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Article
August 14, 1991

Bowen's Disease and Internal Cancer

Author Affiliations

From the Department of Dermatology, Yale University School of Medicine, New Haven, Conn.

From the Department of Dermatology, Yale University School of Medicine, New Haven, Conn.

JAMA. 1991;266(6):842-843. doi:10.1001/jama.1991.03470060104037
Abstract

In 1959 and 1961, Graham and Helwig1,2 reported an unexpected association: Bowen's disease of the skin (epidermoid carcinoma in situ) was followed, after a variable latent period of 1.3 to 13 years, by the eventual development of internal cancer in 48% of affected individuals. The cancers involved all three germ layers and included lymphomas and leukemias. Multiple reports by others supporting these observations followed immediately,3-5 and the concept that Bowen's disease was a high-risk factor for the future development of cancer, especially if it occurred on a part of the body not exposed to the sun, became an established fact in textbooks. In the past decade, however, these findings have not been confirmed,6-8 and the validity of the observation has been questioned because of errors in the methods of data acquisition.6,9,10 The earlier studies have been criticized because of lack of appropriate

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