Incidence of eyelid basal cell carcinoma in England: 2000-2010.

INTRODUCTION: Basal cell carcinomas (BCCs) are the most frequently diagnosed type of skin cancer, with eyelid (including canthus) BCCs accounting for a notable proportion of these. Using population-based data from the English Cancer Registries, we report here the incidence of eyelid BCCs in England, for the period 2000-2010. METHODS: ICD-10 and histology codes for eyelid BCCs (including canthus) from the English National Cancer Data Repository were used to identify incident events. Crude incidence rates by age and sex, together with directly standardised incidence rates for eyelid BCCs in England in 3-year cohorts, are presented, in keeping with the reporting practice of the English Cancer Registries. RESULTS: Over the 11-year study period, there were a total of 33 610 recorded eyelid BCCs; 18 146 in females and 15 464 in males. There were regional variations in registrations. Incidence of eyelid BCCs increased with age. No major change in the age-standardised incidence of BCC was observed during the period 2000-2010. Overall, the age-standardised incidence of BCCs during 2008-2010 was similar for males and females (4.51 per 100 000 (95% CI 4.37 to 4.65) and 4.53 per 100 000 (95% CI 4.40 to 4.67), respectively). However, females under 50 years of age had higher incidence rates, and males over 75 years of age had higher rates. CONCLUSIONS: The findings provide the current frequency and distribution of eyelid BCCs in England, highlighting opportunities for health education and improving reporting and registration of events, and for informing service planning.

Comparison of melanoma incidence and trends among youth under 25 years in Australia and England, 1990-2010.

White populations in Australia and England share many genetic and phenotypic characteristics due to common ancestry, but Australians experience far higher rates of melanoma due to higher ambient ultraviolet radiation (UVR) levels. To gain insight into the role of UVR on melanoma development early in life, we used national cancer registration data and compared recent incidence rates and long-term trends of primary invasive cutaneous melanoma in Australian and English youth aged 0-24 years diagnosed 1990-2010. Incidence rates and standardized rate ratios (SRRs) with 95% confidence intervals (CIs) for 2006-2010 were calculated and incidence trends across the whole period were examined using JoinPoint regression. In Australian youth, overall melanoma incidence was double that in English youth (2.2 and 1.1 per 100,000, respectively). While melanoma rates were similarly rare among children <10 years in both countries, in subsequent 5-year age groups, incidence was significantly higher in Australia compared to England. Melanoma incidence among 15-24 year olds significantly increased by more than 2% per year in both sexes in England. However, after an initial non-significant increase, Australian rates for this older age group significantly decreased by 6.0% (95% CI, -8.2 to -3.8) per year in females from 1997 and decreased by 12.4% (95% CI, -20.3 to -3.8) per year in males from 2004. Long-standing primary prevention strategies targeted at curbing UVR exposure appear to have been effective in mitigating incidence trends in Australian youth, but decreases in incidence in English youth are yet to be observed.

Socio-economic inequalities in survival from screen-detected breast cancer in South West England: population-based cohort study.

BACKGROUND: Socio-economic inequalities in breast cancer survival have been reported worldwide, but whether these exist in screen detected as well as symptomatic women has not been established. Making this distinction will allow inferences about the relative contributions of pre- and post-diagnostic delay to these inequalities. METHODS: Screening-eligible women diagnosed with breast cancer in South West England (2002-06) were followed-up to 2007. Five-year relative survival ratios (RSRs) were calculated for each deprivation quintile, using deprivation-specific life-tables and a period approach. The 'deprivation gap' in survival was calculated as the slope index of inequality between least and most deprived women. RESULTS: The study included 11 018 women, of whom 1176 died during follow-up. Screening status of 54% of women was missing. A clear gradient in survival across deprivation groups ranged from 83.6% [95% confidence interval (CI) 80.0, 86.6] in the most deprived to 90.8% (95% CI 89.0, 92.3) in the least deprived group. Comparing the most deprived to least deprived women, the estimated deprivation gap was -9.42% (95% CI -12.80, -6.04, P = 0.003). Among screen-detected women, inequalities were attenuated, but persisted, ranging from 95.6% (95% CI 90.6, 98.0) in the most deprived to 98.2% (95% CI 95.9, 99.2) in least deprived; the estimated deprivation gap was -3.03% (95% CI -5.75, -0.85, P = 0.023). CONCLUSION: The deprivation gap in survival does not appear as marked with screen-detected breast cancer as the other groups, though still apparent. Efforts to eliminate inequalities should consider both increasing breast screening participation and ensuring equal access through secondary care systems for women of lower socio-economic position.