Materiały źródłowe

• #1 Basal Cell Carcinoma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482439/

  Basal cell carcinoma is the most common cutaneous malignancy, affecting close to one in five Americans. […] BCC is the most common skin cancer in humans, with increasing incidence rates worldwide. Men generally have higher rates of BCC than women. […] Over the last 30 years, estimated incidence rates have risen between 20% and 80%. Incidence rates for BCC also increase with age, with the median age of diagnosis being 68 years. […] The most common predictor of BCC development is a history of squamous cell carcinoma (SCC) or BCC. Patients are at least ten times more likely to develop a second BCC if they have a BCC history compared to patients without a history of non-melanoma skin cancer. […] Mortality from BCC is uncommon and occurs primarily in immunocompromised patients. […] The estimate for age-adjusted mortality rate is 0.12 per 100 000. The mortality risk is related to increasing age, male gender (greater than twice the rate of occurrence compared with women), and White race phenotype.

• #2 Basal Cell Carcinoma: Pathogenesis, Epidemiology, Clinical Features, Diagnosis, Histopathology, and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4445438/

  Basal cell carcinoma (BCC) is the most common malignancy. Exposure to sunlight is the most important risk factor. […] BCC is the most common malignancy. Cancer registries do not collect data on this skin cancer, so the prevalence and incidence is difficult to estimate. According to the American Cancer Society, more than 2 million people were treated in 2006 for non-melanoma skin cancer (NMSC), mostly BCC. A recent study predicted the total number of NMSCs in those 2 million people during the same time period to be approximately 3.5 million. The lifetime risk for the development of skin cancer is estimated to be 1 in 5 with more than 97 percent being NMSC. […] A population-based study in Rochester, Minnesota, estimated the age-standardized annual incidence for BCC in both Caucasian men and women to be 146 cases per 100,000 persons. Another population-based study in Kauai, Hawaii, estimated the combined incidence in Caucasian residents to be 422 cases per 100,000 people, the highest documented incidence in the United States at the time of publication in 1993. Both studies showed rate increased with age and men had a significantly higher incidence of BCC than women. The incidence among Americans younger than 40 appears to be increasing, particularly among women.

• #3 Skin Cancer Facts & Statistics

  https://www.skincancer.org/skin-cancer-information/skin-cancer-facts/

  Basal cell carcinoma (BCC) is the most common form of skin cancer. An estimated 3.6 million cases of BCC are diagnosed in the U.S. each year. […] More than 419,000 cases of skin cancer in the U.S. each year are linked to indoor tanning, including about 245,000 basal cell carcinomas. […] Any history of indoor tanning increases the risk of developing basal cell carcinoma before age 40 by 69 percent.

• #4 Basal Cell Carcinoma: a Review  – Clinical Advisor

  https://www.clinicaladvisor.com/features/basal-cell-carcinoma-risk-diagnosis-treatment/

  Basal cell carcinoma is the most common type of skin cancer in the United States with an estimated 3.6 million new cases diagnosed annually. […] The incidence of basal cell carcinoma is on the rise and increased by 145% between 1976-1984 and 2000-2010. […] Basal cell carcinoma is more common in White populations and an inverse relationship between BCC incidence and darker skin pigment is found. […] BCC incidence is higher in men than women. […] UV radiation exposure, childhood sunburns, age older than 50 years, fair skin tone, blonde or red hair, light eye color, history of skin cancer, environmental exposure, and genetics are all known risk factors for the development of BCC. […] Research suggests that BCC risk is associated with timing, intensity, and pattern of UV radiation exposure.

• #5 Epidemiology of BCC

  https://www.dermatologytimes.com/view/epidemiology-bcc

  Basal cell carcinoma (BCC) is the most common cancer in the world, with the overall incidence significantly rising across the globe by about 3 to 10% annually. […] Basal cell carcinoma (BCC) is the most common cancer in the world, with about a third of individuals developing a BCC at one point in their lifetime, according to David Hogg, M.D., professor of medicine at the University of Toronto in Toronto, Canada. […] The incidence is unfortunately increasing, with the overall incidence significantly rising across the globe by about 3 to 10% annually. Squamous cell carcinomas represent about 20%, and BCCs represent 80% of non-melanoma skin cancers. The development of BCC is strongly linked to exposure to ultraviolet radiation, with the UV exposure resulting in cumulative DNA damage and gene mutations. The rising incidence of BCCs has also been attributed to increased longevity.

