Incidence and trends of first basal cell carcinomas in France between 1980 and 2019: a regional population-based registry study.

ABSTRACT

BACKGROUND: Basal cell carcinoma (BCC) is the most frequent malignancy reported in populations with fair skin. In most countries, BCCs are only partially or not at all recorded, and incidence data are lacking. OBJECTIVES: This study assessed the current incidence rates and trends in the only two French départements where BCCs have been recorded for several decades. METHODS: This regional population-based study thus used data from two French cancer registries (Doubs and Haut-Rhin) where first-time BCC diagnoses were recorded. The European age-standardized incidence rates (EASR) were calculated per 100 000 person-years (PY). The trends and the annual percentages of change were assessed using joinpoint analysis. RESULTS: In all, 48 989 patients were diagnosed with a first BCC in the study period. The median age at diagnosis was 69 years and the BCCs were mainly located on the head and neck (68.8%). In the Doubs area between 1980 and 2016, the EASR of BCC increased from 59.9 to 183.1 per 100 000 PY. The annual increase for men was 5.73% before 1999 and 1.49% thereafter, and among women 4.56% before 2001 and 1.31% thereafter. In the Haut-Rhin area, the EASR increased from 139.2 in 1991 to 182.8 per 100 000 PY in 2019. Among men, the EASR increased annually by 2.31% before 2000, and by 0.29% after 2000; among women, it increased by 0.95% over the entire period (1991-2019). In the most recent period and for these two départements, the age-specific incidence rates of BCC for men and women were close before the age of 60 years, except for the 40-49-year age group, where the rates were significantly higher among women. For patients aged 60 years and over, men had much higher rates of BCC. CONCLUSIONS: BCC incidence has increased since 1980 and is still rising, particularly among men and the elderly. A slowing was observed from 2000, which could be explained by a shift in the management of BCCs and by the possible efficacy of prevention actions. This study provides insight into the BCC burden in France and highlights the need to maintain effective prevention strategies, as incidence is still increasing.

Basal cell carcinoma (BCC) is the most common malignant tumour reported among people with fair skin. BCC is a type of skin cancer that usually develops following prolonged exposure to sunlight. BCC typically grows slowly and is unlikely to spread to other parts of the body. However, if not treated, it can cause damage to nearby tissues and structures. In many countries, cases of BCC are not accurately recorded by cancer monitoring systems, leading to a lack of data on their frequency. Using population-based data, we aimed to determine the frequency of BCC occurrence and the changes in occurrence rates over time in two regions of France where BCC cases have been recorded consistently for many years. We collected information from two French cancer registries, in Doubs and Haut-Rhin, focusing on patients' first diagnosis of BCC. We calculated the incidence rates of BCC and the trends over time. We found that BCCs were diagnosed at a mean age of 68 years and that they were mainly located in the head and neck area. In recent years, we estimated that around 180 new cases were diagnosed each year for every 100 000 people. In both regions, the BCC occurrence rates increased significantly over time, with a slowing since 2000. Overall, the incidence of BCC has been rising since 1980 and is still increasing, especially among men and in older age groups. Our research points to the importance of promoting effective prevention strategies to limit the increase in BCC incidence in France.