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September 2001

Basal Cell Carcinoma: Still an Enigma

Arch Dermatol. 2001;137(9):1239-1240. doi:10.1001/archderm.137.9.1239

IT IS SOMETIMES a paradox in medicine that rare conditions are intensively studied, while common conditions are often overlooked. Such has been the case with basal cell carcinoma (BCC). The public health burden of BCC is considerable, yet the profile afforded to this cutaneous malignancy is low. This is surprising, as BCC is the most common human cancer.1 It may be a reflection of the fact that BCC has a very low mortality rate. Using mortality rates as a measure of the importance of BCC in a population, however, will grossly underestimate its importance. Morbidity from this skin cancer is considerable in terms of cosmetic and functional outcome. Increasing numbers of younger individuals are being affected, and treatment consumes considerable medical resources. Morbidity is likely to increase, as, in the white population of North America, the incidence rate of BCC has doubled approximately every 14 years.2 Incidence figures for BCC are likely to be underestimates, as many lesions are treated without histological confirmation, but figures quoted for males and females range from 175 and 124 per 100 000 in Minnesota3 to 849 and 605 per 100 000, respectively, in Australia.4

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