title: Regional variations of basal cell carcinoma incidence in the U.K. using The Health Improvement Network database (2004-10).
abstract: BACKGROUND
  Basal cell carcinoma (BCC) is one of the most common types of nonmelanoma skin cancer affecting the white population; however, little is known about how the incidence varies across the U.K.
  
  
  OBJECTIVE
  To determine the variation in BCC throughout the U.K.
  
  
  METHODS
  Data from 2004 to 2010 were obtained from The Health Improvement Network database. European and world age-standardized incidence rates (EASRs and WASRs, respectively) were obtained for country-level estimates and levels of socioeconomic deprivation, while strategic health-authority-level estimates were directly age and sex standardized to the U.K. standard population. Incidence-rate ratios were estimated using multivariable Poisson regression models.
  
  
  RESULTS
  The overall EASR and WASR of BCC in the U.K. were 98.6 per 100,000 person-years and 66.9 per 100,000 person-years, respectively. Regional-level incidence rates indicated a significant geographical variation in the distribution of BCC, which was more pronounced in the southern parts of the country. The South East Coast had the highest BCC rate followed by South Central, Wales and the South West. Incidence rates were substantially higher in the least deprived groups and we observed a trend of decreasing incidence with increasing levels of deprivation (P < 0.001). Finally, in terms of age groups, the largest annual increase was observed among those aged 30-49 years.
  
  
  CONCLUSIONS
  Basal cell carcinoma is an increasing health problem in the U.K.; the southern regions of the U.K. and those in the least deprived groups had a higher incidence of BCC. Our findings indicate an increased incidence of BCC for younger age groups below 49 years.
authors.affiliation: Division of Epidemiology and Public Health, University of Nottingham, Clinical Sciences Building (Phase 2), Nottingham, NG5 1PB, U.K.
authors.forename: A
authors.initials: A
authors.lastname: Musah
authors.forename: J E
authors.initials: JE
authors.lastname: Gibson
authors.forename: J
authors.initials: J
authors.lastname: Leonardi-Bee
authors.forename: M R
authors.initials: MR
authors.lastname: Cave
authors.forename: E L
authors.initials: EL
authors.lastname: Ander
authors.forename: F
authors.initials: F
authors.lastname: Bath-Hextall
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012111:Residence Characteristics / Q000706:statistics & numerical data; D017678:Sex Distribution; D012878:Skin Neoplasms / Q000453:epidemiology*; D006113:United Kingdom / Q000453:epidemiology