• #6 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Basal-Cell-Carcinoma-Epidemiology.aspx

  Basal cell carcinoma is the most common type of skin cancer in the United States and Australia and was first described by Arthur Jacob in 1827. The incidence of basal cell carcinoma is highest in Australia, where there are 726 cases per 100,000 people per year. Both genetics and sun exposure are thought to contribute to this high incidence. […] In England, the incidence of basal cell carcinoma has increased from 173.5 to 265.4 per 100,000 inhabitants every year over the last 10 years. […] Over the last few decades, the number of people affected by basal cell carcinoma has been on the increase. Among white individuals, the annual incidence has increased by an average of 3.7% in the U.S., Canada and Australia and in the U.S., the incidence is twice that of 20 years ago. […] Estimates suggest that nearly half of fair-skinned individuals over 60 years old will develop some type of skin cancer.

• #7 Epidemiology of basal cell carcinoma in the United Kingdom: incidence, lifestyle factors, and comorbidities | British Journal of Cancer

  https://www.nature.com/articles/bjc2014265

  Little is known about the epidemiology of basal cell carcinoma (BCC). […] Incidence rose significantly between 2000 and 2011. Basal cell carcinoma risk was increased in alcohol drinkers (slightly) and immunocompromised patients, but reduced in smokers and individuals with abnormal weight. […] Basal cell carcinoma places a growing public health burden. […] Cutaneous basal cell carcinoma (BCC) represents the most common malignancy in Caucasian populations, and the incidence is rising. […] The observed BCC incidence in the UK is considerably high, particularly in the elderly. […] Projecting the crude IR in the CPRD population to the total UK population aged 18 years or older, we estimate that approximately 110000 adults developed BCC for the first time in 2011 alone. […] Along with sun exposure, immunosuppression is an important factor in tumour pathogenesis, whereas lifestyle factors do not appear to have a major role.

• #8 The incidence and clinical analysis of non-melanoma skin cancer | Scientific Reports

  https://www.nature.com/articles/s41598-021-83502-8

  Non-melanoma skin cancers (NMSCs) are the most common malignancies diagnosed in Caucasian populations. Basal cell carcinoma (BCC) is the most frequent skin cancer, followed by squamous cell carcinoma (SCC). […] To evaluate the incidence of primary BCCs and SCCs regarding age, sex, tumour site and tumour subtype to determine trends in epidemiology of both cancers. […] BCC represented 85.2% of all cases. SCC patients were older than BCC patients (77.111.3 years vs. 70.112.3 years, p0.01). […] BCC and SCC are common malignancies developing at various ages and anatomical sites. These data underline the need for better registration policies regarding NMSC in order to improve prevention and treatment strategies for these tumours. […] The data gathered from the Polish National Health Fund database showed an increasing trend of NMSC diagnoses between 1999 and 2019.

• #9 The incidence and clinical analysis of non-melanoma skin cancer | Scientific Reports

  https://www.nature.com/articles/s41598-021-83502-8

  The trend continued after 2014, although the growth rate slowed down with the annual increase rate not exceeding 2%. […] Over the 21-year study period, 10,083 patients were diagnosed with at least one excised and histologically confirmed BCC or SCC. […] The mean age of patients with BCC was 70.112.3 years (range 18101 years), whereas of patients with SCC was 77.111.3 years (range 19102 years) (p0.01). […] The incidence of high-risk BCC, including the infiltrative, micronodular, and morpheaform subtypes, was higher in our study than in previously reported European and Australian data. […] A significant increase in infiltrative subtype was observed in all sites (threefold increase between 2010 and 2019). […] The rising trend in the incidence of BCCs and SCCs may be due to numerous factors.

• #10 Basal Cell Carcinoma: Pathogenesis, Epidemiology, Clinical Features, Diagnosis, Histopathology, and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4445438/

  There is a geographic variation in incidence of BCC with a positive correlation between rate and proximity to the equator. This observation can be explained by higher UV radiation exposure at lower latitudes, such as Hawaii, compared to higher latitudes, as in the Midwest. […] The consumption of arsenic-contaminated water and arsenic-containing medications has been associated with an increased risk of BCC. […] Immunosuppression in organ transplant recipients increases the risk of NMSC in proportion to the duration of immunosuppressive therapy. […] Certain genetic syndromes are associated with the development of BCCs. The most common is NBCCS, in which patients can develop hundreds of BCCs and a variety of developmental abnormalities.

