Primary cutaneous malignancies in the Northern Cape Province of South Africa: A retrospective histopathological review
Master Thesis
2018
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University of Cape Town
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Background: Excessive sun exposure and high human immunodeficiency virus prevalence increase skin cancer risk in South Africa. Objective: To describe the nature and extent of skin cancers presenting in public and private health sectors of the Northern Cape Province. Methods: A retrospective analysis of histologically-confirmed new primary cutaneous malignancies from 1/1/2008 to 31/12/2012 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: 4270 biopsies (14 cutaneous malignancies) were identified. Most common were Squamous Cell Carcinoma (SCC), Basal Cell Carcinoma (BCC), Kaposi Sarcoma (KS), Cutaneous Malignant Melanoma (CMM) and Basosquamous carcinoma. The odds of a White male developing SCC increased by 8% each year (OR: 1.08; CI: 1.01-1.15; p-value: 0.022) whilst the odds of a Black male developing SCC and KS decreased by 9% (OR: 0.91; CI: 0.84-0.99; p-value: 0.033) and 18% (OR: 0.82; CI: 0.70-0.97; p-value: 0.022) each year, respectively. SCC and CMM were diagnosed at more advanced stages within public versus private sectors. 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-value: 0.042). Conclusion: Results suggest that reported skin cancer patterns are changing. There is a need for further research and equitable appropriation of financial resources and effort toward developing primary skin cancer prevention initiatives in South Africa.
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York, K. 2018. Primary cutaneous malignancies in the Northern Cape Province of South Africa: A retrospective histopathological review. University of Cape Town.