Differences in age and topographic distribution of the different histological subtypes of basal cell carcinoma, Taubaté (SP), Brazil

Abstract

BACKGROUND Basal cell carcinoma is the most common form of cancer in humans. OBJECTIVES To identify the epidemiology of basal cell carcinoma in Taubaté-SP and verify a possible association between topography and the different histological subtypes of this tumor. METHODSThis was a cross-sectional study conducted at The University Hospital of Taubaté between 01/01/08 and 12/31/09. The study included patients with a confirmed diagnosis of basal cell carcinoma, of both genders, without age restrictions. The variables studied were incidence of basal cell carcinoma, topography, histological subtype, skin color, age and gender. We employed the chi-square test to identify the association between histological subtype and topography, and the student's t test to compare the mean age of onset for the different histological subtypes. RESULTS The study included 239 individuals. The mean age of the sample was 68.0 years. Male subjects (57.7%) and whites (87.1%) predominated in the study. The predominant histological subtype was nodular (34.7%), followed by the superficial subtype. The most frequent sites of involvement were the head and neck (areas exposed to light), with predominance of the nasal region. The superficial subtype was an exception, as it showed a strong association with unexposed areas like the trunk. The mean age of onset of superficial basal cell carcinoma also differed from that of the other histological subtypes, 63.0 and 69.0 years, respectively. CONCLUSIONThe results of this study suggest an association of the superficial histological subtype with younger patients and unexposed areas of the body, linking this type of tumor with a pattern of intermittent sun exposure, more similar to the standard photocarcinogenesis of melanoma.

Body Site Distribution and Relative Tumor Density of Different Human Cutaneous Malignancies with Emphasis on Sunlight Exposure: A Single Institution Experience

“…In SCC, the head and neck accounted for a larger proportion of lesions for men than women, and the lower limbs were affected more commonly (in our series exclusively) in women, justifying literature data [3,9,15,16,27]. In BCC, the trunk, especially the back, was more frequently involved in men than women, and in comparison, the head and neck region and lower limbs were more frequently affected in women, also corroborating the results from another author [10,11,15,16]. When we regarded the head and neck region alone, males had more commonly involved extrafacial part of the head and neck compared to women in both BCC and SCC lesions, similar to the findings of another study [3,4,9,10].…”

“…Although it is generally accepted that both BCCs and SCCs develop most frequently in the head and neck region, the percentages of tumors in this body part significantly differ among analyses conducted from various countries. Most of the published documents comprising Italian [3], Slovakian [8], Brasilian [9][10][11], Portuguese [12], and Romanian [7], or Iranian [13] studies have found, the head and neck represented 73.6-96.8% of all BCCs [3,7,8,[10][11][12][13] and 70.2-77.6% of all SCCs [3,[7][8][9]12] analyzed. In this study, this body part comprised 69% of BCCs and 81.5% of SCCs diagnosed, corroborating above-mentioned papers.…”

“…These UVR-related differences result in distinct anatomic distribution of the skin cancer types. In general, while MMs arise most commonly on the trunk and limbs [2][3][4][5][6][7], the vast majority of research papers have clearly demonstrated [3,[7][8][9][10][11][12][13] that NMSC occurs predominantly on the head and neck region. In spite of that, however, some studies [4,5,[14][15][16] have found discrepant percentages of BCCs and SCCs at individual body parts compared with the above-mentioned papers and as a consequence, the relative tumor density (RTD) has showed wide variations.…”

Non-melanoma Skin Cancer – a Clinicopathological Study of Patients with Basal Cell Carcinoma and Squamous Cell Carcinoma

“…In BCC, however, the results regard ing gender prevalence are much more controversial. While some authors [1,13,14,16] have demonstrated a higher preponderance of men, other investigators [15,18] found higher prevalence of women. In our series, a proportion of men (49.91%) and women (50.09%) affected by BCC was virtually identical.…”

“…The present data suggest that the "typical" BCC patient in northwestern Europe is becoming younger and is more often female. This inversion of prevalence may be associated with new concept of beauty, such as the "culture of tanned skin" with a ris ing demand for natural and artificial tann ing in young women [14]. Further, it could be at least partially explained by the fact that the female population is the target audience for educational campaigns against cancer, mak ing them more aware and careful about their own body [14,16].…”