Basal cell carcinoma: an emerging epidemic in women in Iceland

Basal cell carcinoma (BCC) is the most common type of skin cancer and largely caused by ultraviolet radiation (UVR), such as from the sun or tanning beds. While it rarely spreads throughout the body, it can be locally destructive (i.e. at the site of the cancer) and can cause serious harm to patients. The researchers, based in Iceland and U.S.A., wanted to look at how the incidence of BCCs has changed from 1981 to 2017 in the Icelandic population, a population normally exposed to a very low amount of natural UVR. We did this looking at the entire Icelandic population, using data from the Icelandic skin cancer registry. We found that the incidence of these cancers has increased 2.3‐fold for men, and 3.7‐fold for women, with this being the only population where women get these cancers significantly more often than men. We found that women tend to get these cancers more often on the trunk and legs, while men get them more often on the head and neck. Today, one in every 10 women in Iceland is expected to develop BCC, and one in every 14 men. These findings are striking, considering the very low background ultraviolet radiation in Iceland. We cannot say for certain why we are seeing this increase in incidence, but the period of notable increase correlated with a period of increase in tanning bed and travel popularity in the country. Sun protection education efforts are of utmost importance to prevent even further increases in BCC incidence in this population. These should be initiated and perhaps specifically targeted towards women. Linked Article: Adalsteinsson et al. Br J Dermatol 2020; 183: 847–856.