Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.
Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands3Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands.
JAMA Dermatol. 2017 Jan 1;153(1):71-78. doi: 10.1001/jamadermatol.2016.3628.
The number of very elderly (≥80 years) is rapidly growing worldwide. Basal cell carcinoma (BCC) are common in this age group and treatment is often challenging in this population.
Obtaining an overview of the epidemiology and clinicopathological features of BCC in the very elderly to guide clinicians and policy makers.
A systematic review of literature was performed using PubMed, Excerpta Medica Database (EMBASE), and the Cochrane Library. Study selection, quality assessment, and data extraction was performed by 2 independent reviewers. For quality assessment (including the risk of bias) the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist was used, combined with the Quality Rating Scheme for Studies and Other Evidence. Data were described though a narrative synthesis and tabulation.
Of 13 628 studies identified, 83 studies were included and quality assesment was performed for 76 studies; 27 studies (representing >350 000 patients) were found that included age-specific incidence rates of BCC in the very elderly. High and increasing incidence rates of BCC in the very elderly were found ranging from 13 to 12 112 per 100 000 person-years, strongly depending on factors like study population and clinical setting. Basal cell carcinoma in the very elderly were more common in men, mostly of the nodular subtype, and located in the head and neck region. Interpretation and generalization of the data was limited by the heterogeneity of study populations, methods, and outcomes. Data concerning impact on health-related quality of life (HRQoL) and prognostication were scarce.
The incidence of BCC among the very elderly is high and increasing. Epidemiologic and clinicopathological data from current literature provide only limited guidance in clinical decision making owing to heterogeneity and scarcity. Future research should focus more specifically on BCC in the very elderly, together with prognostication and their relation with HRQoL in both the short and longer term.
全球非常高龄（≥80 岁）人口数量正在迅速增长。基底细胞癌（BCC）在该年龄段很常见，治疗在该人群中常常具有挑战性。
综述非常高龄人群中基底细胞癌的流行病学和临床病理特征，为临床医生和决策者提供指导。
使用 PubMed、Excerpta Medica Database（EMBASE）和 Cochrane 图书馆对文献进行系统回顾。两名独立审查员进行了研究选择、质量评估和数据提取。为了进行质量评估（包括偏倚风险），使用了 STROBE 清单结合研究和其他证据的质量评分方案。数据通过叙述性综合和制表进行描述。
在确定的 13628 项研究中，纳入了 83 项研究，对 76 项研究进行了质量评估；发现了 27 项研究（代表超过 350000 名患者），这些研究包括非常高龄人群中基底细胞癌的年龄特异性发病率。在非常高龄人群中，BCC 的高且不断增加的发病率从每 100000 人年 13 例到 12112 例不等，强烈取决于研究人群和临床环境等因素。非常高龄人群中的基底细胞癌在男性中更为常见，主要为结节型，位于头颈部。由于研究人群、方法和结果的异质性，对数据的解释和概括受到限制。关于对健康相关生活质量（HRQoL）的影响和预后的数据稀缺。
非常高龄人群中基底细胞癌的发病率很高且呈上升趋势。当前文献中的流行病学和临床病理数据由于异质性和稀缺性，仅为临床决策提供了有限的指导。未来的研究应更具体地关注非常高龄人群中的基底细胞癌，以及短期和长期的预后及其与 HRQoL 的关系。