• #11 Basal cell carcinoma: Epidemiology – Journal of Skin and Sexually Transmitted Diseases

  https://jsstd.org/basal-cell-carcinoma-epidemiology/

  Basal cell carcinoma is the most common skin cancer in white skinned individuals with a rising incidence observed worldwide. […] Recent years have seen a rise in the incidence of both SCC and BCC. This increase is more pronounced for SCC. […] A systematic review that analyzed the data from 38 different countries worldwide over the period 19552007 found the highest annual incidence rate for BCC in Australia (1000/100,000 person-years) and the lowest rates in parts of Africa (1/100,000 person-years). […] A population-based study in Olmsted County, Minnesota (20002010) recorded the incidence of BCC as 360/100,000 persons for men and 292.9 for women. […] European age-standardized incidence rate for BCC as documented in United Kingdom in 20132015 was 285/100,000 person-years. […] Non-melanoma skin cancers are rare in Asians, probably due to the protective effect of melanin against the deleterious effects of UV light.

• #12 Basal Cell Carcinoma: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/276624-overview

  The American Cancer Society (ACS) reports skin cancer as being the most common cancer in the United States, with basal cell carcinoma (BCC) constituting the majority of cases. The ACS cites an estimate that about 5.4 million basal and squamous cell skin cancers are diagnosed each year in about 3.3 million persons in the US, with about 80% of those being BCCs. Although the number of these skin cancers has been increasing for years, death from them remains uncommon: non-melanoma skin cancers are estimated to cause about 2000-8000 deaths annually (mostly from squamous cell skin cancers), and that number has been decreasing in recent years. […] The estimated lifetime risk for BCC in the White population is 33-39% for men and 23-28% for women. BCC incidence doubles every 25 years. […] In the US states near the equator, such as Hawaii, BCC incidence is approaching three-fold that of states in the Midwest, such as Minnesota. BCC incidence also varies globally. The highest rates of skin cancer occur in South Africa and Australia, areas that receive high amounts of UV radiation. Australia has a trend toward increasing BCC incidence, while Finland has a low reported incidence that is approximately one quarter that in Minnesota; BCC incidence in Finland also appears to be increasing, however, especially among young women.

• #13 Basal Cell Carcinoma: Symptoms, Causes, and Treatment

  https://patient.info/doctor/basal-cell-carcinoma

  Basal cell carcinoma predominantly affects Caucasians and is very uncommon in dark-skinned races. BCC is the most common type of carcinoma worldwide and is showing a worldwide increase in incidence. […] An Australian study showed an incidence for superficial basal cell carcinoma of 336/100,000 men and 251/100,000 women per annum. […] Inconsistent data collection means that accurate figures for the incidence in the UK are difficult to obtain. […] There is a regional variation in incidence – eg, approximately 120/100,000 in South West England compared with an incidence for the whole of England of approximately 90/100,000 population. […] Superficial basal cell carcinoma occurs at a younger age than other BCC variants, particularly in women.

• #14 Basal cell carcinoma: Epidemiology – Journal of Skin and Sexually Transmitted Diseases

  https://jsstd.org/basal-cell-carcinoma-epidemiology/

  Incidence rate of BCC in colored skin ranged from 1.5 to 15.57/100,000 population in previous studies. […] A study from Singapore noted age-standardized incidence rates of 6.9, 2.6, and 1.4/100,000 person-years for BCC among the Chinese, Malays, and Indians, respectively, in 2016. […] The same study found that the age-standardized incidence rates for BCC were 2.7, 1.2, and 0.5 tumors/100,000 person-years, respectively, among the Chinese, Malays, and Indians in 1968, showing a clear increase in incidence, which was more pronounced for the Chinese. […] Advancing age is an independent risk factor for BCC with a doubling in incidence from 40 to 70 years. […] The mean age of the affected varied from 60 to 65 years in most of the studies, but a mean age of 70.1 years was documented in a study on 11,548 patients with BCC, which gathered the data from the Polish National Health Fund database (19992019).

• #15 Epidemiology, prevention, screening and surveillance of NMSC

  https://oncologypro.esmo.org/education-library/esmo-books/essentials-for-clinicians/melanoma-other-skin-cancers/epidemiology-prevention-screening-and-surveillance-of-nmsc

  NMSCs make up the greatest proportion of all human cancers, with an incidence of 8% worldwide. […] Common NMSCs comprise basal cell carcinoma (BCC) arising from basal cells: 57%-80% of all NMSCs, and cutaneous squamous cell carcinoma (cSCC) arising from epidermal keratinocytes: 20%-25% of all NMSCs. […] BCCs more often arise in males (ratio 2.1:1) and elderly patients; the median age at diagnosis is 67 years. […] Around 80% of all BCCs are located in the head and neck region, followed, more rarely, by the hands. […] High-risk patients should be screened regularly with a whole-body examination, e.g. at 3-month intervals after organ transplantation or after previous high-risk NMSC.

