• Vol. 36 No. 3, 189–193
  • 15 March 2007

Squamous Cell Carcinoma and Bowen’s Disease of the Skin in Singapore



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Introduction: Non-melanoma skin cancer is one of the commonest cancers in Singapore and worldwide. The aim of our study was to evaluate the demographic and clinicopathological patterns of squamous cell carcinoma (SCC) and Bowen’s disease (BD) of the skin, in order to better understand the characteristics of these tumours in our population. Materials and Methods: Histologically proven cases of SCC and BD seen at our centre between 2002 and 2003 were retrospectively analysed according to age, sex, race, predisposing factors such as immunosuppression and ultraviolet therapy, site and size of tumour, histological differentiation and subtype, and treatment method. Results: A total of 161 patients were studied – 81 with SCC, 68 with BD, and 12 with both tumours. There were 199 tumours in total – 105 SCC and 94 BD. For both SCC and BD, males outnumbered females (ratio of 2.4:1 and 1.5:1 respectively); patient age averaged 72.9 years and 66.8 years respectively; and Chinese were the majority race. The mean duration to presentation was 21.2 months for SCC compared with 39.9 months for BD, and common symptoms were itch, pain and bleeding for both. The mean tumour size was 19.0 mm and 18.5 mm, and the commonest site was the head and neck for both. Conclusions: SCC and BD show rather similar patient characteristics, with a predominance among males, having a predilection for the head and neck region, and with a tendency towards slow growth. As incidences increase worldwide, it is important for healthcare providers to be adept at recognising and managing non-melanoma skin cancers.

Skin cancer is the seventh most common cancer in Singapore.1 Koh et al2 reported a total of 1407 squamous cell carcinomas (SCCs) occurring in the Asian population of Singapore using data obtained from the Singapore Cancer Registry over a 30-year period between 1968 and 1997. Tan et al3 reported a total of 520 patients with skin cancer seen at the National Skin Centre (NSC) between 1980 and 1991, of which 36.5% were basal cell carcinomas (BCCs), 24.4% SCCs and 16.7% Bowen’s disease (BD). Skin cancers represent a major public health problem worldwide, with increasing workload and cost in dealing with this problem, together with significant morbidity suffered by those affected. We sought to analyse retrospectively, data on histologically proven cases of SCC and BD seen over a 2-year period from 2002 to 2003, in order to develop a better understanding of the characteristics of these skin cancers among the different races in Singapore. Previous studies have not characterised SCC or BD in our local context according to clinical subtype or histological differentiation.

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