Epidemiology of melanoma and squamous cell carcinoma

Date: July, 1990

Squamous cell carcinoma of the skin is customarily not reported to tumor registries. Thus, little is known about the incidence and trends of this disease. Glass and Hoover use data from a population-based registry of cases within a single prepaid health plan to describe the epidemiology of squamous cell carcinoma. The authors also compared the data on squamous cell carcinoma with data on melanoma, which has been more widely studied.

From 1960 through 1986, the incidence of squamous cell carcinoma increased approximately threefold, while the incidence of melanoma increased about fourfold. Both types of skin cancer increased at the same rate on sun-exposed areas of the body, such as the head, neck and extremities. However, melanomas of the trunk appeared to increase at a faster rate.

Although the data are subject to error, the authors believe that the data probably reflect a true increase in skin cancer rates among the middle-class, employed population. The growing popularity of outdoor recreational activities may account for the increased incidence of skin cancer.

In an accompanying editorial, Weinstock reviews the epidemiology of squamous cell carcinoma and discusses methods for reducing the morbidity and mortality caused by this malignancy. These methods include minimizing ultraviolet radiation in the environment by preservation of the ozone layer of the atmosphere; encouraging the use of sunscreens with a sun protection factor of 15 or greater; minimizing sun exposure from 10 a.m. to 2 p.m.; actively recognizing and treating precursor lesions, such as actinic keratoses, and encouraging early detection and treatment of squamous cell carcinoma. (JAMA, October 20, 1989, vol. 262, pp. 2097,2138.)

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