Prevalence of a history of skin cancer in 2007: results of an incidence-based model

Abstract

Objectives: To estimate the 2007 person prevalence of common types of nonmelanoma skin cancer (NMSC), basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), or both, in the United States using an incidence-based mathematical model; and to compare the prevalence of skin cancer with that of other common cancers.

Design: I developed a mathematical model to estimate the prevalence of NMSC in the United States in 2007. This model used age-specific incidence data adjusted to reflect changes in incidence from 1957 to 2006, the age distribution of the population from 1957 to 2006, and the likelihood that an incident tumor was the first ever for that person. I performed sensitivity analyses that varied my assumption about change in incidence over time and proportion of incident tumors that were a first-ever NMSC for an individual. I used standard methods for analysis of survey data to calculate the number of persons who report a history of the selected cancers and published Surveillance, Epidemiology, and End Results (SEER) estimates for incidence-based estimates for prevalence of cancers other than NMSC.

Setting: National Health Interview Survey (NHIS) 2007 data, National Cancer Institute Skin Cancer Incidence data (1977-1978), and SEER data. Main Outcome Measure Incidence-based estimate of prevalence of NMSC and melanoma and patient reports of a history of skin and selected other cancers.

Results: Approximately 13 million white non-Hispanics living in the United States at the beginning of 2007 have had at least 1 NMSC. About 1 in 5 seventy-year-olds have had NMSCs, and most of those affected have had multiple NMSCs. In the 2007 NHIS estimates, only 5 million persons report a history of skin cancer, less than half the number estimated based on incidence and survival data.

Conclusions: My incidence-based model indicates that the prevalence of a skin cancer history is about 5 times higher than that of breast or prostate cancer and greater than the 31-year prevalence of all other cancers combined. Despite their high frequency, population-based incidence and burden data for BSC and SCC are largely lacking.