THE EPIDEMIOLOGY OF SKIN-CANCER

BACKGROUND. The incidence of skin cancer is increasing at an alarming rate. OBJECTIVE. TO discuss current epidemiologic data concerning the incidence, morbidity, environmental influences, predisposing, host con ditions, precursor lesions, and prevention of melanoma and nonmelanoma (basal and squamous cell) skin cancer. METHODS. The current literatur e was reviewed in order to provide current epidemiologic data for mela noma, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC). R ESULTS. Skin cancer is exceedingly common and the incidence is rising rapidly. Although the mortality rate for nonmelanoma skin cancer (NMSC ) is decreasing, that of melanoma is increasing. Both NMSC and melanom a are associated with significant morbidity. Whereas chronic sun expos ure is the main cause of NMSC, the development of melanoma appears to be related to intense, intermittent sun exposure. Ozone depletion has contributed to rising incidence rates of both NMSC and melanoma. In co ntrast to NMSC, there is not a direct relationship between ultraviolet radiation and melanoma. Genetic susceptibility significantly increase s the lifetime risk of acquiring melanoma. There is no precursor lesio n for BCC. Precursor lesions for invasive SCC include actinic keratose s and SCC in situ. Melanoma may arise from benign nevi and dysplastic nevi. Prevention of melanoma and NMSC is extremely important since pro gnosis improves with early detection. Prevention may be achieved by ed ucating patients and physicians how to detect skin cancers early and b y decreasing or eliminating exposure to ultraviolet light. CONCLUSION. The incidence of skin cancer has reached epidemic proportions. Only t hrough heroic efforts by health care professionals and the general pub lic to prevent the development or progression of skin cancer will this epidemic be abated.