Basal cell carcinoma in young adults

Abstract

The epidemiology and outcome of basal cell carcinoma (BCC) in adults aged 15-34 years were examined. Northern Region Cancer Registry data from 1979 to 1989 revealed a crude annual incidence of 37/100,000 total population and the incidence was constant in all age-groups during this period; 150 patients (1.2%) were aged 15-34 years. There was a small excess of females in the young age-group. The outcome of BCC in young adults was determined using records of all patients registered over 5 years ago and additional information from family doctors where required. Patients with BCC in naevus sebaceous or with syndromes of which BCCs are a feature were excluded. Median duration of BCC pre-diagnosis was 3 years. Of 39 patients with completed 5-year follow-up data, 21% had either incomplete excision requiring further early treatment (n = 4), a later local recurrence (n = 2), metastatic BCC (n = 1) or a subsequent further primary tumour (n = 1); an additional three patients had two primary tumours at initial presentation. Median hospital follow-up was 12 months but the apparent disease-free interval in patients with recurrent or new BCC was frequently over 2 years. BCC in young adults may not be suspected because it is uncommon. However, the high frequency of local recurrence and of multiple primary tumours indicates that careful follow-up is prudent in young patients with this tumour.