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Basal Cell Carcinoma: A Chronic Condition?

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Results from a large 6-year study of individuals at high risk for basal cell carcinoma (BCC) support the developing belief that BCC is a chronic disease that often repeatedly affects older people. According to researchers, major predictors of BCC include high sun exposure before the age of 30 along with a history of eczema. Study findings were published online July 19 in the Journal of Investigative Dermatology.

“Basal cell carcinoma is a chronic disease once people have had multiple instances of it, because they are always at risk of getting more,” said Dr Martin Weinstock, corresponding author of the study and professor of dermatology in the Warren Alpert Medical School of Brown University.

For the trial, researchers analyzed the risk predictors of BCC recurrence among the 1131 participants. All of the patients were veterans, 97% of them were men, and the median age of those participating was 72 years. On average, before entering the study, patients experienced more than 3 instances of BCC or squamous cell carcinoma.

During the study period, 44% of participants developed new BCCs. The strongest factor related to another BCC occurrence after 3 to 4 years of follow-up was a prior history of BCC. The 129 participants who had more than 5 BCC cases in the 5 years prior to the study had a hazard rate ratio nearly 4 times that of the 204 people who had none or 1 BCC episode. Moreover, compared with the 200 people who had 3 BCC instances, the hazard rate ratio was more than twice as high.

Researchers discovered eczema was another predictor of BCC recurrence. After statistical adjustments, study participants with a family history of eczema had a hazard rate ratio 1.54 times higher than people without family history of the condition.

Study results also showed that intense sun exposure prior to the age of 30 was a strong a predictor of BCC occurrence among the high-risk study population. “We talk about sun protection, which is important, but that’s something for basal cell that’s most important in your youth,” Weinstock said. “While we don’t exonerate UV exposure in one’s 40s, 50s, and 60s, it was particularly UV exposure before the age of 30 that was most closely related to BCC in our study.”

Source: Brown University.