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ARTICLE | June 24, 1992

Risk of Subsequent Basal Cell Carcinoma and Squamous Cell Carcinoma of the Skin Among Patients With Prior Skin Cancer
Margaret R. Karagas, PhD; Thérèse A. Stukel, PhD; E. Robert Greenberg, MD; John A. Baron, MD; Leila A. Mott, MS; Robert S. Stern, MD JAMA. 1992;267(24):3305-3310. doi:10.1001/jama.1992.03480240067036. Text Size: A A A

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ABSTRACT
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Objective. —The primary aims of this study were to assess risk of subsequent basal and squamous

cell skin cancer among patients with a prior history of these tumors and to examine these risks in relation to patient characteristics and life-style factors. Design. —Follow-up of participants in a randomized trial of betacarotene as a possible skin cancer preventive agent. Setting. —Clinical centers in Los Angeles, Calif, San Francisco, Calif, Minneapolis, Minn, and Hanover, NH. Participants. —Patients (n=1805) who were diagnosed as having a basal or squamous cell skin cancer between January 1980 and February 1986 and were free of skin cancer at study entry. Main Outcome Measure. —Time from study entry to first new occurrence of basal and squamous cell skin cancer. Results. —The estimated risk of developing one or more new skin cancers was 35% at 3 years and 50% at 5 years. New skin cancers tended to be of the same cell type as the previous skin cancers. For both basal and squamous cell skin cancer, risk was higher among patients who were male, were over the age of 60 years, had more prior skin cancers, had severe actinic skin damage, or who burned easily with sun exposure. Compared with those who had never smoked, the rate of subsequent squamous cell skin cancer was higher among current smokers (rate ratio, 2.01; 95% confidence interval,1.21 to 3.34) and former smokers (rate ratio,1.62; 95% confidence interval, 1.07 to 2.47) and increased with both duration and amount smoked. There was no clear relationship between smoking and basal cell skin cancer; the rate appeared lower among heavy smokers but was unrelated to duration of smoking. Conclusions. —Persons with a prior nonmelanoma skin cancer had a substantial 5-year risk of developing another tumor of the same histologic type. Number of previous skin cancers, solar damage, and skin sensitivity to sun exposure were particularly related to this risk. The increased risk of squamous cell skin cancer associated with cigarette smoking merits further study.(JAMA. 1992;267:3305-3310)

Minn. the subsequent rate of internal cancer was compared with that prevailing in the community.7. Source Department of Health Sciences Research. Comment in  The following popper user interface control may not be accessible. and 146 for basal cell carcinoma. The estimated relative risk for subsequent cancer was 0.0 (95% confidence limits. Chuang TY. or January 1.6) among patients with squamous cell carcinoma and 1. 1. These risks were not significantly different for various durations of follow-up or for sun-exposed vs sunprotected sites. Minn. 0. moved from Rochester. MAIN OUTCOME MEASURE: The relative risk of subsequent internal cancer among patients with Bowen's disease compared with that of the population base from which they arose was 1. all patients were followed up for the development of subsequent internal cancer until they died. Mayo Clinic. Rochester. 1986. PATIENTS: Enrolled were all permanent residents in the population base of Rochester. Minn. 0. Abstract OBJECTIVE: To address the subsequent risk of internal cancer in a population-based cohort of patients with Bowen's disease. RESULTS: Annual incidence rates. adjusted to the 1980 US white population. 1991] . [JAMA. DESIGN: Incident cases of skin cancers other than malignant melanoma occurring in a defined population were classified as basal cell carcinoma. 1.8 for squamous cell carcinoma. Su WP. Through medical records. A population-based study.1 (95% confidence limits. Tab to the next button to revert the control to an accessible version.9 per 100. Chute CG.The subsequent risk of internal cancer with Bowen's disease.5. squamous cell carcinoma. 0. CONCLUSIONS: We find no evidence in these population-based cohort data of and increased risk of subsequent internal cancer associated with Bowen's disease or other forms of nonmelanomatous skin cancer.5.9 (95% confidence limits. whichever came first. who developed basal cell carcinoma (n = 657).3) for patients with basal cell carcinoma. or Bowen's disease. 38.000 for Bowen's disease. or Bowen's disease (n = 71) on the basis of pathologic examination and clinical presentation from 1976 through 1984. 1. Destroy user interface controlBowen's disease and internal cancer. Bergstralh EJ. were 14. squamous cell carcinoma (n = 169).6). Incidence rates of skin cancer and subsequent cancer were computed.

Three (50%) of these individuals were found to be positive for human immunodeficiency virus. OBJECTIVE: To investigate the potential association of human immunodeficiency virus infection with the emergence of this atypical presentation of conjunctival intraepithelial neoplasia. Abstract BACKGROUND: Conjunctival intraepithelial neoplasia has traditionally been found at the limbus in elderly individuals. 1991. six were available for serologic testing. Recently. Chang TS. Scott IU. Attempts were made to contact those patients younger than 50 years for clinical evaluation and human immunodeficiency virus serologic testing. Pflugfelder SC. and December 31. Source Bascom Palmer Eye Institute. DESIGN. CONCLUSION: Human immunodeficiency virus testing and counseling should be considered in patients younger than 50 years in whom conjunctival intraepithelial neoplasia is diagnosed. AND PARTICIPANTS: Records of patients at the Bascom Palmer Eye Institute (Miami. RESULTS: Conjunctival intraepithelial neoplasia was diagnosed in 73 patients during the study period. University of Miami School of Medicine. 1993. A possible marker for human immunodeficiency virus infection? Karp CL. Florida 33136. Of the nine patients younger than 50 years. . were reviewed. USA. Fla) in whom conjunctival intraepithelial neoplasia was diagnosed between January 1.Conjunctival intraepithelial neoplasia. SETTING. this ocular tumor has been observed in younger patients.