title: Trends in Basal Cell Carcinoma Incidence and Identification of High-Risk Subgroups, 1998-2012.
abstract: OBJECTIVE
  The incidence of basal cell carcinomas (BCCs) is increasing globally, but incidence rates in the United States are difficult to quantify because BCCs are not reportable tumors.
  
  
  OBJECTIVE
  To estimate annual BCC incidence rates by age, sex, and race/ethnicity to identify demographically distinct high-risk subgroups and to assess changes in rates over time.
  
  
  METHODS
  In this retrospective cohort study (January 1, 1998, through December 31, 2012), we studied 147 093 patients with BCC from Kaiser Permanente Northern California, a large, integrated health care provision system, identified using a previously validated BCC registry.
  
  
  METHODS
  We estimated annual BCC incidence rates by age, sex, and race/ethnicity and assessed changes in rates over time. The BCC incidence rates were standardized to the age, sex, and race/ethnicity distribution of the 2010 US Census population.
  
  
  RESULTS
  In models adjusting for age, sex, and race, male patients had higher rates than female patients (incidence rate ratio [IRR], 1.65; 95% CI, 1.60-1.70). Persons 65 through 79 years of age and those 80 years and older had higher rates than persons 40 through 64 years of age (IRR, 2.96; 95% CI, 2.86-3.06; and IRR, 5.14; 95% CI, 4.94-5.35, respectively). Whites had higher rates than multiracial persons (IRR, 1.96; 95% CI, 1.80-2.13), Hispanics (IRR, 8.56; 95% CI, 7.79-9.41), Asians (IRR, 33.13; 95% CI, 27.84-39.42), and blacks (IRR, 72.98; 95% CI, 49.21-108.22).
  
  
  CONCLUSIONS
  We estimate that BCCs occur in approximately 2 million Americans annually. Our findings provide an updated estimate of the incidence of BCCs, highlight the changing epidemiologic findings, and better identify demographically distinct high-risk subgroups.
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland2Department of Dermatology, University of California at San Francisco, San Francisco3Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston.
authors.forename: Maryam M
authors.initials: MM
authors.lastname: Asgari
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland.
authors.forename: Howard H
authors.initials: HH
authors.lastname: Moffet
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland.
authors.forename: G Thomas
authors.initials: GT
authors.lastname: Ray
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland.
authors.forename: Charles P
authors.initials: CP
authors.lastname: Quesenberry
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D002280:Basal Cell Carcinoma / Q000208:ethnology*; D002648:Child; D002675:Child, Preschool; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D017678:Sex Distribution; D012737:Sex Factors; D012878:Skin Neoplasms / Q000208:ethnology*; D055815:Young Adult