The Epidemiology of Skin Cancer in Queensland: The Influence of Phenotype and Environment

Abstract

SUMMARY.-On the basis of data gathered from long term residents of 3 widely separated regions of Queensland a multivariate analysis has been made to determine the influence of a number of factors in the aetiology of skin cancer and solar keratosis. Factors considered were age, sex, susceptibility to sunburn, complexion, eye colour, ancestry, occupation, clothing habits and residential district. For both sexes, both diseases and all age groups the factor " susceptibility to sunburn " proved to be the most powerful single discriminant. On the whole it appeared that the genetically based factors as a group provided more information on susceptibility than the environmental factors. The relative importance of " occupation " remains in some doubt. In the tropical area away from the coast it appears to be of considerable importance. In coastal areas its influence appears to be blunted, presumably by factors such as sports and recreation habits.AN earlier article in this series (Carmichael and Silverstone, 1961) used actuarial techniques to estimate the cumulative lifetime risk of incurring skin cancer in various parts of the coastal areas of Queensland, Australia. The proportion of males between 20 and 80 years of age who might be expected to produce at least one cancer varied from about 5 or 60 in the sub-tropical areas around Brisbane, to 12 or 130% in the tropical areas of Townsville and Cairns some 1000 miles nearer the equator (see Fig. 1). Rates for females were about 50 to 60% of those for males.These estimates were based on recorded data at the various skin cancer clinics, and while the survey would have provided reasonably accurate results it was not possible to relate the prevalence of skin cancer to the personal characteristics of those affected. The existence of such extremely high risks makes it possible, however, to conduct field surveys of the population to achieve this latter purpose. With this in view, three separate field surveys were made in areas which had widely different climatological conditions but which at the same time provided a good cross-section of the population.Procedures have been described in detail in two preliminary reports (Silverstone et al., 1963;Silverstone and Gordon, 1966) but for convenience a brief summary follows.Regional Surveys The areas studied were located on the sub-tropical coast (annual sunshine 2740 hours; annual rainfall 44 inches); the dry north-west tropical inland (sunshine 3300 hours; rainfall 17 inches); and the wet north tropical coast (sunshine 2660

Clinical and Pathological Study of 328 Cases of Actinic Keratosis in Eastern Chinese Patients

“…However, this is not the case in China. As is known, the skin phenotype is a recognized risk factor for the development of AK [7,8,9]. Moreover, AKs and squamous cell carcinomas (SCCs) are part of a clinical continuum and the boundary between them is indistinct [10].…”

Incidence of non-melanocytic skin cancer treated in Australia

“…There have been few epidemiological studies of these lesions at a community level and there has never been a population wide survey of their incidence in Australia, which purportedly has the highest rates of skin cancer in the world. [1][2][3][4][5] Because of the heightened risk to Australians, most of whom are of European origin (Aborigines account for only about 1% of the population), education campaigns have been carried out to try to decrease skin cancer by promoting behavioural changes with respect to exposure to the sun. Without routine monitoring of non-melanocytic skin cancer in the community the only evaluation of these programmes has been by assessment of behavioural end points.…”

A Comparison Between England and Wales and Sweden in the Incidence and Mortality of Malignant Skin Tumours

“…The other is in biological terms. People with pale skins have an increased risk of developing each of the 3 principal types of skin neoplasia (Gellin et al, 1965;Gellin et al, 1969;Silverstone et al, 1970). There is evidence that people, for example, of Irish origin, from comparatively high latitudes have disproportionately high rates of skin cancer both in their own1 country (Urbach et al, 1971) and among their descendants when they migrate to Australia or the United States (McGovern et al, 1971;Urbach et al, 1971).…”