Global mortality from conditions with skin manifestations

Boyers, Lindsay N.; Karimkhani, Chanté; Naghavi, Mohsen; Sherwood, David E.; Margolis, David J.; Hay, Roderick J.; Williams, Hywel C; Naldi, Luigi; Coffeng, Luc E.; Weinstock, Martin A.; Dunnick, Cory A.; Pederson, Hannah; Vos, Theo; Dellavalle, Robert P.

doi:10.1016/j.jaad.2014.08.022

Cited by 26 publications

(20 citation statements)

References 32 publications

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“…For example, melanoma causes significantly greater disease burden and mortality in developed regions such as North America and Europe, when compared with developing regions in Africa, Asia, and South America. 23 Melanoma NIH funding vastly exceeded all other skin conditions with almost half of total allocation and appeared overfunded when compared with disease burden. Although over 80% of malignant melanoma is diagnosed in early stages, patients with advanced disease use 34% to 55% of total cost and experience tremendous distress.…”

Section: Discussionmentioning

confidence: 99%

Comparing cutaneous research funded by the US National Institutes of Health (NIH) with the US skin disease burden

Hagstrom

Patel

Karimkhani

et al. 2015

Journal of the American Academy of Dermatology

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Section: Discussionmentioning

confidence: 99%

Comparing cutaneous research funded by the US National Institutes of Health (NIH) with the US skin disease burden

Hagstrom

Patel

Karimkhani

et al. 2015

Journal of the American Academy of Dermatology

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“…Mortality rates of SCC are not well documented . Global mortality rates for KCs, likely dominated by deaths from SCC, are estimated to be 0·52 per 100 000 in developed countries and 0·41 per 100 000 in developing countries .…”

Section: Incidence Mortality and Geographic Differencesmentioning

confidence: 99%

“…16,18 Mortality rates of SCC are not well documented. 23 Global mortality rates for KCs, likely dominated by deaths from SCC, are estimated to be 0Á52 per 100 000 in developed countries and 0Á41 per 100 000 in developing countries. 23 A U.S. study reported KC mortality rates of 0Á52 per 100 000, with rates for men threefold higher than for women, and approximately threefold higher in whites than in blacks.…”

Section: Incidence Mortality and Geographic Differencesmentioning

confidence: 99%

Cutaneous squamous cell carcinoma: an epidemiological review

2017

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Cutaneous squamous cell carcinoma (SCC) is a common cancer in white populations and its disease burden is often substantially underestimated. SCC occurs more often in men than women and increases dramatically with age; those affected often develop multiple primaries over time, which increases the burden. The main external cause is solar ultraviolet radiation (UVR), with immunosuppression being the other established risk factor, shown by the high SCC rates in organ transplant recipients. Sunbed use and certain genetic disorders and medical conditions are also associated with SCC, while associations with human papillomavirus infection and high bodyweight are not established. The presence of actinic keratoses (AKs) on sun-damaged skin is one of the strongest predictors of SCC in unaffected people and a very small proportion of AKs are SCC precursors, although the true rate of malignant transformation of AKs is unknown. The mainstay of SCC prevention is protection of the skin from undue sun exposure by use of clothing cover and sunscreen during summer or in sunny places. Educational, behavioural and multicomponent interventions directed at individuals ranging from parents of newborns, to school children and adolescents, to outdoor workers, have repeatedly been shown to be effective in improving sun-protective behaviours. Health policies can facilitate SCC prevention by setting standards for relevant behaviours to reduce UVR exposure, for example, by legislated restriction of the tanning industry. Skin cancer prevention initiatives are generally highly cost-effective and public investment should be encouraged to control the growing public health problems caused by SCC.

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“…A range of genetic factors have been associated with BCC and recurrent BCC (Madan et al, 2010), but unlike cutaneous squamous cell carcinoma, the relationship between sun exposure patterns and different types of BCC is still unclear. Although deaths from BCC are rare (Boyers et al, 2014), considerable morbidity may result due to the local aggressive nature of BCC and BCC recurrences (Hollestein et al, 2014). Trends in ageing populations means that supply of appropriate treatment such as excisional surgery may be stretched in State healthcare systems such as the UK National Health Service, and it has been estimated that the number of cases presenting to dermatologists will increase by 50% by 2030 (Madan et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Surgery Versus 5% Imiquimod for Nodular and Superficial Basal Cell Carcinoma: 5-Year Results of the SINS Randomized Controlled Trial

Williams

Bath‐Hextall

Ozolins

et al. 2017

Journal of Investigative Dermatology

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Abbreviations BCC = basal cell carcinoma; nBCC = nodular basal cell carcinoma sBCC = superficial basal cell carcinoma; PDT = photodynamic therapy RCT = randomised controlled trial Abstract -200 words Main text -2600 words Tables -1 Figures -1 References -23 2 ABSTRACT Background: We previously reported modest clinical 3-year benefit for topical imiquimod compared with surgery for superficial or nodular basal cell carcinoma (sBCC, nBCC) at low risk sites in our non-inferiority randomised controlled SINS trial. Here we report 5-year data.Methods: Participants were randomised to imiquimod 5% cream once daily (sBCC, 6 weeks; nBCC, 12 weeks) or excisional surgery (4 mm margin). Primary outcome was clinical absence of initial failure or signs of recurrence at 3 year dermatology review. Five year success was defined as 3 year success plus absence of recurrences identified through hospital, histopathology and general practitioner records. Results:Of 501 participants randomised, 401 contributed to the modified intention-to-treat analyses at year 3 (primary outcome), 383 (96%) of whom had data at year 5. Five year success rates for imiquimod were 82·5% (170/206) compared to 97·7% (173/177) for surgery (relative risk of imiquimod success 0·84, 95% CI 0·77 to 0·91, p<0.001). These were comparable to year 3 success rates of 83·6% (178/213) and 98.4% (185/188), for imiquimod and surgery, respectively. Most imiquimod treatment failures occurred in year one. Interpretation:Although surgery is clearly superior to imiquimod, this study shows sustained benefit for lesions that respond early to topical imiquimod.

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Global mortality from conditions with skin manifestations

Cited by 26 publications

References 32 publications

Comparing cutaneous research funded by the US National Institutes of Health (NIH) with the US skin disease burden

Comparing cutaneous research funded by the US National Institutes of Health (NIH) with the US skin disease burden

Cutaneous squamous cell carcinoma: an epidemiological review

Surgery Versus 5% Imiquimod for Nodular and Superficial Basal Cell Carcinoma: 5-Year Results of the SINS Randomized Controlled Trial

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