title: Epidemiologic risk factors of basal cell carcinoma development and age at onset in a Southern European population from Greece.
abstract: BACKGROUND
  Basal cell carcinoma (BCC) is the most common form of skin cancer with increasing incidence rates worldwide.
  
  
  METHODS
  To assess the association of BCC with epidemiologic risk factors in a Southern European population from Greece, we conducted a hospital-based case-control study of 199 patients with BCC and 200 controls.
  
  
  RESULTS
  In the multivariate analysis, fair skin colour was associated with increased risk of BCC (OR: 4.9, 95% CI: 2.4-10.0). However, darker skin phototypes III/IV (patient's reported sun sensitivity/tanning ability) showed a higher BCC risk (OR: 3.9, 95% CI: 1.8-8.5). Persons with occupational UV exposure of 5 years or more had a 2.7-fold increased risk (95% CI:1.4-5.3). There was an increased risk of BCC related to the number of sunburns after the age of 20 years (OR: 3.2, 95% CI: 1.4-7.3) and solar lentigines (OR: 6.8, 95% CI: 3.6-12.8). Subgroup analysis showed that different risk factors are associated with early onset BCC including the presence of dysplastic nevi (OR: 6.4, 95% CI: 1.5-27.2), the number of weeks per year spent at the beach during childhood (OR: 8.9, 95% CI: 3.3-24.1) and the history of sunburns during childhood (OR:5.0, 95% CI: 1.3-19.1).
  
  
  CONCLUSIONS
  Fair skin colour was significantly associated with BCC risk. The relation of sunburns during adulthood with BCC underlies the importance of sunburn prevention throughout life time. Early onset BCCs seem to have a different pathogenetic background and were associated with dysplastic nevi as well as intermittent sun exposure and sunburns during the early years of life.
authors.affiliation: First Department of Dermatology, University of Athens, Andreas Sygros Hospital, Athens, Greece. cliodes@hotmail.com
authors.forename: Clio
authors.initials: C
authors.lastname: Dessinioti
authors.forename: Kimon
authors.initials: K
authors.lastname: Tzannis
authors.forename: Vana
authors.initials: V
authors.lastname: Sypsa
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Nikolaou
authors.forename: Katerina
authors.initials: K
authors.lastname: Kypreou
authors.forename: Christina
authors.initials: C
authors.lastname: Antoniou
authors.forename: Andreas
authors.initials: A
authors.lastname: Katsambas
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Stratigos
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000453:epidemiology* / Q000208:ethnology* / Q000209:etiology; D016022:Case-Control Studies; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000208:ethnology* / Q000209:etiology; D012880:Skin Pigmentation; D013471:Sunburn / Q000150:complications; D014466:Ultraviolet Rays / Q000009:adverse effects