• #16 Basal cell carcinoma: Epidemiology – Journal of Skin and Sexually Transmitted Diseases

  https://jsstd.org/basal-cell-carcinoma-epidemiology/

  However, recent years have witnessed a rise in incidence of BCC among those below 40 years. […] Many Indian studies have noted a female preponderance. […] This is attributed to the long hours spent in sun by women in rural areas, while doing agriculture work and homestead activities, and caring for farm/domestic animals. […] A female predilection is noted for BCC among African Americans also. […] A patient with a history of BCC has a 17-fold higher risk for a second BCC in comparison to general population. […] It is reported that patients with a keratinocyte carcinoma (BCC or SCC) often develop another BCC or SCC and different signs of photodamage such as solar keratosis and actinic keratosis. […] With the rising trend noted in BCC, we are expected to see more cases in the coming years.

• #17 Advanced Basal Cell Carcinoma: Epidemiology and Therapeutic Innovations | springermedizin.de

  https://www.springermedizin.de/advanced-basal-cell-carcinoma-epidemiology-and-therapeutic-innov/9273274

  BCC comprises the majority of non-melanoma skin cancers (NMSCs) and is more common than all other human malignancies combined. Several lines of evidence suggest that the worldwide incidence of BCCs is increasing. In the United States, the diagnosis and treatment of NMSCs has increased dramatically with a growth rate of 77 % over the past two decades. The fastest growing group is in women under the age of 40 years. […] More than 2.8 million new cases of BCC are diagnosed each year in the United States alone, and are estimated to result in over 3,000 deaths. […] Given the high incidence of BCCs, this recurrence rate results in a large number of BCCs that are not cured by surgical excision. Furthermore, BCCs that are extensive and infiltrate structures below the skin or abut vital structures such as the brain or eyes may be difficult to surgically clear without significant morbidity. Many of these may become locally advanced or metastasize. BCCs that metastasize to either local or distant lymph nodes or distant organs would best be addressed through systemic therapy. Together, these locally advanced or metastatic BCCs comprise a disease group termed advanced BCCs (aBCCs). While accurate estimates of the incidence of aBCCs are difficult to obtain, in part due to the lack of widespread use of a staging system by dermatologists and lack of uniform reporting requirements for NMSCs, aBCCs are thought to represent roughly 110 % of all BCCs, with metastatic BCCs accounting for 0.00280.5 %.

• #18 Basal Cell Carcinoma | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116072/all/Basal_Cell_Carcinoma?q=Alternative+Complementary+Medicine+and

  Basal cell carcinoma (BCC) is the most common type of skin cancer, originating from the basal cell layer of the skin appendages. […] Most common cancer in Europe, Australia, and the United States; the most common type of skin cancer. […] Over 2 million new cases each year in the United States; 2.5 times more common than squamous cell carcinoma (SCC). […] White individuals have a 1 in 5 chance of developing BCC during their lifetime. […] Most common skin cancer in Asian and Hispanic individuals; second most common skin cancer in African American/black individuals. […] Predominant age: generally 60 years. […] Predominant sex: male female (2:1 ratio).

• #19 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Basal-Cell-Carcinoma-Epidemiology.aspx

  The rise in the number of newly diagnosed cases may be attributed to a greater awareness and understanding of the condition, with healthcare professionals making greater efforts to diagnose and refer patients. […] Previous data has shown that men are more commonly affected by basal cell cancer than women. However, recent studies suggest a rise in the amount of females being diagnosed, possibly due to an increase in the use of sun beds and to an increased tendency to seek dermatological care and early medical attention.

• #20 What Are Basal and Squamous Cell Skin Cancers? | Types of Skin Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/basal-and-squamous-cell-skin-cancer/about/what-is-basal-and-squamous-cell.html

  Basal cell carcinoma (BCC, also called basal cell skin cancer, or just basal cell cancer) is most common type of skin cancer. About 8 out of 10 skin cancers are basal cell carcinomas. […] These cancers start in the basal cell layer, which is the lower part of the epidermis. […] BCCs usually develop on sun-exposed areas, especially the face, head, neck, and arms. They tend to grow slowly. Its very rare for a basal cell cancer to spread to other parts of the body. But if BCC is left untreated, it can grow into nearby areas and invade the bone or other tissues beneath the skin. […] If not removed completely, BCC can come back (recur) in the same place on the skin. People who have had basal cell skin cancers are also more likely to get new ones in other places. […] Wu PA. Epidemiology, pathogenesis, clinical features, and diagnosis of basal cell carcinoma. UpToDate. 2023. Accessed at https://www.uptodate.com/contents/epidemiology-pathogenesis-clinical-features-and-diagnosis-of-basal-cell-carcinoma on August 16, 2023.

