Basal cell carcinoma: A Nationwide clinicopathologic study in an Israeli population Basal cell cancer distribution

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Ariel Berl
Ofir Shir-az
Gilad Winder
Manar Kawar
Prof. Avshalom Shalom


Basal cell carcinoma, Skin neoplasms, Epidemiology, Healthcare delivery, Risk factors


Background: Basal cell carcinoma (BCC) is the most common malignancy worldwide, with a continuously increasing incidence. BCC occurs mostly on areas of the body subject to chronic sun exposure in older people.

Aim: To characterize the anatomical distribution and properties of BCC in a nationwide sample in Israel.

Methods: This retrospective study included histologically confirmed BCC samples obtained from surgeons throughout Israel during the first trimester of 2012.

Results: A total of 1,716 BCC lesions were diagnosed during the study period. The head and neck had the highest density of BCC (65.9%). The mean lesion horizontal diameter was larger in males than in females (0.91 cm vs. 0.8 cm; P<0.001). Male sex and older age were risk factors for lesion ulceration.

Conclusions: According to our population-based study, males of older ages are at increased risk of developing larger and ulcerated BCC lesions. The head and neck are the most affected areas. With increasing age, the frequency of upper limb BCC increases in males and on the lower limbs in females. Increased frequency of evaluations in at-risk groups such as males of older age with an emphasis on high-risk areas of the body, is recommended.

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