The rate of squamous cell carcinoma affecting the eyelids has risen steadily in England over the past 15 years, according to an analysis published today.
The main cause of the problem is the ageing of the population, according to the study.
To compile the figures, a team from the National Cancer Registration and Analysis Service identified all diagnosed cases between 2000 and 2014. Over this period there were 4,022 cases, rising by about 2% per year.
"Age was exponentially correlated with incidence," the researchers report in today’s (24 January) British Journal of Ophthalmology. There was an approximate doubling of the risk for every decade over the age of 60.
The relative risk of eyelid squamous cell carcinoma in men compared with women was almost double. Social deprivation did not appear to be linked to risk of squamous cell carcinoma.
The authors, led by Dr James Wawrzynski, of Moorfields Eye Hospital NHS Foundation Trust, London, UK, write: "The incidence of eyelid squamous cell carcinoma in England is rising. In addition, the age-standardised and population standardised rate of squamous cell carcinoma is also rising. A higher risk of squamous cell carcinoma is strongly correlated with age and male sex but not with deprivation."
They add: "The reason for the strong association between eyelid squamous cell carcinoma and age is likely to be due to cumulative exposure to environmental risk factors including UV radiation and iatrogenic [medically induced] causes, such as the use of systemic immunosuppression to treat autoimmune disease and prevent rejection of solid organ transplant."
They are less clear about the reasons behind the sex difference, but they suggest that it may be behavioural, with men more likely to be exposed to sunlight, or it might even be that the female hormone oestrogen is protective.
Wawrzynski, J. et al. Report on the incidence of squamous cell carcinomas affecting the eyelids in England over a 15-year period (2000-2014). British Journal of Ophthalmology 24 January 2018; doi: 10.1136/bjophthalmol-2017-310956 [abstract]
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