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The epidemiology, healthcare and societal burden of basal cell carcinoma in Wales 2000–2018: a retrospective nationwide analysis

Nader Ibrahim, Matt Jovic, Stephen Ali, Namor Williams, John Gibson, Rowena Griffiths, Thomas Dobbs, Ashley Akbari Orcid Logo, Ronan A Lyons, Hayley Hutchings Orcid Logo, Iain Whitaker

British Journal of Dermatology, Volume: 188, Issue: 3, Pages: 380 - 389

Swansea University Authors: Nader Ibrahim, Matt Jovic, Stephen Ali, John Gibson, Rowena Griffiths, Thomas Dobbs, Ashley Akbari Orcid Logo, Hayley Hutchings Orcid Logo, Iain Whitaker

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DOI (Published version): 10.1093/bjd/ljac090

Abstract

BackgroundBasal Cell Carcinoma (BCC) represents the most commonly occurring cancer worldwide within the Caucasian population. Reports predict 298 308 cases of BCC in the UK by 2025, at a cost of £265-366 million to the National Health Service (NHS). Despite the morbidity, societal and healthcare pre...

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Published in: British Journal of Dermatology
ISSN: 0007-0963 1365-2133
Published: Oxford University Press (OUP) 2023
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Reports predict 298 308 cases of BCC in the UK by 2025, at a cost of £265-366 million to the National Health Service (NHS). Despite the morbidity, societal and healthcare pressures that manifest, routinely collected healthcare data and global registration remains limited.ObjectivesTo calculate the incidence of BCC in Wales between 2000-2018 and to establish the healthcare utilisation and estimated cost of care.MethodsThe Secure Anonymised Information Linkage (SAIL) Databank is one of the largest and most robust health and social care data repositories in the UK. Cancer registry data was linked to routinely collected healthcare databases between 2000-2018. Pathological data from Swansea Bay University Health Board (SBUHB) was used for internal validation.Results61,404 histologically proven BCC were identified during the study period within the SAIL databank. The European age standardised incidence (EASR) for BCC in 2018 was 224.6 per 100,000. Based on validated regional data a 45% greater incidence was noted within SBUHB pathology versus matched regions within SAIL between 2016-2018. A negative association between deprivation and incidence was noted with a higher incidence in the least socially deprived and rural dwellers. Approximately 2% travelled 25-50 miles for dermatological services in comparison to 37% for plastic surgery. Estimated NHS costs of surgically managed lesions 2002-2019 equated to £119.2-164.4 million.ConclusionRobust epidemiological data which are internationally comparable, and representative is scarce within non-melanoma skin cancer despite cases of individual improvement. The rising global incidence coupled with struggling healthcare systems in the post Covid-19 recovery period serves to intensify the societal and healthcare impact. This study is the first to demonstrate the incidence of BCC in Wales and one of a small number in the UK using internally validated large cohort datasets, and further demonstrates one of the highest published incidences within the UK and Europe. In the modern era of health informatics and advanced analytics it is imperative that we capitalise on routinely collected healthcare data. Therefore, it must be accurate, comprehensive, and accessible otherwise services will under-deliver.</abstract><type>Journal Article</type><journal>British Journal of Dermatology</journal><volume>188</volume><journalNumber>3</journalNumber><paginationStart>380</paginationStart><paginationEnd>389</paginationEnd><publisher>Oxford University Press (OUP)</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0007-0963</issnPrint><issnElectronic>1365-2133</issnElectronic><keywords/><publishedDay>22</publishedDay><publishedMonth>2</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-02-22</publishedDate><doi>10.1093/bjd/ljac090</doi><url>http://dx.doi.org/10.1093/bjd/ljac090</url><notes/><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm>SU Library paid the OA fee (TA Institutional Deal)</apcterm><funders>This research was supported via the RESECT project, which is part of the Scar Free Foundation Programme of Regenerative Research at the Reconstructive Surgery &amp; Regenerative Medicine Research Centre (ReconRegen) in partnership with Health and Care Research Wales. This work was supported by Health Data Research UK, which receives its funding from HDR UK Ltd (HDR-9006) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust; ADR Wales is part of the Economic and Social Research Council (part of UK Research and Innovation) funded ADR UK (grant ES/S007393/1).