Faculty of Medicine, University of Iceland, Saemundargata 2, Reykjavik, 101, Iceland.
Department of Dermatology, University of Connecticut, 21 South Road, Farmington, CT, USA.
Br J Dermatol. 2021 Sep;185(3):537-547. doi: 10.1111/bjd.19879. Epub 2021 May 9.
The worldwide incidence of cutaneous squamous cell carcinoma (cSCC) is increasing.
To evaluate the tumour burden of in situ and invasive cSCC in Iceland, where the population is exposed to limited ultraviolet radiation.
This whole-population study used the Icelandic Cancer Registry, which contains records of all in situ and invasive cSCC cases from 1981 to 2017. Incidence of cSCC was evaluated according to age, anatomical location, residence and multiplicity, and trends were assessed using joinpoint analysis. Age-standardized rates (WSR) and age-specific incidence rates per 100 000 person-years were calculated, along with cumulative and lifetime risks.
Between 1981 and 2017, in situ cSCC WSR increased from 1·2 to 19·1 for men and from 2·0 to 22·3 for women. Invasive cSCC WSR rose from 4·6 to 14 for men and from 0·3 to 13·2 for women. The average number of in situ cSCC lesions was 1·71 per woman and 1·39 per man. Women developed more in situ cSCCs than invasive cSCCs in almost all anatomical locations, whereas men developed more invasive cSCCs, mostly on the head and neck. The rates of in situ cSCC were higher in Reykjavik compared with rural areas. Furthermore, women more commonly developed multiple in situ lesions. For lip cSCCs, invasive lesions occurred more frequently than in situ lesions among both sexes. Joinpoint analysis showed that in situ cSCC in women exhibited the most rapid incidence increase.
cSCC has become an increasingly significant public health problem in Iceland. Tanning bed use and travelling abroad may contribute to skin cancer development. Public health efforts are needed to stem the behaviours leading to this rapid rise in cSCC.
全球皮肤鳞状细胞癌（cSCC）的发病率正在上升。
评估冰岛原位和浸润性 cSCC 的肿瘤负担，因为该国人群暴露于有限的紫外线辐射下。
这项全人群研究使用了冰岛癌症登记处的数据，该登记处包含了 1981 年至 2017 年所有原位和浸润性 cSCC 病例的记录。根据年龄、解剖部位、居住地和多发性评估 cSCC 的发病率，并使用 joinpoint 分析评估趋势。计算了年龄标准化率（WSR）和每 10 万人年的年龄特异性发病率，以及累积和终身风险。
1981 年至 2017 年间，男性原位 cSCC 的 WSR 从 1.2 升至 19.1，女性从 2.0 升至 22.3。男性浸润性 cSCC 的 WSR 从 4.6 升至 14，女性从 0.3 升至 13.2。女性平均每人发生 1.71 例原位 cSCC 病变，男性平均每人发生 1.39 例。在几乎所有解剖部位，女性发生的原位 cSCC 都多于浸润性 cSCC，而男性发生的浸润性 cSCC 则主要集中在头颈部。与农村地区相比，雷克雅未克的原位 cSCC 发病率更高。此外，女性更常发生多发性原位病变。对于唇部 cSCC，两性的浸润性病变都比原位病变更常见。joinpoint 分析显示，女性的原位 cSCC 发病率增长最快。
cSCC 已成为冰岛日益严重的公共卫生问题。晒床使用和出国旅行可能导致皮肤癌的发生。需要采取公共卫生措施来遏制导致 cSCC 迅速上升的行为。
