title: Insight into the number of pre-malignancies and malignancies of the skin in a hospital population in the Netherlands.
abstract: BACKGROUND
  Skin cancer incidence is rising, placing a burden on healthcare systems worldwide. This problem may even be more extensive than expected, since registration of (pre)malignancies of the skin is poor.
  
  
  OBJECTIVE
  To provide insight into the numbers of (pre)malignancies in patients with actinic keratosis (AK) or basal cell carcinoma (BCC) in 2 university and 2 general hospitals.
  
  
  METHODS
  The types and numbers of previous tumours and of tumours during a two-year follow-up were collected from 574 patients.
  
  
  RESULTS
  Mean time between the first diagnosed (pre)malignancy and time of inclusion was 6.6 years. Overall, 60% had multiple types of (pre)malignancies. In BCC patients, 61% had multiple BCCs, in patients with squamous cell carcinoma (SCC), 40% had multiple SCCs. The combination 'BCC and SCC' occurred in 10%, 'BCC and AK' in 47%, 'SCC and AK' in 14%.
  
  
  CONCLUSIONS
  High numbers of patients with multiple (pre)malignancies were found in this patient population in university and general hospitals, which may well reflect the Dutch hospital population. We conclude that skin cancer patients are more extensively affected than was expected up till now. Consequently, the management of skin cancer may be in need of adaptation in near future and the question arises whether dermatologists have the capacity for providing care for all these patients.
authors: Department of Dermatology, Radboud university medical center, PO Box 9101, 6500 HB Nijmegen, the Netherlands.
authors: Margit
authors: M
authors: van Rijsingen
authors: Department of Dermatology, Radboud university medical center, PO Box 9101, 6500 HB Nijmegen, the Netherlands.
authors: Inge
authors: I
authors: Seubring
authors: Department of Dermatology, Rijnstate Hospital, Arnhem, The Netherlands.
authors: Birgitte
authors: B
authors: Maessen-Visch
authors: Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands.
authors: Sjan
authors: S
authors: Lavrijsen
authors: Department of Dermatology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
authors: Bert
authors: B
authors: van Bergen
authors: Department for Health Evidence, Radboud university medical center, Nijmegen, the Netherlands.
authors: Johannes
authors: J
authors: Groenewoud
authors: Department of Dermatology, Radboud university medical center, PO Box 9101, 6500 HB Nijmegen, the Netherlands.
authors: Marie-Jeanne
authors: MJ
authors: Gerritsen
mesh_terms: D000368:Aged; D002280:Basal Cell Carcinoma / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D055623:Keratosis, Actinic / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology; D009426:Netherlands / Q000453:epidemiology; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000473:pathology
keywords: burden; management; pre-malignancies; registration; skin cancer