</funders><projectreference/><lastEdited>2023-09-13T15:46:04.8940687</lastEdited><Created>2022-11-26T17:48:15.6938120</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Nader</firstname><surname>Ibrahim</surname><order>1</order></author><author><firstname>Matt</firstname><surname>Jovic</surname><order>2</order></author><author><firstname>Stephen</firstname><surname>Ali</surname><order>3</order></author><author><firstname>Namor</firstname><surname>Williams</surname><order>4</order></author><author><firstname>John</firstname><surname>Gibson</surname><order>5</order></author><author><firstname>Rowena</firstname><surname>Griffiths</surname><order>6</order></author><author><firstname>Thomas</firstname><surname>Dobbs</surname><order>7</order></author><author><firstname>Ashley</firstname><surname>Akbari</surname><orcid>0000-0003-0814-0801</orcid><order>8</order></author><author><firstname>Ronan A</firstname><surname>Lyons</surname><order>9</order></author><author><firstname>Hayley</firstname><surname>Hutchings</surname><orcid>0000-0003-4155-1741</orcid><order>10</order></author><author><firstname>Iain</firstname><surname>Whitaker</surname><orcid/><order>11</order></author></authors><documents><document><filename>62055__26915__ae11794993454389b6ceddbb7f50caaa.pdf</filename><originalFilename>ljac090.62055.VOR.pdf</originalFilename><uploaded>2023-03-22T10:59:10.8237586</uploaded><type>Output</type><contentLength>1334736</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© The Author(s) 2022. 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spelling v2 62055 2022-11-26 The epidemiology, healthcare and societal burden of basal cell carcinoma in Wales 2000–2018: a retrospective nationwide analysis f1e47991b9903dae5fc909ae0019e9b0 Nader Ibrahim Nader Ibrahim true false c7bbcd83338d226f4c6157a682694a6d Matt Jovic Matt Jovic true false 8c210736c07c6aa2514e0f6b3cfd9764 Stephen Ali Stephen Ali true false 681cf87df3796a68ef3da257db7a0a3f John Gibson John Gibson true false 381464f639f98bd388c29326ca7f862c Rowena Griffiths Rowena Griffiths true false d18101ae0b4e72051f735ef68f45e1a8 Thomas Dobbs Thomas Dobbs true false aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false bdf5d5f154d339dd92bb25884b7c3652 0000-0003-4155-1741 Hayley Hutchings Hayley Hutchings true false 830074c59291938a55b480dcbee4697e Iain Whitaker Iain Whitaker true false 2022-11-26 HDAT BackgroundBasal Cell Carcinoma (BCC) represents the most commonly occurring cancer worldwide within the Caucasian population. Reports predict 298 308 cases of BCC in the UK by 2025, at a cost of £265-366 million to the National Health Service (NHS). Despite the morbidity, societal and healthcare pressures that manifest, routinely collected healthcare data and global registration remains limited.ObjectivesTo calculate the incidence of BCC in Wales between 2000-2018 and to establish the healthcare utilisation and estimated cost of care.MethodsThe Secure Anonymised Information Linkage (SAIL) Databank is one of the largest and most robust health and social care data repositories in the UK. Cancer registry data was linked to routinely collected healthcare databases between 2000-2018. Pathological data from Swansea Bay University Health Board (SBUHB) was used for internal validation.Results61,404 histologically proven BCC were identified during the study period within the SAIL databank. The European age standardised incidence (EASR) for BCC in 2018 was 224.6 per 100,000. Based on validated regional data a 45% greater incidence was noted within SBUHB pathology versus matched regions within SAIL between 2016-2018. A negative association between deprivation and incidence was