• #21 Basal Cell Carcinoma: Diagnosis, Management and Prevention

  https://www.mdpi.com/2673-5261/5/2/10

  It is a widely recognized fact that, with the advancing years of life, there is a rise in the cases of these tumours. Age is taken as an independent risk factor. An estimated 90% of patients are aged ≥ 60 years. The number of cases increases by 100% when reaching the age of 70 years (from 40 years). […] It is typically recognized in white people (skin type 1 or type 2), who have a positive tumour history in the family. Those living at higher altitudes and in the equatorial regions (subject to more radiation) demonstrate greater incidence rates, while Asians, Blacks and Hispanics tend to have a comparatively lower incidence. […] Males outnumber women with a ratio of 1.5–2:1. The potential reason is the greater sun exposure of males during outdoor work and sports activities. […] A proportion of 70–80% of lesions are encountered above the torso on the face, neck and scalp, following that, the trunk (~one-quarter) and the perineum, including the genitalia (about 5%).

• #22 Basal Cell Carcinoma: Diagnosis, Management and Prevention

  https://www.mdpi.com/2673-5261/5/2/10

  Certain histological variants occur preferentially at specific anatomical sites, the torso being a favourable location for the superficial subtype, particularly at ≤40 years of age. This supports the premise that intermittent sun exposure causes superficial BCC. Nodular BCC, in contrast, is predominantly noticed on the face, holding up the concept that links chronic cumulative sun exposure to the nodular type of BCC.

• #23 Learn More About Basal Cell Carcinoma (BCC)

  https://www.advancedskincancers.com/bcc/what-is-advanced-bcc

  BCC is the most common type of skin cancer worldwide, representing up to 80% of NMSC. […] BCC often manifests as an enlarging, nonhealing lesion that may sometimes cause pruritus and tends to grow slowly. […] UV exposure is a major risk factor for developing BCC. […] Based on an analysis of BCC incidence, this cancer appears frequently on the head and neck. […] While most patients with early-stage BCC are effectively treated with complete surgical excision and/or radiation, a small percentage of patients progress to advanced BCC. […] of the >2 million new cases of BCC progress to advanced disease each year in the United States—and some of these cases are not amenable to surgery or radiation. […] Advanced BCC includes both locally advanced as well as metastatic disease. While the definition of locally advanced BCC may vary, it generally includes large, deep, aggressive, or recurrent tumors and/or those for which surgery or radiation are inappropriate. Metastatic BCC is more uncommon, but it can arise with greater frequency in large, untreated, or aggressive primary tumors or with recurrent tumors.

• #24 Basal Cell Carcinoma: Pathogenesis, Epidemiology, Clinical Features, Diagnosis, Histopathology, and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4445438/

  The risk of developing a subsequent BCC after an initial diagnosis of NMSC is substantial. Patients with one index BCC developed one, two, or three new BCCs in 33 percent, 14 percent, and 7 percent of cases, respectively, within 1 year, the time frame in which the highest risk was observed during a 3-year study. […] A more recent meta-analysis suggested the risk may be even higher. It estimated the 3-year cumulative risk is 44 percent or at least a tenfold increase in incidence compared to the general comparable population. […] Sun exposure is the most important environmental cause of BCC. The risk of BCC appears to depend on the nature of this exposure. A population-based, case-control study conducted in Alberta, Canada, revealed an increased risk with recreational sun exposure in childhood and adolescence, suggesting that these life periods may be critical for establishing adult risk for BCC.

• #25 BASAL CELL CARCINOMA | Hand Surgery Resource

  https://www.handsurgeryresource.net/basal-cell

  Basal cell carcinoma (BCC) is a malignant neoplasm originating from the basal cells of the epidermis. It accounts for ~80% of all skin cancers, making it the most common type of skin cancer, as well as the most common cancer overall. […] The incidence of BCC jumped from 20% to 80% over the last 30 years and is increasing annually by ~4-8%. BCCs currently affects ~2.8 million people each year. […] BCCs are most common in Fitzpatrick skin types I and II, and these populations have an estimated lifetime risk of 30%. […] The incidence rate for BCC increases with age, with most cases occurring over the age of 40 years and the median age for diagnosis being 68 years. […] The low occurrence of BCCs on the hands and upper extremities is odd, as other types of skin cancers like squamous cell carcinoma occur just as frequently in these areas as they do on other sun-exposed parts of the body.

