title: Risk factors for early-onset basal cell carcinoma in a German institution.
abstract: BACKGROUND
  Genetic predisposition and ultraviolet (UV) exposure are the most important risk factors for basal cell carcinoma (BCC). Recent reports have demonstrated an increasing incidence of BCC among younger patients. We investigated potential risk factors for sporadic BCC in a subset of young German patients.
  
  
  METHODS
  Twenty-five patients with BCC at the age of 19 to 40 years (mean 34.4 years) were included in the study. They were selected from a total of 2,058 patients who received surgical treatment for BCC between December 2004 and November 2008. Patients were contacted by telephone interview and asked about sun habits, associated medical conditions, and lifestyle-related variables. Data were compared with interview results from sex-, age- and skin type-matched controls.
  
  
  RESULTS
  We found 1.4% (29) of 2,058 BCC patients to be ≤40 years of age. Four patients had Gorlin-Goltz syndrome and were excluded from further analysis. Multivariate analysis showed tanning bed use (OR= 25.0; IC95%: 2.26-277.36) and smoking (OR=13.34; IC95%: 1.56-113.8) to be the most significant independent risk factors for BCC, while sunscreen use had a protective effect.
  
  
  CONCLUSIONS
  BCCs in young patients were only rarely related to hereditary syndromes, but were associated with environmental carcinogens, i.e. UV radiation and smoking.
authors.affiliation: Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil.
authors.forename: Renato Marchiori
authors.initials: RM
authors.lastname: Bakos
authors.forename: Martin
authors.initials: M
authors.lastname: Kriz
authors.forename: Michael
authors.initials: M
authors.lastname: Mühlstädt
authors.forename: Christian
authors.initials: C
authors.lastname: Kunte
authors.forename: Thomas
authors.initials: T
authors.lastname: Ruzicka
authors.forename: Carola
authors.initials: C
authors.lastname: Berking
mesh_terms: D000328:Adult; D017668:Age of Onset; D002280:Basal Cell Carcinoma / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology*; D012907:Smoking / Q000453:epidemiology; D013471:Sunburn / Q000453:epidemiology