title: Increasing incidence and survival of a rare skin cancer in the Netherlands. A population-based study of 2,220 cases of skin adnexal carcinoma.
abstract: OBJECTIVE
  The aim of this study was to describe the epidemiology and treatment of skin adnexal carcinoma (SAC) in the Netherlands and to identify prognostic factors for survival in patients with SAC.
  
  
  METHODS
  We used population-based nationwide data from the Netherlands Cancer Registry with cases diagnosed during 1989-2010 and followed up to February 1st, 2012.
  
  
  RESULTS
  A total of 2,220 SACs were diagnosed during 1989-2010 (age-standardized incidence rate 5.3 per million). Incidence increased by 2.7% and 1.7% annually in males and females, respectively. Fifteen different morphological types were registered. The 5-year relative survival rate increased from 80% in 1989-1994 to 91% in 2006-2010. The majority of all patients (91%) received surgery. Adjuvant radiotherapy and/or lymph node dissection was performed in only a minority of cases. The risk of death was significantly higher in patients who did not receive surgery.
  
  
  CONCLUSIONS
  The rising incidence of SAC together with the predilection for the head and neck region suggests a role for UV radiation in the carcinogenesis of SAC. Furthermore, we found an improved survival of SAC in the Netherlands between 1989 and 2010. In view of the low proportion of patients receiving adjuvant therapy there may be further room for improving survival.
authors.affiliation: Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Hanneke
authors.initials: H
authors.lastname: Stam
authors.forename: Peter J F M
authors.initials: PJ
authors.lastname: Lohuis
authors.forename: Biljana
authors.initials: B
authors.lastname: Zupan-Kajcovski
authors.forename: Michel W J M
authors.initials: MW
authors.lastname: Wouters
authors.forename: Jos A
authors.initials: JA
authors.lastname: van der Hage
authors.forename: Otto
authors.initials: O
authors.lastname: Visser
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018280:Carcinoma, Skin Appendage / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D018714:Radiotherapy, Adjuvant; D012042:Registries; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D014466:Ultraviolet Rays / Q000009:adverse effects