• #26 Basal Cell Carcinoma: a Review  – Clinical Advisor

  https://www.clinicaladvisor.com/features/basal-cell-carcinoma-risk-diagnosis-treatment/

  Other risk factors for BCC include exposure to ionizing radiation or arsenic (via contaminated water, food, or medications), chronic immunosuppression (HIV infection or immunosuppressive medication following solid organ transplantation), use of photosensitizing drugs, and genetic predisposition. […] Melanocortin-1 receptor (MC1R) gene polymorphisms have been linked to BCC risk and somatic patched 1 (PTCH1) gene mutations are found in 70% to 75% of BCCs.

• #27 Nevoid Basal Cell Carcinoma Syndrome | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/nevoid-basal-cell-carcinoma-syndrome

  Basal cell carcinomas can appear in early childhood, but more often appear between puberty and 35 years of age, with the mean age of onset at age 25. […] Basal cell carcinomas are typically treated by surgical removal when the number of lesions is limited. Other therapies may be utilized, but radiation therapy should always be avoided in individuals with nevoid basal cell carcinoma syndrome as new tumors can arise in the radiation fields even after many years. […] Annual dermatologic examination until first basal cell carcinoma. After first BCC, repeat every 6 months or more frequently as needed. […] In addition to the recommended cancer surveillance guidelines, children and adults with nevoid basal cell carcinoma syndrome should be encouraged to lead as healthy a lifestyle as possible with avoidance of exposure to the sun and ionizing radiation, which increase the likelihood of developing basal cell carcinomas. […] Early treatment of basal cell carcinomas is essential to prevent cosmetic problems. The priorities of treatment are to ensure complete eradication of aggressive basal cell carcinomas, and to preserve normal tissue to prevent disfigurement.

• #28 Basal Cell Carcinoma: Comprehensive Review with Emphasis on Scar Tissue Manifestation and Post-Vaccination Incidence

  https://www.mdpi.com/2227-9059/12/8/1769

  Basal cell carcinoma (BCC) cases comprise approximately 80% of malignant skin neoplasms. In Europe, the incidence is allegedly estimated at 400–800/100,000. The BCC rate frequency epitomizes an instance of an inadequately reported disease whose prevalence is undoubtedly higher. The epidemiological research indicates a 10% increase in incidence every ten years. Typically, the onset of the disease occurs between the sixth and eighth decade of life with a slight male predominance. However, an expanded prevalence has been registered among the younger population, mainly women, which stems from increased UV exposure to artificial sources of the sun or inappropriate sunbathing. The risk factors for BCC development encompass phototypes I and II according to Fitzpatrick’s scale, excessive exposure to UV radiation (particularly UVB), alterations in immunosurveillance, radiation therapy, HIV and HPV infections. Furthermore, excessive sun exposure in childhood has a pivotal role in BCC development. Increased risk of BCC occurs in patients with genetic syndromes such as xeroderma pigmentosum, epidermolysis bullosa, Ferguson-Smith syndrome, Rasmussen syndrome, Muir–Torre syndrome, Rombo syndrome, Bazex–Dupré–Christol syndrome, albinism, and Darier’s disease. Moreover, historically, microinjuries, long-lasting scars, non-healing ulcerations, deep abrasions, surgical incisions, and persistent skin irritation were considered contributory factors for SCC, but increasingly, these factors are also recognized as contributing to BCC development.

• #29 Basal Cell Carcinoma: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/276624-overview

  The 5-year recurrence rate is about 5%, but it depends on the histologic subtype and type of treatment; the recurrence rate is less than 1% for primary (previously untreated) BCCs treated with Mohs micrographic surgery. Most reports show that the distance to the closest resection margin is an important predictor of recurrence. […] The following is a list of treatments and their 5-year recurrence rates for primary (previously untreated) BCCs: Surgical excision – 10.1%; Radiation therapy – 8.7%; Curettage and electrodesiccation – 7.7%; Cryotherapy – 7.5%; All non-Mohs modalities – 8.7%; Mohs micrographic surgery – 1%. […] Recurrences usually occur 4-12 months after initial treatment. One meta-analysis found that the 3-year cumulative risk of developing a second BCC after an index BCC is about 44%, which is a 10-fold increase over that of the general population.

