Histologic and Demographic Profile of Nonmelanoma Skin Cancer (NMSC) in Filipinos Seen in a Tertiary Care Clinic: A Retrospective Study from 2018 To 2021

Abstract

Introduction: Nonmelanoma Skin Cancer (NMSC) is the most frequent type of malignancy in humans. It includes a variety of cutaneous malignancies that are not melanocytic in origin. Demographic and histologic characteristics are helpful in prognosticating patients with NMSC. Available data on the demographic and histologic profile of NMSCs only include Caucasians and data from developed countries. This study provides an updated profile on NMSC prevalence in Filipinos, providing an avenue to further strengthen knowledge, hasten advancement of research, and facilitate creation of better health policies and programs regarding NMSC in Filipino skin. Study design: Retrospective study. Methodology: Medical records and biopsy logbooks of patients seen at a tertiary care center in the Philippines who were diagnosed with a nonmelanoma skin cancer from 2018-2021 from the available medical records and biopsy logbooks were included in this study. One hundred sixty-five (165) patient records and 189 available slides were reviewed. Data for age were analyzed using means and standard deviation. Data for tumor location, histopathologic diagnosis and histologic characteristics were analyzed using frequencies and proportions. Results: The mean age of patients affected with nonmelanoma skin cancer at diagnosis is 62.75  15.12 years old with a range of 21 years old to 97 years old. There is female preponderance, with a sex ratio of 0.53:1. The head and neck area are the most common affected site in the patients included in this study, comprising of 135 out of 188 tumors (71.81%). The most common nonmelanoma skin cancer upon review of slides in this study is basal cell carcinoma accounting for 64.36% (121 out of 188) tumors biopsied, with the nodular type being the most common histopathologic subtype. There was no perineural and lymphovascular invasion seen in the slides reviewed. Squamous cell carcinoma was the second most common NMSC, comprising 22 patients and 22 tumors reviewed, composed mostly of well-differentiated tumors with two exhibiting acantholysis, a poor prognostic feature. Eleven (11) patients had squamous cell carcinoma-in-situ, none exhibiting eccrine gland involvement. Nine (9) patients with actinic keratosis were found on review of records and slides with 3 patients having hypertrophic actinic keratosis, a high-risk feature for progression to overt malignancy. Patients with Paget's disease were