Subramaniam Padmini, Olsen Catherine M, Thompson Bridie S, Whiteman David C, Neale Rachel E
Department of Population Health, QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Queensland, Australia2Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia3National Health and Medical Research Council Centre for Research Excellence in Sun and Health, Queensland University of Technology, Queensland, Australia.
Department of Population Health, QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Queensland, Australia4School of Public Health, University of Queensland, Queensland, Australia.
JAMA Dermatol. 2017 Feb 1;153(2):175-182. doi: 10.1001/jamadermatol.2016.4070.
Keratinocyte cancers (KCs), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are the most common cancers among fair-skinned populations worldwide. Although studies have indicated that the anatomical distribution of BCC and SCC differ, few have compared them directly in well-defined population samples.
To describe and compare the anatomical distribution of BCC and SCC in a population-based sample in Queensland, Australia.
DESIGN, SETTING, AND PARTICIPANTS: This study was nested within the population-based QSkin Sun and Health Study in Queensland, Australia. Of 37 103 study participants linked to national medical insurance records, 3398 diagnosed with KCs from September 1, 2010, to September 30, 2012, were identified, and information about their KCs was extracted from pathology reports. Data were analyzed from January 1, 2013, to March 30, 2016.
The relative tumor densities (RTDs) on defined body sites, calculated by dividing the proportion of tumors occurring at a specified site by the proportion of skin area of that site.
A total of 5150 KCs with complete data were identified in 2374 study participants (1339 men [56.4%] and 1035 women [43.6%]; mean [SD] age, 59.7 [7.4] years). Of these, 3846 KCs (74.7%) were BCCs. Most BCCs were on the head and/or neck (1547 [40.2%]) and the trunk (1305 [33.9%]); most SCCs were on the head and/or neck (435 [33.4%]) and upper limbs (455 [34.9%]). The greatest differences in RTDs between BCC and SCC were on the hand (BCC:SCC ratio, 1:14) and the back and/or buttocks (BCC:SCC ratio, 8:1). Relative tumor densities of KCs were higher on the scalp and ear in men compared with women, and on the upper arm in women compared with men. The pattern of RTDs did not differ with age for BCC. Compared with younger adults (40-54 years), the RTDs in older adults (55-69 years) were 2-fold higher for SCC on the scalp (0.38 [95% CI, 0.00-0.81] vs 1.07 [95% CI, 0.75-1.38]) and the back and/or buttocks (0.05 [95% CI, 0.00-0.12] vs 0.12 [95% CI, 0.07-0.16]).
The high RTDs on sun-exposed body sites for BCC and SCC are in keeping with sun exposure as the primary etiologic factor for both tumors. However, for BCC, the low RTD on the hand and high RTDs on less sun-exposed sites suggest a complex association between sun exposure and occurrence of BCC. Knowledge about the anatomical distribution of BCC and SCC may provide insight into their diagnoses and causes.
角质形成细胞癌（KCs），包括基底细胞癌（BCC）和鳞状细胞癌（SCC），是全球白种人群中最常见的癌症。尽管研究表明BCC和SCC的解剖分布有所不同，但很少有研究在明确界定的人群样本中对它们进行直接比较。
描述并比较澳大利亚昆士兰州基于人群样本中BCC和SCC的解剖分布。
设计、背景和参与者：本研究嵌套于澳大利亚昆士兰州基于人群的QSkin阳光与健康研究中。在与国家医疗保险记录相关联的37103名研究参与者中，确定了2010年9月1日至2012年9月30日期间被诊断为KCs的3398人，并从病理报告中提取了他们KCs的相关信息。数据于2013年1月1日至2016年3月30日进行分析。
通过将特定部位发生肿瘤的比例除以该部位皮肤面积的比例来计算特定身体部位的相对肿瘤密度（RTDs）。
在2374名研究参与者（1339名男性[56.4%]和1035名女性[43.6%]；平均[标准差]年龄为59.7[7.4]岁）中，共确定了5150例有完整数据的KCs。其中，3846例KCs（74.7%）为BCC。大多数BCC位于头部和/或颈部（1547例[40.2%]）和躯干（1305例[33.9%]）；大多数SCC位于头部和/或颈部（435例[33.4%]）和上肢（455例[34.9%]）。BCC和SCC之间RTDs的最大差异在于手部（BCC与SCC的比例为1:14）以及背部和/或臀部（BCC与SCC的比例为8:1）。男性头皮和耳部KCs的相对肿瘤密度高于女性，女性上臂KCs的相对肿瘤密度高于男性。BCC的RTD模式在不同年龄组之间没有差异。与年轻成年人（40 - 54岁）相比，老年成年人（55 - 69岁）头皮上SCC的RTDs高出2倍（0.38[95%CI，0.00 - 0.81]对1.07[95%CI，0.75 - 1.38]），背部和/或臀部SCC的RTDs也高出2倍（0.05[95%CI，0.00 - 0.12]对0.12[95%CI，0.07 - 0.16]）。
BCC和SCC在阳光暴露身体部位的高RTDs与阳光暴露作为这两种肿瘤的主要病因因素相符。然而，对于BCC，手部的低RTD和较少阳光暴露部位的高RTD表明阳光暴露与BCC发生之间存在复杂关联。了解BCC和SCC的解剖分布可能有助于深入了解它们的诊断和病因。
