Carcinogenesis, Vol 18, 1499-1503, Copyright © 1997 by Oxford University Press
JT Lear, AG Smith, AH Heagerty, B Bowers, PW Jones, J Gilford, J Alldersea, RC Strange and AA Fryer
Basal cell carcinoma (BCC) is the commonest cancer in Caucasians. Its
incidence is rising and many patients develop multiple primary tumours at
separate sites. Factors determining time between first primary tumour
presentation and the next new primary lesion are unclear. We used Cox's
proportional hazards model to study, in 856 Caucasians, the influence of
tumour site, individual characteristics and polymorphism in glutathione
S-transferase (GSTM1, GSTT1) and cytochrome P450 (CYP2D6, CYP1A1) loci on
time to next primary tumour presentation. More than one tumour at first
presentation (P <0.0001, hazard ratio 2.72) and GSTT1 null (P = 0.028,
hazard ratio 1.74) were associated with decreased time to next primary
tumour presentation. Significant two- factor interactions, corrected for
number of tumours at presentation, were identified between a truncal tumour
at first presentation and each of male gender, GSTM1 null and CYP2D6 EM (P
<0.003, hazard ratios 3.09- 3.82). In each of these cases, all patients
with the risk combination demonstrated further separate tumours within 5
years of first presentation. Thus, patients with a truncal tumour at first
presentation, especially males and those presenting with more than one
lesion have a significantly decreased time to presentation of further
tumours and should receive more meticulous follow-up. Polymorphism in GSTM1
and CYP2D6 also influences the rate of new primary tumour accrual giving
insights into the link between ultraviolet exposure and multiple tumour
development.
ARTICLES
Truncal site and detoxifying enzyme polymorphisms significantly reduce time to presentation of further primary cutaneous basal cell carcinoma
Department of Dermatology, North Staffordshire Hospital, Stoke-on- Trent, UK.
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