According  to an article to be published in the August 10  issue of the Journal of the American Medical Association (JAMA),  the incidence of keratinocyte cancer (squamous and basal cell carcinomas), often referred to as nonmelanoma skin cancer, is increasing in young adults. The increase is attributed to several potential factors, including increased exposure to UV light, ozone depletion and increased surveillance.

American Cancer Society national volunteer Martin Weinstock, MD, PhD, chair of the Society's skin cancer advisory group, professor of dermatology and community health at Brown University, and chief of dermatology at VA Medical Center, Providence, R.I., explains the importance of this JAMA article:

"This article is important in that it supports our understanding that skin cancer is a concern not only for people over 50, but also forteenagers and young adults. It is also one of the few articles that gives us data on keratinocyte cancer, as most of the data we have is on melanoma. Of particular concern is the fact that young women are developing skin cancer at a much higher rate than their malecounterparts. We suspect, and the authors of this study allude to this, that this may be due to the fact that young women use tanningbooths much more often than young men. So, getting the word out to young women about the importance of  protection from ultravioletradiation, from the sun or tanning booths, should be a priority for us. In addition, people who develop keratinocyte cancer at a youngage are more likely to have repeated occurrences as they get older."

Press Release:  Incidence of Nonmelanoma Skin Cancer on the Rise Among Young Adults

TUESDAY, AUGUST 9, 2005

CHICAGO - A new study from Minnesota finds the incidence of nonmelanoma skin cancer increasing among men and women under the age of 40, according to an article in the August 10 issue of JAMA.

The overall incidence of nonmelanoma skin cancer, consisting of squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), is increasing, according to background information in the article. This increasing incidence is most likely due to a combination of factors, including increased exposure to UV light, ozone depletion, and increased surveillance. Long-term exposure to the sun resulting inphotodamage is perhaps the biggest risk factor for nonmelanoma skin cancer.  In the United States, approximately 800,000 new cases of BCC and 200,000 new cases of SCC were diagnosed in 2000. Nonmelanoma skin cancer generally occurs in persons older than 50 years, and in this age group, its incidence is increasing rapidly. However, little is known about its incidence in persons younger than 40 years.

Leslie J. Christenson, M.D., of Mayo Clinic, Rochester, Minn., and colleagues conducted a study to estimate the sex- and age-specific incidence of BCC and SCC in Olmsted County, Minnesota, in a young population (less than 40 years old) from the beginning of 1976 through 2003.  The patients in this study have comprehensive medical records captured through the Rochester Epidemiology Project.

During the study period, 451 incident basal cell carcinomas were diagnosed in 417 patients, and 70 incident squamous cell carcinomas were diagnosed in 68 patients. Overall, the age-adjusted incidence of basal cell carcinoma per 100,000 persons was 25.9 for women and 20.9 for men. The incidence of basal cell carcinoma increased significantly during the study period among women but not among men. Nodular basal cell carcinoma was the most common histologic subtype; 43.0 percent of tumors were solely nodular basal cell carcinoma and 11.0 percent had a mixed composition, including the nodular subtype. The incidence of squamous cell carcinoma was similar in men and women, with an average age- and sex-adjusted incidence of 3.9 per 100,000 persons; the incidence of squamouscell carcinoma increased significantly over the study period among both women and men. Comparing the change in incidence rates for basal cell carcinoma, per 100,000 persons the rate for 1976-1979 for women was 13.4; for men, 22.9, and for both sexes, 18.2. For 2000-2003, the rate for women was 31.6; for men, 26.7; and for both sexes, 29.1.

For squamous cell carcinoma, per 100,000 persons the rate for 1976-1979 for women was 0.6; for men, 1.3, and for both sexes, 0.9. For 2000-2003, the rate for women was 4.1; for men, 4.2; and for both sexes, 4.1.

"This increase [in nonmelanoma skin cancer in young adults] may lead to an exponential increase in the overall occurrence ofnonmelanoma skin cancer over time as the population ages. This may mean even greater demands for health care related tononmelanoma skin cancer. Our results also emphasize the need to focus on the prevention of skin cancer in the very young so that the increasing incidence of a potentially preventable cancer can be halted," the authors conclude.

(JAMA. 2005; 294:681-690.)