The Journal of clinical and aesthetic dermatology · 2025
Nonmelanoma Skin Cancer in South Florida: A Change in the Relative Incidence of Basal and Squamous Cell Carcinoma.
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Vanaria Robert J, Chaudry Aysham, Nestor Mark S
Аннотация
OBJECTIVE: Ultraviolet (UV) radiation is a major cause of nonmelanoma skin cancer (NMSC), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Due to its demographics and geographic location, Florida's population is at increased risk of NMSC. While historical epidemiology suggests BCC has a significantly greater incidence than SCC, a 2012 study in South Florida reported a reverse in this ratio, with significantly higher SCC rates, warranting further investigation.
METHODS: A South Florida dermatology database was analyzed for confirmed NMSC biopsy results from 2024. Lesions were categorized into BCC (superficial and nonsuperficial subtypes) and SCC (in situ SCC [isSCC] and invasive subtypes).
RESULTS: Among 856 NMSC lesions, 247 (28.9%) were BCC and 609 (71.1%) were SCC. Subtypes included 54 superficial BCC (6.3%), 193 nonsuperficial BCC (22.5%), 268 isSCC (31.3%), and 341 invasive SCC (39.8%).
DISCUSSION: These results align with earlier findings, contradicting the belief that BCC is the most common NMSC. SCC subtypes represented more than 70% of cases, suggesting a shift in incidence patterns. This trend may be linked to the early use of UV-B protection-dominant sunscreens, which offer less protection against UV-A, a significant factor in the development of SCC. Additionally, treating SCC-suspicious lesions as actinic keratoses in favor of biopsy for BCC-suspicious lesions may have contributed to prior findings.
CONCLUSION: Our findings challenge traditional epidemiologic teachings, showing a higher incidence of SCC than BCC. These trends may reflect historical photoprotection and/or changing biopsy practices.
METHODS: A South Florida dermatology database was analyzed for confirmed NMSC biopsy results from 2024. Lesions were categorized into BCC (superficial and nonsuperficial subtypes) and SCC (in situ SCC [isSCC] and invasive subtypes).
RESULTS: Among 856 NMSC lesions, 247 (28.9%) were BCC and 609 (71.1%) were SCC. Subtypes included 54 superficial BCC (6.3%), 193 nonsuperficial BCC (22.5%), 268 isSCC (31.3%), and 341 invasive SCC (39.8%).
DISCUSSION: These results align with earlier findings, contradicting the belief that BCC is the most common NMSC. SCC subtypes represented more than 70% of cases, suggesting a shift in incidence patterns. This trend may be linked to the early use of UV-B protection-dominant sunscreens, which offer less protection against UV-A, a significant factor in the development of SCC. Additionally, treating SCC-suspicious lesions as actinic keratoses in favor of biopsy for BCC-suspicious lesions may have contributed to prior findings.
CONCLUSION: Our findings challenge traditional epidemiologic teachings, showing a higher incidence of SCC than BCC. These trends may reflect historical photoprotection and/or changing biopsy practices.