• #30 Basal Cell Carcinoma: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/276624-overview

  Tumors on the nose or T-zone of the face have a higher incidence of recurrence. Recurrence is most common on the nose and nasolabial fold, but this observation may be secondary to lack of adequate margins obtained in these areas. Infiltrative, micronodular, and multifocal types are more likely than nodular types to recur. […] A recurrence of BCC should be suspected when one of the following conditions occurs: Nonhealing ulceration; Tissue destruction; Scar that becomes red, scaled, or crusted or enlarges with large adjacent telangiectasia; Scar that slowly enlarges over time (months); Development of papule/nodule within a scar. […] Histologic types of BCC at higher risk for recurrence include morpheaform (sclerotic), micronodular, infiltrative, and superficial (multicentric). Higher recurrence rates are also seen with the following: Recurrent tumors that have been treated previously; Large tumors (≥ 2 cm); Deeply infiltrating tumors.

• #31

  https://link.springer.com/article/10.1007/s13671-014-0069-y

  Advanced basal cell carcinomas are a subset of basal cell carcinomas that can be difficult to treat either due to their local invasiveness, proximity to vital structures, or metastasis. The incidence of all basal cell carcinoma is increasing in the United States, although it is not known whether advanced basal cell carcinomas (aBCCs) are also increasing. […] BCC comprises the majority of non-melanoma skin cancers (NMSCs) and is more common than all other human malignancies combined. Several lines of evidence suggest that the worldwide incidence of BCCs is increasing. In the United States, the diagnosis and treatment of NMSCs has increased dramatically with a growth rate of 77 % over the past two decades. The fastest growing group is in women under the age of 40 years. […] More than 2.8 million new cases of BCC are diagnosed each year in the United States alone, and are estimated to result in over 3,000 deaths.

• #32

  https://link.springer.com/article/10.1007/s13671-014-0069-y

  Nevertheless, a recent large, retrospective analysis from a major academic center reported 5-year recurrence rates at 23 %. Given the high incidence of BCCs, this recurrence rate results in a large number of BCCs that are not cured by surgical excision. […] While accurate estimates of the incidence of aBCCs are difficult to obtain, in part due to the lack of widespread use of a staging system by dermatologists and lack of uniform reporting requirements for NMSCs, aBCCs are thought to represent roughly 110 % of all BCCs, with metastatic BCCs accounting for 0.00280.5 %. […] Advanced BCCs are often difficult to treat and life-threatening.

• #33 Learn More About Basal Cell Carcinoma (BCC)

  https://www.advancedskincancers.com/bcc/what-is-advanced-bcc

  Locally advanced BCC comprises ~95% of all advanced BCC cases while metastatic BCC represents ~5%. […] Although no formal, widely accepted definition exists, locally advanced BCC is generally classified as: Large lesions that penetrate deep into the skin or surrounding tissue, causing local tissue destruction; Cases for which further surgery or radiation is considered inappropriate or ineffective (eg, would be substantially disfiguring, may cause significant morbidity, loss of function). […] Metastatic BCC is defined as disease with distant lymph node or organ (eg, bone, liver, lung) involvement: While lymphatic infiltration accounts for ≈70% of cases, hematologic spread or subcutaneous spread can occur as well.

• #34 Basal Cell Carcinoma: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/276624-overview

  BCC is the least likely cancer to metastasize. BCC differs from squamous cell carcinoma, which accounts for 16% of skin cancers and is more life-threatening. […] The prognosis for patients with BCC is excellent, with a 100% survival rate for cases that have not spread to other sites. Nevertheless, if BCC is allowed to progress, it can result in significant morbidity, and cosmetic disfigurement is not uncommon. […] Typically, basal cell tumors enlarge slowly, relentlessly and tend to be locally destructive. Periorbital tumors can invade the orbit, leading to blindness, if diagnosis and treatment are delayed. BCC arising in the medial canthus tends to be deep and invasive and more difficult to manage; this type of BCC can result in perineural extension and loss of nerve function. […] Although treatment is curative in more than 95% of cases, BCC may recur, especially in the first year, or develop in new sites. Therefore, regular skin screenings are recommended.

• #35 BASAL CELL CARCINOMA | Hand Surgery Resource

  https://www.handsurgeryresource.net/basal-cell

  After treatment, patients should be monitored closely in the long termpossibly for lifeparticularly those with multiple or high-risk tumors. […] All patients with BCC should be referred to dermatology for routine skin examinations. […] The risk of metastasis from basal cell skin cancers is low, but increases with size and is most closely associated with tumors 3 cm. […] The hallmark of BCCs under dermatoscope is the presence of well-focused arborizing vessels that cross the midline of the lesion. Additional findings include multiple blue-gray globules, leaf-like structures, large blue-gray ovoid nests, and spoke-wheel areas.

