Risk factors and outcomes of nonmelanoma skin cancer in children and young adults Journal Article
| Authors: | Huang, J. T.; Coughlin, C. C.; Hawryluk, E. B.; Hook, K.; Humphrey, S. R.; Kruse, L.; Lawley, L.; Al-Sayegh, H.; London, W. B.; Marghoob, A.; Phung, T. L.; Pope, E.; Gerami, P.; Schmidt, B.; Robinson, S.; Bartenstein, D.; Bahrani, E.; Brahmbhatt, M.; Chen, L.; Haddock, E.; Mansour, D.; Nguyen, J.; Raisanen, T.; Tran, G.; Travis, K.; Wolner, Z.; Eichenfield, L. F. |
| Article Title: | Risk factors and outcomes of nonmelanoma skin cancer in children and young adults |
| Abstract: | Objective: To identify risk factors associated with nonmelanoma skin cancer (NMSC) occurrence and survival in children. Study design: This was a multicenter, retrospective, case-control study of patients <20 years of age diagnosed with NMSC between 1995 and 2015 from 11 academic medical centers. The primary outcome measure was frequency of cases and controls with predisposing genetic conditions and/or iatrogenic exposures, including chemotherapy, radiation, systemic immunosuppression, and voriconazole. Results: Of the 124 children with NMSC (40 with basal cell carcinoma, 90 with squamous cell carcinoma), 70% had at least 1 identifiable risk factor. Forty-four percent of the cases had a predisposing genetic condition or skin lesion, and 29% had 1 or more iatrogenic exposures of prolonged immunosuppression, radiation therapy, chemotherapy, and/or voriconazole use. Prolonged immunosuppression and voriconazole use were associated with squamous cell carcinoma occurrence (cases vs controls; 30% vs 0%, P =.0002, and 15% vs 0%, P =.03, respectively), and radiation therapy and chemotherapy were associated with basal cell carcinoma occurrence (both 20% vs 1%, P <.0001). Forty-eight percent of initial skin cancers had been present for >12 months prior to diagnosis and 49% of patients were diagnosed with ≥2 skin cancers. At last follow-up, 5% (6 of 124) of patients with NMSC died. Voriconazole exposure was noted in 7 cases and associated with worse 3-year overall survival (P =.001). Conclusions: NMSC in children and young adults is often associated with a predisposing condition or iatrogenic exposure. High-risk patients should be identified early to provide appropriate counseling and management. © 2019 Elsevier Inc. |
| Keywords: | chemotherapy; radiation therapy; xeroderma pigmentosum; voriconazole; basal cell nevus syndrome; iatrogenic; genodermatosis; prolonged immunosuppression |
| Journal Title: | Journal of Pediatrics |
| Volume: | 211 |
| ISSN: | 0022-3476 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2019-08-01 |
| Start Page: | 152 |
| End Page: | 158 |
| Language: | English |
| DOI: | 10.1016/j.jpeds.2019.04.017 |
| PUBMED: | 31103258 |
| PROVIDER: | scopus |
| PMCID: | PMC7916541 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 2 August 2019 -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work