title: Basal cell carcinoma in farmers: an occupation group at high risk.
abstract: BACKGROUND
  Skin cancer is the most commonly diagnosed cancer type worldwide, and 80 % of skin cancers are basal cell carcinoma (BCC). The main risk factor for developing BCC is exposure to ultraviolet radiation (UVR), particularly high-dose exposure at a young age. Outdoor workers, particularly farmers, are at high risk of developing BCC. However, studies of BCC in this population are scant.
  
  
  OBJECTIVE
  To comprehensively evaluate all cases of BCC of the head and neck region treated during the years 2007-2013 at our hospital in Poland, and to compare the tumour characteristics in farmers to non-farmers.
  
  
  METHODS
  Retrospective analysis of 312 patients treated for head and neck BCC during the study period (2007-2013).
  
  
  RESULTS
  Most patients (198 cases; 63 %) were males, with 114 females (37 %). Median age was 73 years (range 32-96 years). The most common tumour location was the nose and cheek (114 pts; 37 %) followed by the auricle (82 pts; 26 %), lips (54 pts; 18 %), scalp (26 pts; 8 %), and eye (36 pts; 12 %). The most common disease stage on presentation was stage T2 (104 pts, 33 %), followed by stage T1 (79 pts; 25 %), stage T3 (89 pts; 28 %), and stage T4 (40 pts; 14 %). By occupation, farmers accounted for 33 % of all patients (102 of 312 pts). The most common tumour localisations in the farmer subgroup were the nose and cheek (50 pts; 49 %; p < 0.001; odds ratio [OR] 2.19; 95 % confidence interval [CI] 1.35-3.57), followed by the auricle (32 pts; 31 %), scalp (16 pts; 16 %), ocular region (3 pts; 3 %), and lips (1 pt; 1 %). Patients in the farmer group were significantly younger than non-farmers (62 vs. 73 years; p < 0.001; OR 0.90, 95 % CI 0.88-0.93). Farmers were significantly more likely to present disease recurrence (27 vs. 12 % of cases; p < 0.001; OR 5.94; 95 % CI 2.86-12.33).
  
  
  CONCLUSIONS
  The results highlight the increased incidence and risk of recurrence of BCC in farmers. It is therefore necessary to consider enhancing educational programmes and other preventative measures in this occupational group and to evaluate the effectiveness of such programmes.
authors.affiliation: Department of Head and Neck Surgery, Greater Poland Cancer Centre, Poznan University of Medical Sciences, Garbary 15, 61-866, Poznan, Poland. mateuszszewczyk@yahoo.pl.
authors.forename: Mateusz
authors.initials: M
authors.lastname: Szewczyk
authors.affiliation: Department of Head and Neck Surgery, Greater Poland Cancer Centre, Poznan University of Medical Sciences, Garbary 15, 61-866, Poznan, Poland.
authors.forename: Jakub
authors.initials: J
authors.lastname: Pazdrowski
authors.affiliation: Department of Head and Neck Surgery, Greater Poland Cancer Centre, Poznan University of Medical Sciences, Garbary 15, 61-866, Poznan, Poland.|Department of Biology and Environmental Studies, Poznan University of Medical Sciences, Dluga 1⁄2, 61-848, Poznan, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Golusiński
authors.affiliation: Department of Dermatology, Poznan University of Medical Sciences, Przybyszewskiego 49, Poznan, Poland.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Dańczak-Pazdrowska
authors.affiliation: Department of Head and Neck Surgery, Greater Poland Cancer Centre, Poznan University of Medical Sciences, Garbary 15, 61-866, Poznan, Poland.
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Łuczewski
authors.affiliation: Department of Head and Neck Surgery, Greater Poland Cancer Centre, Poznan University of Medical Sciences, Garbary 15, 61-866, Poznan, Poland.|Department of Rehabilitation in Internal Medicine, University School of Physical Education, Poznan, Poland.
authors.forename: Sławomir
authors.initials: S
authors.lastname: Marszałek
authors.affiliation: Department of Head and Neck Surgery, Greater Poland Cancer Centre, Poznan University of Medical Sciences, Garbary 15, 61-866, Poznan, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Majchrzak
authors.affiliation: Department of Head and Neck Surgery, Greater Poland Cancer Centre, Poznan University of Medical Sciences, Garbary 15, 61-866, Poznan, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Golusiński
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000382:Agricultural Workers' Diseases / Q000453:epidemiology* / Q000209:etiology; D002280:Basal Cell Carcinoma / Q000453:epidemiology* / Q000209:etiology; D000067565:Farmers; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects; D011044:Poland / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000209:etiology; D014466:Ultraviolet Rays / Q000009:adverse effects
keywords: Basal cell carcinoma; Exposure; Farmers; Occupation; Recurrence; Sun