Primary cutaneous malignancies in the Northern Cape Province of South Africa: A retrospective histopathological review

Research Areas
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Publication Details
Author list: York K., Dlova N., Wright C., Khumalo N., Kellett P., Kassanjee R., Mosam A.
Publisher: Health and Medical Publishing Group (HMPG)
Publication year: 2017
Journal: South African Medical Journal
Journal name: South African Medical Journal
Journal acronym: SAMJ
Volume number: 107
Issue number: 1
Start page: 83
End page: 88
Total number of pages: 6
ISSN: 0256-9574
eISSN: 2078-5135


Background. Excessive sun exposure and a high prevalence of HIV increase skin
cancer risk in South Africa (SA).

Objective. To describe the nature and extent of skin cancers presenting in
the public and private health sectors of the Northern Cape Province of SA.

Methods. A retrospective analysis of histologically confirmed new primary
cutaneous malignancies from 1 January 2008 to 31 December 2012 was conducted
using public and private health sector databases. Types, quantity and
distribution of common invasive malignancies by population group, age, gender,
anatomical site and health sector were explored. One-year cumulative incidence
was calculated and logistic regression models were used to analyse incidence and
melanoma thickness trends.

Results. A total of 4 270 biopsies (13 cutaneous malignancies) were
identified. The commonest was squamous cell carcinoma (SCC), followed by basal
cell carcinoma, Kaposi’s sarcoma (KS), cutaneous malignant melanoma (CMM) and
basosquamous carcinoma, in descending order. The odds of a white male developing
SCC increased by 8% each year (odds ratio (OR) 1.08, 95% confidence interval
(CI) 1.01 - 1.15; p=0.022), while the odds of a black male developing SCC and KS
decreased by 9% (OR 0.91, 95% CI 0.84 - 0.99; p=0.033) and 18% (OR 0.82, 95% CI
0.70 - 0.97; p=0.022), respectively, each year. SCC and CMM were diagnosed at
more advanced stages in the public than in the private healthcare sector. CMM is
being detected earlier, as indicated by low-stage depth increasing by 72%
annually (OR 1.72, 95% CI 1.04 - 3.01; p=0.042).

Conclusions. Results suggest that reported skin cancer patterns are changing.
There is a need for further research and equitable appropriation of financial
resources and effort towards developing primary skin cancer prevention
initiatives in SA.

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Last updated on 2017-06-09 at 08:46