Sun exposure is the main cause of squamous (SCC) and basal cell carcinoma (BCC) although pattern and amount differ by cancer type, and sun sensitivity is the major host risk factor. Our study investigated risk factors and residential ambient UV in a population-based sample of Australian 45 and Up Study participants: 916 BCC cases, 433 SCC cases, 1224 controls. Unconditional logistic regression models adjusting for key covariates demonstrated 60% increased BCC risk and two-fold increased SCC risk with sun sensitivity, and three- and four-fold increased risk, respectively, with solar keratoses. BCC but not SCC risk increased with higher early-life residential UV in all participants (odds ratio (OR) = 1.54; 95% CI 1.22-1.96 for intermediate; OR = 1.31; 95% CI 1.03-1.68 for high UV at birthplace) and similarly in Australian-born participants (P-values < 0.05). Risk of SCC but not BCC increased with long-term cumulative sun exposure assessed by self-reported outdoor work (OR 1.74, 95% CI 1.21-2.49). In conclusion, sun sensitivity is important for both cancers, early-life UV but not cumulative UV appears to increase BCC risk, the former an apparently novel finding, and SCC risk appears only to be related to long-term cumulative sun exposure.

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Section: Discussionsupporting

confidence: 58%

Early Life UV and Risk of Basal and Squamous Cell Carcinoma in New South Wales, Australia

Kricker

Weber

Sitas

et al. 2017

Photochem & Photobiology

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“…This study was nested within the Queensland BCC Study (QBS), carried out in Brisbane, Queensland, Australia. The QBS aimed to compare the phenotypic characteristics and environmental risk factors in people who were newly diagnosed with BCC arising on anatomic sites that are usually protected by clothing with those of people newly diagnosed with BCC on anatomic sites that are habitually exposed.…”

Section: Methodsmentioning

confidence: 99%

“…Truncal BCCs are predominantly of the superficial subtype, whereas BCCs on the head and neck are most commonly nodular . Thus, there are suggestions that the pathophysiology of BCCs arising on different anatomic sites and developing into different histological subtypes differs …”

Section: Introductionmentioning

confidence: 99%

Comparison of PTCH1, COX‐2, p53, and Ki‐67 protein expression in basal cell carcinomas of nodular and superficial subtypes arising on the head and trunk

et al. 2016

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“…[16] Since this body part represents the primary area of permanently sun-exposed skin in humans, this reinforces cumulative sun exposure as the main risk factor for BCC. However, the fact that about one-quarter of BCC lesions occur on anatomical sites that are not habitually exposed to the sun, such as the trunk, [18] indicates that discontinuous episodes of intense sunlight exposure may also play an important role in tumor pathogenesis. Epidemiological studies [19,20] have confirmed such a hypothesis and found that intermittent solar exposure (including severe sunburns, especially in childhood), rather than chronic exposure, was a more prejudicial etiological determinant in BCC carcinogenesis.…”

Section: A Ultraviolet Radiation Exposurementioning

confidence: 99%

Multiple Development of Basal Cell Carcinoma of the Skin – a Comprehensive Review

Bartoš

2019

Sisli Etfal

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B asal cell carcinoma (BCC) of the skin constitutes approximately 75% of all malignant skin tumors [1] and it is now the most common malignancy in the Caucasian population. [1, 2] The incidence rate varies significantly around the world, ranging from 2 in East Asia to 1600/100.000 per year in Queensland, Australia. [2] This oncological entity represents a heterogeneous group of tumors with a variable clinical manifestation, histomorphology, and biological behavior. Although it is usually a slow-growing neoplasia with only minimal metastatic potential, some subtypes grow aggressively, causing extensive tissue destruction. [1] The disease can be classified into sporadic (non-syndromic) and syndromic (hereditary) forms. In the first group, which comprises the vast majority of the cases, the affected individuals do not have any genodermatosis susceptible to developing cutaneous malignancies. BCC lesions usually occur in middle-aged and older adults. In the second group, the patients suffer from a genetic skin disorder (e.g., Gorlin-Goltz syndrome, Bazex syndrome, xeroderma pigmentosum), which predisposes them to BCC development at an early age. One of the interesting clinical features of this cancer is a marked variation in tumor number, sites, and accrual (number of tumors per year from the first presentation) between individuals. [3-5] Some patients have developed only 1 BCC lesion throughout their life with no impact on their health status. On the other hand, a significant pro-An interesting clinical feature of basal cell carcinoma (BCC) of the skin is a marked variation in tumor number, sites, and accrual. Some individuals develop only a single BCC lesion with no impact on health status, while a significant proportion is affected repeatedly with new primary tumors at various body sites. Approximately 29% of patients with a first BCC will develop at least 1 more lesion during their lifetime. The candidate predictors for multiple BCC development include younger age and a superficial BCC subtype at the time of the first diagnosis, red hair phenotype, initial or frequent tumor location on the trunk or on the upper limbs, and male gender. The pathogenesis of multiple BCC development does not seem to be related to greater UVR exposure. Individual genetic susceptibility may have a greater impact than extrinsic factors. In clinical practice, it is meaningful to estimate the probability of new BCC development in patients who have an initial lesion. A reliable prediction model for individualized risk stratification remains a subject of continued research; however, a focus on the risk factor profile is beneficial for clinical screening and may help clinicians to determine the individuals who should be followed up more closely.

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Basal cell carcinomas on sun‐protected vs. sun‐exposed body sites: a comparison of phenotypic and environmental risk factors

Abstract: BCCs on sun-protected sites arise as a result of excessive sun exposure, most likely combined with phenotypic susceptibility. The strong negative association with nevi also suggests that there are constitutional factors that underlie the propensity for BCCs to arise on these body sites.

Cited by 11 publications

References 48 publications

Early Life UV and Risk of Basal and Squamous Cell Carcinoma in New South Wales, Australia

Early Life UV and Risk of Basal and Squamous Cell Carcinoma in New South Wales, Australia

Comparison of PTCH1, COX‐2, p53, and Ki‐67 protein expression in basal cell carcinomas of nodular and superficial subtypes arising on the head and trunk

Multiple Development of Basal Cell Carcinoma of the Skin – a Comprehensive Review

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