Skin cancer in Geraldton, Western Australia: a survey of incidence and prevalence

Abstract

A survey of the incidence and prevalence of non‐melanocytic skin cancer in Geraldton, Western Australia, was undertaken in November 1987. All residents aged 40 to 64 years whose names were on the electoral roll on August 1, 1987 were invited to undergo a whole‐body skin examination by a dermatologist. When a skin cancer was suspected, participants were referred for treatment to their usual medical practitioner. Subjects were asked to recall incident skin cancers over the preceding two years, and medical records were searched for confirmatory evidence. Histological confirmation of all lesions, both prevalent and incident, was sought and sections were obtained for a standardized review. The prevalence of confirmed non‐melanocytic skin cancer in those aged 40 to 64 years was 7.0% in men and 4.7% in women. The prevalence of basal‐cell carcinoma (BCO was 6.5% in men and 4.5% in women while the prevalence of squamous‐cell carcinoma (SCO was 1.2% in men and 0.3% in women. The estimated incidence rate of non‐melanocytic skin cancer in this age group was 1560 per 100 000 person‐years. The estimated incidence rate of BCC in men was 1335 per 100 000 person‐years, and in women 817 per 100 000, while in men the estimated incidence rate of SCC was 890 per 100 000 person‐years, and in women it was 289 per 100 000 person‐years.

Basal‐cell carcinoma in temperate and tropical Australia

“…The trend for the trunk to be a common site for BCCs has been detected in other surveys in Australia (Green, 1982;Kricker et al, 1990;Giles et al, 1988) and is believed to be due to a change in fashion and sun-exposure habits.…”

“…100,OO in the subtropical north (Kricker et at., 1990) and 1,153 in the tropics (Stenbeck et al, 1990).…”

The Majority of Cutaneous Squamous Cell Carcinomas Arise in Actinic Keratoses

“…In two studies, random biopsies of clinically diagnosed AKs were carried out and it was found that the diagnosis was incorrect in 15% of the cases in one study and in 19% of the cases in another. 11,12 In the latter study, the authors claimed that up to 25% of the AKs disappeared. In a third study, three dermatologists could not agree on the diagnosis in 16% of the cases and the authors claimed that 19% of AKs disappeared.…”

Comparison of the expression of p53, p21, Bax and the induction of apoptosis between patients with basal cell carcinoma and normal controls in response to ultraviolet irradiation

“…[9][10][11] Causes of BCC involve UV induced or inheritable p53 or patched gene mutations. [41][42][43] p53 mutations result in the loss of cell arrest and hence damaged cells are not repaired or deleted.…”

“…[9][10][11] They are derived from aberrant keratinocytes possibly related to follicular epithelium. White individuals are most frequently affected and are most at risk between 40 and 79 years of age.…”