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Risk Factors and Behavioral Changes in Basal Cell Carcinoma: Perspective From Romania

By: Kayci Reyer
Posted: Wednesday, December 23, 2020

According to the results from an observational study from Romania, published in Experimental and Therapeutic Medicine, there may be a need for public health initiatives that focus on sun-related education as well as vitamin D deficiency. Mihaela Carmen Mihu, MD, PhD, of the University of Medicine and Pharmacy, Cluj-Napoca, Romania, and colleagues, sought to identify risk factors for basal cell carcinoma among the Romanian population.

Conducted between November 2017 and March 2018, the study included 52 patients with basal cell carcinoma and 59 healthy individuals acting as controls, all of whom were from the same geographic region. Patients were then categorized according to tumor occurrence: single, multiple, recurrent, or both multiple and recurrent. Participants responded to questions regarding disease risk factors and provided blood samples for vitamin D serum level testing.

Overall, patients with basal cell carcinoma had experienced lentigines and at least one childhood sunburn (P < .001). Patients also reported spending more time in the sun than did those in the control group (3–8 hours vs 1.5–4 hours, respectively; P < .001), though both groups reported a similar number of hours of outdoor work. Among both groups, vitamin D serum levels were lower than anticipated.

The limited size of the case pool resulted in no statistical differences between the four subgroups. However, fewer sunburns were reported by patients who had developed basal cell carcinomas at multiple sites than by patients with a single, recurrent tumor (P = .02). Vitamin D serum levels were marginally lower among patients with multiple and recurrent tumors than in those with single tumors (P = .1), despite a higher rate of vitamin D supplement use among those with multiple and recurrent tumors after diagnosis (P = .2). In general, patients were more likely to use sunscreen following diagnosis, though half remained noncompliant with sun-protection guidelines.

Disclosure: The study authors reported no conflicts of interest.

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