• #36 Basal Cell and Cutaneous Squamous Cell Carcinomas: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0915/p339.html

  After diagnosis, screening of the patient for new primary skin cancers, including BCC, CSCC, and melanoma, should be performed at least once per year. A prospective cohort study found the five-year probability of a subsequent keratinocyte carcinoma after a first diagnosis was 40.7%. After more than one diagnosis, the five-year risk probability increased to 82%.

• #37 Basal cell carcinoma in skin of colour

  https://dermnetnz.org/topics/basal-cell-carcinoma-in-skin-of-colour

  There are no established guidelines for the follow-up after the removal of a BCC. An annual skin check is recommended for anyone who has had a BCC, given the estimated 3077% cumulative risk of experiencing another one within three years. […] Basal cell carcinomas are very slow-growing tumours and are unlikely to reach an advanced stage unless significantly neglected. As long as the tumour has been completely excised, BCC does not recur. However, another may develop elsewhere.

• #38 Epidemiology of basal cell carcinoma in the United Kingdom: incidence, lifestyle factors, and comorbidities – Boston Collaborative Drug Surveillance Program (BCDSP)

  https://bcdsp.org/epidemiology-of-basal-cell-carcinoma-in-the-united-kingdom-incidence-lifestyle-factors-and-comorbidities/

  Little is known about the epidemiology of basal cell carcinoma (BCC). […] Incidence rose significantly between 2000 and 2011. […] Basal cell carcinoma places a growing public health burden.

• #39

  https://www.czytelniamedyczna.pl/3184,basal-cell-carcinoma-current-views-part-i-epidemiology-pathogenesis-clinical-fea.html

  Basal Cell Carcinoma (BCC) is one of the most common human malignancies. The constantly increasing incidence of BCC observed within the last couple of years and the fact that this malignancy tends to occur in younger and younger people prove that BCC is now and will be in the future an important clinical problem. However, this problem is undernoticed and underestimated mainly to its low mortality and the fact that this malignancy is not listed in incidence reports. Diagnosis of BCC basing only on the clinical appearance is difficult and depends on physician’s experience to a large extent. A histopathological examination is the only test that can verify and complete the BCC diagnosis. Epidemiology Among all human malignancies skin cancer occurs the most frequently and it accounts for almost 1/3 of all detectable neoplasms. Despite the fact that since the early 1990s the global incidence of neoplasms has been decreasing the rate of incidence of skin cancer has been rising and it is estimated to be 10-15% annually, what is almost ten times higher than the population growth rate. It has to be emphasised that there are no precise records especially with regard to BCC and therefore epidemiological data are often understated and not included in global lists of incidence rates of neoplasms. Global statistics unanimously indicate that BCC is one of the most common neoplasms in Europe, Australia and the USA, and the number of new cases is increasing every year. Polish epidemiological data are also alarming despite the fact that they are not complete due to lack of precise records. Epidemiology of skin cancer unanimously indicates that it is a significant global problem. However, this problem is not noticed and is underestimated especially because of the fact that mortality related with these neoplasms is low and that this neoplasm is not listed in incidence records. The importance of this problem is mainly affected by the number and dynamics of new cases, a high recurrence rate (even 18%) and generally high costs of treatment.

• #40 Epidemiology of Basal Cell Carcinoma – Observations of One…

  https://sciendo.com/article/10.2478/phr-2020-0011

  Basal cell carcinoma is the most common malignant skin cancer. It is one of the so-called nonmelanoma skin cancers, the incidence of which has increased rapidly worldwide in recent years. Unfortunately, the National Cancer Registry in Poland does not classify basal cell skin cancer separately. Therefore, the precise data on the incidence in the population remain unknown. […] The data collected indicate that between 2005 and 2015 a total of 922 patients with basal cell carcinoma received dermatological treatment. Over the years, there has been a clear increase in the number of patients with basal cell carcinoma. The disease occurred mainly in people over 59 years of age, with the majority of women living in cities. […] Basal cell carcinoma of the skin is frequent in our society. Its incidence has been increasing in recent years. Therefore, action should be taken to create consistent international registries to gather reliable epidemiological data that would show the scale of the problem, which we are dealing with almost all over the world.

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