Brewster D H, Bhatti L A, Inglis J H C, Nairn E R, Doherty V R
Scottish Cancer Registry, Information Services Division, NHS National Services Scotland, Edinburgh, UK.
Br J Dermatol. 2007 Jun;156(6):1295-300. doi: 10.1111/j.1365-2133.2007.07892.x.
Historically, ascertainment of nonmelanoma skin cancer (NMSC) by cancer registries in the U.K. has been shown to be incomplete in several studies. However, recent evidence suggesting that almost all clinically diagnosed NMSCs are verified histologically, coupled with the increasing availability of electronic histopathology data to cancer registries, raises the possibility that this situation may have improved.
To assess recent trends in incidence of the main types of NMSC and carcinoma in situ (CIS) of the skin in Scotland.
The study was restricted to selected health board areas in the East of Scotland for which pathology data have been used routinely to support cancer registration since the early 1990s. Incident cases of squamous cell carcinoma (SCC) of the skin, CIS of the skin, and first ever basal cell carcinoma (BCC) were extracted from the Scottish Cancer Registry covering the period of diagnosis 1992-2003. Sex-specific, age-standardized and age-specific incidence rates were calculated for four consecutive 3-year periods of diagnosis. Estimated annual percentage changes (EAPCs) in incidence were calculated by Poisson regression modelling, with adjustment for age. The percentage distribution of SCC, BCC and CIS of the skin by anatomical site and sex was calculated for the period of diagnosis 1997-2003.
The crude incidence of SCC for the period 1995-97 was 34.7 per 100,000, comparable with the best existing Scottish estimate of 32.2 derived from a prospective survey in Glasgow during March 1995. Age-adjusted rates of SCC, first ever BCC, and CIS of the skin have all increased significantly in both sexes between 1992 and 2003 (all P < 0.001), with EAPCs ranging in magnitude from +1.4% (first ever BCC in males) to +5.1% (CIS in males). The majority of lesions arose on the head and neck area, with the exception of CIS, which in females was more commonly located on the limbs.
Ascertainment of NMSC has probably improved since the advent and use of electronic pathology data. Ongoing increases in age-adjusted incidence, combined with ageing of the population, will have major implications for the clinical workload associated with NMSC for the foreseeable future.
从历史上看，英国癌症登记机构对非黑色素瘤皮肤癌（NMSC）的确诊情况在多项研究中显示并不完整。然而，最近有证据表明，几乎所有临床诊断的NMSC都经过了组织学验证，再加上癌症登记机构越来越容易获取电子组织病理学数据，这增加了这种情况可能已经得到改善的可能性。
评估苏格兰NMSC主要类型及皮肤原位癌（CIS）发病率的近期趋势。
该研究仅限于苏格兰东部选定的卫生委员会区域，自20世纪90年代初以来，这些区域的病理学数据一直被常规用于支持癌症登记。从苏格兰癌症登记处提取了1992 - 2003年诊断期间皮肤鳞状细胞癌（SCC）、皮肤原位癌和首例基底细胞癌（BCC）的发病病例。计算了四个连续3年诊断期的性别特异性、年龄标准化和年龄特异性发病率。通过泊松回归模型计算发病率的估计年百分比变化（EAPC），并对年龄进行了调整。计算了1997 - 2003年诊断期间皮肤SCC、BCC和原位癌按解剖部位和性别的百分比分布。
1995 - 1997年期间SCC的粗发病率为每10万人34.7例，与1995年3月在格拉斯哥进行的前瞻性调查得出的现有最佳苏格兰估计值32.2相当。1992年至2003年期间，男女的SCC、首例BCC和皮肤原位癌的年龄调整发病率均显著上升（均P < 0.001），EAPC范围从+1.4%（男性首例BCC）到+5.1%（男性原位癌）。除原位癌外，大多数病变发生在头颈部区域，原位癌在女性中更常见于四肢。
自电子病理学数据出现并使用以来，NMSC的确诊情况可能有所改善。年龄调整发病率的持续上升，加上人口老龄化，在可预见的未来将对与NMSC相关的临床工作量产生重大影响。
