Basal cell carcinoma epidemiology in the UK: the elephant in the room

BACKGROUND: UK Cancer registries have difficulties in recording the incidence of basal cell carcinoma (BCC). AIM: To estimate the total numbers of BCCs in the UK requiring surgical treatment. METHODS: The histopathology records of each year from 1999 to 2010 were examined to estimate the total annual numbers of BCCs and of people with BCC in the East Norfolk and Waveney area of the UK. RESULTS: Over this period, the numbers of patients with surgically treated BCCs increased by 81%, and the numbers of BCCs by 70%. The ratio of BCCs recorded by the cancer registry was 2-2.2 times lower than that recorded in the histopathology data. Extrapolating the data to the UK population suggests that in 2010, approximately 200,000 patients had 247,000 BCCs treated surgically (this estimate does not include those treated by other means such as cryotherapy, topical chemotherapy, photodynamic therapy or radiotherapy, without histology). In 2008, 114,000 nonmelanoma skin cancers were registered in England and Wales and 309,000 total cancers (excluding nonmelanoma skin cancers) were registered in the UK. CONCLUSIONS: These data indicate that in the UK, BCC is nearly as common as all other cancers in all other body sites combined.