Non-melanoma skin cancer and solar keratoses. I. Methods and descriptive results of the South Wales Skin Cancer Study

Abstract

Summary This study aimed to describe the prevalence and incidence of solar keratoses and skin cancers and the natural history of solar keratoses in a random population sample. It was a cross-sectional study, with follow-up, conducted in South Wales, and involved 1034 subjects aged 60 years and over drawn from the Family Health Services Authority register. The main outcome measures were detection of the presence of solar keratoses and skin cancers on sun-exposed skin and photographic validation of solar keratoses and biopsy confirmation of cancers wherever possible. We found that solar keratosis prevalence was 23% (95% confidence interval 19.5-26.5) and that of skin cancer (all types) 2% (95% confidence interval 1.0-3.5). The incidence rate of solar keratoses was 149 lesions per 1000 person-years and of non-melanoma skin cancer 9 per 1000 person-years. In all 21% (95% CL 16-26) of solar keratoses regressed spontaneously during follow-up. None underwent malignant change. We believe that the failure of individuals to seek medical advice and the variable under-registration of non-melanoma skin cancer makes population-based study important. The high prevalence and incidence of malignant and pre-malignant skin lesions in this random sample raise major public health concerns. The high rate of spontaneous regression of solar keratoses and the low rate of malignant change challenges conventional views about the need for routine treatment of these lesions.

Non-melanoma skin cancer and solar keratoses II analytical results of the South Wales Skin Cancer Study

“…The methods have been described in detail previously (Harvey et al, 1996). Briefly, a random sample of 1034 subjects age 60 years and over was drawn from the South Glamorgan Family Health Services Authority (FHSA) register, and after seeking informed consent, these subjects were visited in their homes by a research registrar in dermatology.…”

“…A full introduction to previous research findings concerning skin cancer and to the present study is contained in a companion paper (Harvey et al, 1996).…”

Id3 induces a caspase-3- and -9-dependent apoptosis and mediates UVB sensitization of HPV16 E6/7 immortalized human keratinocytes

“…Different studies have estimated the AK regression rates at 21% (Harvey et al, 1996), 25.9% (Marks et al, 1986), and 29% per year (Frost et al, 2000) for new lesions, and 74% per year for prevalent lesions (Frost et al, 2000). In contrast, the rates of AK progression to SCC are much lower, with rate estimates of 0.2% (Marks et al, 1986), 0.1% (Marks et al, 1988), and 0-1.1% per year (Frost et al, 2000).…”

Prevalencia de Queilitis Actínica en Pescadores Artesanales, Valdivia, Chile

“…La historia natural de la QA puede seguir cualquiera de las siguientes opciones: regresión espontánea de la lesión, permanecer sin cambios a través del tiempo o evolucionar a un carcinoma espinocelular (CEC) invasivo. Se ha reportado una tasa de regresión espontánea de la lesión de entre un 15 % a un 55 % en un periodo de un año (Harvey et al, 1996). Sin embargo, el porcentaje de casos de QA que evoluciona en un CEC invasivo no se conoce con certeza.…”