title: Population-based estimates of the occurrence of multiple vs first primary basal cell carcinomas in 4 European regions.
abstract: OBJECTIVE
  To estimate the population-based incidence of first and multiple basal cell carcinomas (BCCs) throughout Europe.
  
  
  METHODS
  The registry practices of 4 population-based cancer registries that routinely register BCC incidence were evaluated for inclusion of first and subsequent histologically confirmed BCCs. Where multiple BCCs were not routinely registered, comparisons with hospital databases were made.
  
  
  METHODS
  Cancer registry databases from Finland, Malta, the Netherlands (Eindhoven), and Scotland were inspected for registry of first and multiple BCCs in recent years. Cross-checks with hospital and pathology databases were made to check for completeness.
  
  
  RESULTS
  Age-standardized first BCC incidence rates varied between 77 (Malta) and 158 (Eindhoven) per 100 000 person-years. Generally, rates were higher in males than in females, and incidences increased steeply with increasing age. There were approximately 30% more patients with a BCC and 40% to 100% more BCC tumors diagnosed in a given calendar year than were routinely reported for patients with a first primary BCC. The difference between the number of first primary BCCs and the total number of BCCs in a calendar year was generally slightly higher for males than for females and increased substantially with increasing age.
  
  
  CONCLUSIONS
  Currently, routinely reported first BCC incidence rates of the included countries should be multiplied by a factor of 1.3 for an estimate of total number of patients diagnosed as having a BCC in a given year.
authors.affiliation: Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
authors.forename: Esther
authors.initials: E
authors.lastname: de Vries
authors.forename: Rita
authors.initials: R
authors.lastname: Micallef
authors.forename: David H
authors.initials: DH
authors.lastname: Brewster
authors.forename: James H
authors.initials: JH
authors.lastname: Gibbs
authors.forename: Sophie C
authors.initials: SC
authors.lastname: Flohil
authors.forename: Olli
authors.initials: O
authors.lastname: Saksela
authors.forename: Risto
authors.initials: R
authors.lastname: Sankila
authors.forename: Alasdair D
authors.initials: AD
authors.lastname: Forrest
authors.forename: Myrto
authors.initials: M
authors.lastname: Trakatelli
authors.forename: Jan Willem W
authors.initials: JW
authors.lastname: Coebergh
authors.forename: Charlotte M
authors.initials: CM
authors.lastname: Proby
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D012042:Registries; D012737:Sex Factors; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology