Basal cell carcinoma in Singapore: a prospective study on epidemiology and clinicopathological characteristics with a secondary comparative analysis between Singaporean Chinese and Caucasian patients.
BACKGROUND/OBJECTIVES
Susceptibility to and clinical presentation of basal cell carcinoma (BCC) differ in Asian and Caucasian populations. This study aims to evaluate the epidemiological and clinicopathological characteristics of BCC in a multiracial Singaporean population, with a secondary comparative analysis between Chinese and Caucasian patients.


METHODS
We prospectively studied patients with newly diagnosed, histologically confirmed BCC at the National Skin Centre, Singapore from 2004 to 2008.


RESULTS
In total, 274 BCC from 260 patients were studied, with 19 patients having two or more tumours. Their mean age was 67.5 years and 54% were male. Chinese comprised 80% and Caucasians 14%. The Chinese were 1.8-fold as likely as Caucasians to be older than 60 years, and experienced itch thrice more frequently. Caucasians developed multiple BCC threefold and truncal or upper limb BCC 2.9-fold more frequently than the Chinese. In terms of tumour subtype, morphoeic BCC was 2.7-fold more common in Caucasians. Pigmented BCC occurred 2.7-fold more often in the Chinese, most frequently on the head and neck of elderly Chinese.


CONCLUSIONS
Compared to the Chinese, BCC occurred more often in younger Caucasians, with a predilection for the trunk and upper limb, suggesting a greater role for recreational sun exposure as a risk factor. Pigmented BCC more commonly occurred on the head and neck of elderly Chinese and may be reflective of cumulative sun exposure as a risk factor. Aggressive morphoeic BCC was more common in Caucasians than in Singaporean Chinese patients.
['Tan|Eugene St|ES|', 'Ee|Melvin|M|', 'Shen|Liang|L|', 'Chua|Hilary|H|', 'Chan|Yiong-Huak|YH|', 'Tan|Suat-Hoon|SH|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D002280:Carcinoma, Basal Cell D002681:China D005260:Female D006257:Head D006801:Humans D017495:Hyperpigmentation D008297:Male D008875:Middle Aged D009333:Neck D009378:Neoplasms, Multiple Primary D011446:Prospective Studies D011537:Pruritus D012846:Singapore D012878:Skin Neoplasms D060726:Torso D034941:Upper Extremity D044465:Whites
basal cell carcinoma Singapore epidemiology Chinese Caucasian Asia