Epidemiology of actinic keratoses and squamous cell carcinoma
Section snippets
Epidemiology of AK
The discipline of epidemiology studies the frequency, distribution, and determinants of a disease and applies this study to the improvement of health.
AKs are incredibly common lesions, especially on the sun-exposed skin of fair-skinned Caucasians. As noted above, they account for a significant proportion of a dermatologist's practice. In the National Ambulatory Medical Care Survey noted earlier,6 it was estimated that in the 2-year period of 1993–1994 alone, there were 4.55 million visits to
Epidemiology of SCC
As stated earlier, there are approximately 200,000 new SCCs each year. It has been estimated that a Caucasian male born in l994 has a 9% to 14% chance of developing an SCC within his lifetime. The estimates for white women range from 4% to 9%.1
The same risk factors apply to SCC as were noted for AK: the fair-skinned phenotype, excessive cumulative overexposure to UV radiation, advancing age, outdoor vocation, or avocation, and sunbelt latitudes. The highest risk factors are the presence of AKs
Conclusions
Although any individual AK has a low probability of progressing to an invasive SCC, it is important because it identifies persons who not only have a unique genetic propensity but also have sustained sufficient solar radiation exposure and consequent damage to produce these incipient malignancies. This is not a trivial event. The presence of an AK separates an exclusive subset of persons who are already progressing toward invasive, and potentially lethal, SCC. This same combination of genetic
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