Estimating baseline skin cancer incidence

The text on this page is taken from an equivalent page of the IEHIAS-project.

As part of the EU-funded INTARESE project, which contributed to the development of this Toolbox, a case study was carried out to assess health impacts associated with exposures to ultraviolet radiation (UVR), under different climate change scenarios.

In order to estimate health impacts, baseline health data were required for each of the health outcomes of interest: malignant melanoma (CMM) squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). Data were required for three study areas (Greater London, Helsinki and Rome) as follows:

• Case definitions: melanoma of the skin (ICD-10, C4) and non-melanoma skin cancer (ICD-10, C44 )
• Incidence rates by 5-year age groups, males and females separately
• Baseline period: circa 2001

Sources of data, and some of the issues encountered, are summarised below.

Explanation of the method

London

In London, incidence data were obtained from the Thames Registry (including London), provided by the CI5 IX database (Curado, Edwards et al. 2007). Data covered the period 1998-2002 and comprised incidence rates for C43 (malignant melanoma) and C44 (excluding BCC, hence assuming that all C44 cases relate to SCC). BCC data were therefore are drawn from a study by Bath-Hextall et al. (2007) on the THIN-database (1996-2002).

In each case, data were available for males/females and several age groups (Table 1).

Table 1. UK (Greater London): estimating baseline incidence rates

	Sources	Notes
BCC	Bath-Hextall et al (2007). Trends in incidence of skin basal cell carcinoma. Additional evidence for a UK primary care database study. International Journal of Cancer. Vol 121(9); 2105-8.	UK (Thin database) 1996-2003 Age groups: 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80+ Male, female
SCC	Thamesregistry*, C44 data provided by the CI5 IX database** Basal cell carcinomas (BCC) of the skin are not registered (see report by the Thames Cancer registry entitled ‘Cancer in South East England 2001’). Assume that all C44 cases are SCC	Thames registry, including London 1998-2002 5 year age groups up to 85+ Male, female
CMM	Thamesregistry*, C43 data provided by the CI5 IX database**	Thames registry, including London 1998-2002 5 year age groups up to 85+ Male, female

* Note: Thames cancer registry website (http://www.thames-cancer-reg.org.uk/) only provides data on melanoma incidence, without age or gender break outs.

** CI5 IX data (C43 and C44) for males/females and 5-year age groups (based on Thames cancer registry data for 1998-2002) are available on the IARC website. CI5 IX publication date 2007, covering the period 1998-2002 (approximately 225 registries in 60 countries) Cancer in five continents (CI5) Volume IX presents incidence data from populations all over the world for which good quality data are available. Curado, M., B. Edwards, et al., Eds. (2007). Cancer Incidence in Five Continents, Vol. IX Lyon, IARC Scientific Publications No. 160.

Helsinki

For Helsinki data (for the period 1997-2001) were obtained from the Finish Cancer registration (Data covered Helsinki and Uusimaa, and comprised incidence rates for C43 (malignant melanoma), C44 (excluding BCC, and hence assuming that all C44 cases are SCC. BCC data were provided separately. Data are available for males/females and several age groups (Table 2).

Table 2. Finland (City of Helsinki): estimating baseline incidence rates

	Sources	Notes
BCC	Finish Cancer registration* BCC reported separately	BCC reported separately Helsinki and Uusimaa 1997-2001 5 year age groups up to 85+ Male, female
SCC	Finish Cancer registration* C44 Non-melanoma cancer of the skin, <stockticker>BCC</stockticker> not included Assume that all C44 cases are SCC	C44 does not include BCC Helsinki and Uusimaa 1997-2001 5 year age groups up to 85+ Male, female
Melanoma	Finish Cancer registration* C43	Helsinki and Uusimaa 1997-2001 5 year age groups up to 85+ Male, female

*data obtained via personal communication with Risto Sankila Nov 6 2008.

Rome

Rome is not covered by any of the Italian cancer registries. Hence, for Rome data (for the period 2000-2002) were obtained from the Umbrian population-based Cancer Registry, provided by the CI5 IX database (Curado, Edwards et al. 2007). Umbria is a small region placed in central Italy, and situated close to Rome. Data are available for males/females and several age groups. Incidence rates were obtained for C43 (malignant melanoma) and C44: C44 includes both BCC (circa 75%) and SCC (20%) (Crocetti 2006). These percentageswere applied to all age groups to estimate the incidence rates for SCC and BCC separately (Table 3).

Table 3 Italy (City of Rome): estimating baseline incidence rates

	Sources	Notes
BCC	Romenot covered Umbrian population-based Cancer Registry*, C44 data provided by the CI5 IX database** C44 includes SCC and BCC. In 1998-2002, BCC accounts for 75% of non-melanoma cases in Italy* Crocetti (2006), apply to all ages	Incidence rate: 75% of C44 incidence is BCC Umbria region 2000-2002 Age groups: 0-14, 18-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54,55-59, 60-64, 65-69, 70-74, 75-79, 80-84, 85+ Male, female
SCC	Romenot covered Umbrian population-based Cancer Registry*, C44 data provided by the CI5 IX database** C44 includes SCC and BCC. In 1998-2002, BCC accounts for 15-20% of non-melanoma cases in Italy***, apply to all ages (Crocetti 2006).	Incidence: 20% of C44 incidence is BCC Umbria region 2000-2002 Age groups: 0-14, 18-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54,55-59, 60-64, 65-69, 70-74, 75-79, 80-84, 85+ Male, female
CMM	Umbrian population-based Cancer Registry* - Rome not covered, use C43 (melanoma skin cancer) data from Umbria region*	Umbria region 2000-2002Age groups: 0-14, 18-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54,55-59, 60-64, 65-69, 70-74, 75-79, 80-84, 85+ Male, female

*The Umbrian population-based Cancer Registry covers the population of the whole Umbria Region. Umbria is a small Region placed in central Italy. It is one of the Cancer registries that is closest to the Rome and for which data is [(http://www.registri-tumori.it/ available]. Umbrian population-based Cancer Registry website does not provide data.

** CI5 IX data (C43 and C44) for males/females and 5-year age groups (based on Thames cancer registry data for 1998-2002) are available on the IARC website. CI5 IX publication date 2007, covering the period 1998-2002 (approximately 225 registries in 60 countries) Cancer in five continents (CI5) Volume IX presents incidence data from populations all over the world for which good quality data are available. Curado, M., B. Edwards, et al., Eds. (2007). Cancer Incidence in Five Continents, Vol. IX Lyon, IARC Scientific Publications No. 160, available [here http://www-dep.iarc.fr/].

References

• Bath-Hextall, F., Leonardi-Bee, J., Smith, C., Meal, A. and Hubbard, R. 2007 Trends in incidence of skin basal cell carcinoma. Additional evidence for a UK primary care database study. International Journal of Cancer 121(9), 2105-8.
• Curado, M., Edwards, B., et al. (eds.) 2007. Cancer Incidence in five continents. Vol. IX. IARC Scientific Publications No. 160: Lyon:IARC.
• Crocetti, E. 2006 I tumori in Italia. Rapporto 2006. Associazione Italiana Registri Tumori (AIRT).

See also

• Changing ambient UVR and future melanoma skin cancer
• Changing ambient UVR and future non-melanoma skin cancer