title: Nonmelanoma skin cancer of the ear: frequency, patients' knowledge, and photoprotection practices.
abstract: BACKGROUND
  Nonmelanoma skin cancer (NMSC) is the most common cancer in the world. Information about NMSC on the ear and photoprotection practices of the ear is limited.
  
  
  OBJECTIVE
  To determine the frequency of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) at precise anatomical sites, with a special focus on the ear. To evaluate dermatology patients' knowledge about skin cancer, photoprotection practices, and use of photoprotection on the ear.
  
  
  METHODS
  At a dermatology practice in Fresno, California, a retrospective chart review of 643 patients diagnosed with NMSC was performed and categorized into detailed anatomical sites. An anonymous questionnaire was given to patients aged 18 and older seen at this private practice.
  
  
  RESULTS
  One thousand three hundred eleven NMSCs were biopsied and histologically confirmed. Of these, 538 were BCC (41%) and 773 (59%) were SCC. Seven hundred sixty-five tumors (58.4%) were on the head. The ear was the fifth most common site for NMSC on the head. The male:female ratio for NMSC of the ear was 17:1. There were 269 survey responses; 72.8% used sunscreen, but only 26.0% of those who used sunscreen always apply it to their ears.
  
  
  CONCLUSIONS
  Directed public education about the ear as a high-risk, common site for NMSC is needed. The authors have indicated no significant interest with commercial supporters.
authors.affiliation: Department of Dermatology, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, Somerset, New Jersey 08873, USA. jenragi@gmail.com
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Ragi
authors.forename: Devi
authors.initials: D
authors.lastname: Patel
authors.forename: Aisha
authors.initials: A
authors.lastname: Masud
authors.forename: Babar K
authors.initials: BK
authors.lastname: Rao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D002280:Basal Cell Carcinoma / Q000453:epidemiology* / Q000517:prevention & control; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000517:prevention & control; D004428:Ear Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D006258:Head and Neck Neoplasms / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D055815:Young Adult