Non-melanoma skin cancer (NMSC) including basal cell carcinoma (BCC)
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According to the American Cancer Society, skin cancer is the most common form of cancer in the US, accounting for more than 50% of all cancers and 10,000 deaths annually; in terms of incidence skin cancer is more common than all other cancers combined. It also has the fastest growing incidence of all cancers, increasing by 6-7% per annum.
Skin cancer is divided into two general types: non-melanoma skin cancer (NMSC), and melanoma skin cancer. Melanoma is a relatively rare and very aggressive cancer; although accounting for only 4% of all skin cancers, melanoma causes more than 80% of skin cancer related deaths. Peplin is focused on non-melanoma skin cancer and primarily basal cell carcinoma, the most common form of skin cancer.
NMSC, chiefly basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), is the most common form of skin cancer accounting for 95% of all skin cancers. They are called non-melanoma because they develop from skin cells other than melanocytes and are named after the skin layer in which they originate. NMSC occurs most often after years of UV exposure and is more prevalent in older Caucasians and farmers, sailors, sportspeople and others who spend much of their time outdoors. NMSC is not very aggressive and the choice of therapy can depend upon the type and size of the lesion, its location, the general condition of the patient and cosmetic considerations. Surgical excision is the standard therapy.
BCC begins in the lowest layer of the epidermis called the basal cell layer. It is the most common skin cancer and about 80% of all skin cancers are BCCs. BCCs usually develop on sun-exposed areas, especially the head, neck and hands.
SCCs are malignant tumours which can arise from a number of tissue types including higher levels of the epidermis. They account for about 16% of all skin cancers and commonly appear on sun-exposed areas of the body such as the face, ear, neck, and back of the hands. SCCs are less common but more dangerous than BCCs since they have a greater tendency to metastasise.
BCC is the most common form of skin cancer. In the US each year more than one million cases of BCC are diagnosed. Annual cost to the US healthcare system for the treatment and management of NMSC is US$1.4 billion. There were 1.6 million office visits in 2002(1).
The major shortcoming of surgical excision is the pain and discomfort and then potential for long term scarring and morbidity.
The prevalence of skin cancer worldwide is highest in Australia. According to the Australian Cancer Council, NMSC is the most common cancer diagnosed in Australia, with 374,000 Australians over the age of 14 being treated for NMSC in 2002. Of all cancers, skin cancer is the biggest burden on the health system in Australia, costing approximately $300 million per year to treat.
(1) Source: Lewin Group
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