Trends of cutaneous basal cell carcinoma, squamous cell carcinoma, and melanoma among the Chinese, Malays, and Indians in Singapore from 1968-2016. 2021

Choon Chiat Oh, and Aizhen Jin, and Woon-Puay Koh
Department of Dermatology, Singapore General Hospital, Singapore.

BACKGROUND Previous analysis showed that the incidence rates of skin cancer in Singapore increased from 1968 to 2006, especially among older Chinese, and particularly for basal cell carcinoma (BCC). OBJECTIVE We updated the skin cancer incidence rates and time trends among the Chinese, Malays, and Indians in Singapore. METHODS We analyzed the skin cancer incidence from the nationwide Singapore Cancer Registry from 1968 to 2016. RESULTS Among 12,692 cases diagnosed from 1968 to 2016, there were 8367 (65.9%) cases of BCC, 3598 (28.3%) of squamous cell carcinoma (SCC), and 727 (5.8%) of melanoma. The mean ages at skin cancer diagnosis were 72.7 years for SCC, 66.9 years for BCC, and 59.8 years for melanoma. Sun-exposed areas accounted for 81.3% of BCCs, 61.6% of SCCs, and 26.7% of melanomas. The age-standardized incidence rate of cutaneous BCC was highest in the Chinese and increased by 2.5 fold over the study period, followed by a lower rate and slower increase in the Malays, and the lowest rate among the Indians. The SCC and melanoma incidences remained low in all 3 ethnicities during this study period. The Chinese had the highest relative risk for developing any skin cancer (P < .0001) compared with those of the Malays and Indians. Most cases of skin cancer were diagnosed at age ≥60, with men showing a higher incidence of SCC compared with that of women. CONCLUSIONS Incidence rates of BCC have increased in Singapore, especially among the Chinese, in the past 5 decades. The SCC and melanoma incidence rates remained low and stable.

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