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18 The Impact of Social Deprivation on TNM Staging of Non-Melanoma Skin Cancers: An Initial Review

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Over 150,000 cases of non-melanoma skin cancer (NMSC) are diagnosed per year in the UK [1], with greatest incidence in less deprived socioeconomic groups [2]. The association between social deprivation… Click to show full abstract

Over 150,000 cases of non-melanoma skin cancer (NMSC) are diagnosed per year in the UK [1], with greatest incidence in less deprived socioeconomic groups [2]. The association between social deprivation and melanoma staging has been reported [3], however is not as well considered in Basal or Squamous Cell Carcinomas (BCCs/SCCs). A pilot review of 200 NMSC excision biopsies completed at a single hospital was undertaken. Specimens were identified via the histopathology database and included all excising specialities and anatomical locations. Registered postcodes were categorised into a decile via the English Indices of Deprivation 2019 database (1= most deprived, 10= least deprived). Tumour staging was identified from the histopathology report. 200 specimens were reviewed including 9 deprivation deciles ranging from Decile 2 to Decile 10. Decile 6 was the most common decile, incorporating 20% of all specimens. pT1 BCCs were the most commonly excised lesion at 68.5%, pT3 BCCs and SCCs were least commonly excised (1.5% of specimens each). Increased proportions of pT2 BCCs and SCCs occurred in less deprived deciles, contrasting with pT3 BCCs which clustered in Deciles 6 and 7. pT3 SCCs comprised 11.1% of excised lesions in Decile 4, the greatest proportion outside of pT1 lesions. This initial review suggests that the distribution of NMSC staging is not even across social deprivation levels. Increased proportions of pT2 staged lesions occurred in less deprived cohorts. Further expansion of the dataset is justified to assess the degree to which social deprivation may affect NMSC stage at excision.

Keywords: non melanoma; social deprivation; histopathology; deprivation; initial review; melanoma skin

Journal Title: British Journal of Surgery
Year Published: 2021

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