title: Skin Cancer Incidence and Mortality in Spain: A Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  The aim of this systematic review was to describe the incidence and mortality of basal cell carcinoma, squamous cell carcinoma, melanoma, and Merkel cell carcinoma in Spain.
  
  
  METHODS
  We performed a search of the MEDLINE and Embase databases and reviewed articles from the Spanish Network of Cancer Registries (REDECAN) and the International Agency for Research on Cancer (IARC). The methodological quality of the studies was evaluated and statistical heterogeneity was measured using the I(2) index. A random-effects model was used to perform the meta-analysis because of the heterogeneity of the data.
  
  
  RESULTS
  Thirty-two papers were included in the systematic review. The crude incidence rate for basal cell carcinoma was 113.05 (95% CI, 89.03-137.08) cases per 100 000 person-years for the studies based on the registration methodology normally used by registries (in which only 1 tumor with histological confirmation is counted per person). However, the same incidence rate calculated on the basis of clinical and histologic criteria and counting tumors rather than individual patients was 253.23 (95% CI, 273.01-269.45) cases per 100 000 person-years. The incidence was 38.16 (95% CI, 31.72-39.97) cases per 100 000 person-years for squamous cell carcinoma, 8.76 (95% CI, 7.50-10.02) cases per 100 000 person-years for melanoma, and 0.28 (95% CI, 0.15-0.40) cases per 100 000 person-years for Merkel cell carcinoma.
  
  
  CONCLUSIONS
  The registration methodology normally used by cancer registries probably underestimates the incidence rates of basal cell and squamous cell carcinoma in Spain. The incidence rates of cutaneous melanoma and Merkel cell carcinoma are lower in Spain than in other European countries.
authors: Servicio de Dermatología, Instituto Dermatológico GlobalDerm, Palma del Río, Córdoba, España. Electronic address: antoniotejera@aedv.es.
authors: A
authors: A
authors: Tejera-Vaquerizo
authors: Unidad de Investigación, Fundación AEDV, Madrid, España.
authors: M A
authors: MA
authors: Descalzo-Gallego
authors: Servicio de Dermatología, Hospital Universitario Lucus Augusti, Lugo, España.
authors: M M
authors: MM
authors: Otero-Rivas
authors: Servicio de Dermatología, Complexo Hospitalario Universitario de Vigo, Vigo, España.
authors: C
authors: C
authors: Posada-García
authors: Servicio de Dermatología, Complexo Hospitalario Universitario de Vigo, Vigo, España.
authors: L
authors: L
authors: Rodríguez-Pazos
authors: Interdisciplinary Research Institute, Université Libre de Bruxelles, Bruselas, Bélgica.
authors: I
authors: I
authors: Pastushenko
authors: Institut Català d'Oncologia, Pla Director d'Oncologia, Unitat d'Epidemiologia i Registre de Càncer de Girona (UERCG), Institut d'Investigació Biomèdica de Girona (IdIBGi), Universitat de Girona, Girona, España.
authors: R
authors: R
authors: Marcos-Gragera
authors: Unidad de Investigación, Fundación AEDV, Madrid, España; Servicio de Dermatología, Complexo Hospitalario Universitario de Vigo, Vigo, España.
authors: I
authors: I
authors: García-Doval
mesh_terms: D002280:Basal Cell Carcinoma / Q000453:epidemiology; D015266:Carcinoma, Merkel Cell / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008545:Melanoma / Q000453:epidemiology; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000401:mortality; D013030:Spain / Q000453:epidemiology
keywords: Basal cell carcinoma; Carcinoma de células basales; Carcinoma de células de Merkel; Carcinoma de células escamosas; Epidemiology; Epidemiología; Incidence; Incidencia; Merkel cell carcinoma; Meta-analysis; Metaanálisis; Mortalidad; Mortality; Review; Revisión; Squamous cell carcinoma