noted with a higher incidence in the least socially deprived and rural dwellers. Approximately 2% travelled 25-50 miles for dermatological services in comparison to 37% for plastic surgery. Estimated NHS costs of surgically managed lesions 2002-2019 equated to £119.2-164.4 million.ConclusionRobust epidemiological data which are internationally comparable, and representative is scarce within non-melanoma skin cancer despite cases of individual improvement. The rising global incidence coupled with struggling healthcare systems in the post Covid-19 recovery period serves to intensify the societal and healthcare impact. This study is the first to demonstrate the incidence of BCC in Wales and one of a small number in the UK using internally validated large cohort datasets, and further demonstrates one of the highest published incidences within the UK and Europe. In the modern era of health informatics and advanced analytics it is imperative that we capitalise on routinely collected healthcare data. Therefore, it must be accurate, comprehensive, and accessible otherwise services will under-deliver. Journal Article British Journal of Dermatology 188 3 380 389 Oxford University Press (OUP) 0007-0963 1365-2133 22 2 2023 2023-02-22 10.1093/bjd/ljac090 http://dx.doi.org/10.1093/bjd/ljac090 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University SU Library paid the OA fee (TA Institutional Deal) This research was supported via the RESECT project, which is part of the Scar Free Foundation Programme of Regenerative Research at the Reconstructive Surgery & Regenerative Medicine Research Centre (ReconRegen) in partnership with Health and Care Research Wales. This work was supported by Health Data Research UK, which receives its funding from HDR UK Ltd (HDR-9006) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust; ADR Wales is part of the Economic and Social Research Council (part of UK Research and Innovation) funded ADR UK (grant ES/S007393/1). 2023-09-13T15:46:04.8940687 2022-11-26T17:48:15.6938120 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Nader Ibrahim 1 Matt Jovic 2 Stephen Ali 3 Namor Williams 4 John Gibson 5 Rowena Griffiths 6 Thomas Dobbs 7 Ashley Akbari 0000-0003-0814-0801 8 Ronan A Lyons 9 Hayley Hutchings 0000-0003-4155-1741 10 Iain Whitaker 11 62055__26915__ae11794993454389b6ceddbb7f50caaa.pdf ljac090.62055.VOR.pdf 2023-03-22T10:59:10.8237586 Output 1334736 application/pdf Version of Record true © The Author(s) 2022. Published by Oxford University Press on behalf of British Association of Dermatologists. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (CC-BY), which permits unrestricted reuse,distribution, and reproduction in any medium, provided the original work is properly cited. true eng https://creativecommons.org/licenses/by/4.0/
title The epidemiology, healthcare and societal burden of basal cell carcinoma in Wales 2000–2018: a retrospective nationwide analysis
spellingShingle The epidemiology, healthcare and societal burden of basal cell carcinoma in Wales 2000–2018: a retrospective nationwide analysis
Nader Ibrahim
Matt Jovic
Stephen Ali
John Gibson
Rowena Griffiths
Thomas Dobbs
Ashley Akbari
Hayley Hutchings
Iain Whitaker
title_short The epidemiology, healthcare and societal burden of basal cell carcinoma in Wales 2000–2018: a retrospective nationwide analysis
title_full The epidemiology, healthcare and societal burden of basal cell carcinoma in Wales 2000–2018: a retrospective nationwide analysis
title_fullStr The epidemiology, healthcare and societal burden of basal cell carcinoma in Wales 2000–2018: a retrospective nationwide analysis
title_full_unstemmed The epidemiology, healthcare and societal burden of basal cell carcinoma in Wales 2000–2018: a retrospective nationwide analysis
title_sort The epidemiology, healthcare and societal burden of basal cell carcinoma in Wales 2000–2018: a retrospective nationwide analysis
author_id_str_mv f1e47991b9903dae5fc909ae0019e9b0
c7bbcd83338d226f4c6157a682694a6d
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d18101ae0b4e72051f735ef68f45e1a8
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author_id_fullname_str_mv f1e47991b9903dae5fc909ae0019e9b0_***_Nader Ibrahim
c7bbcd83338d226f4c6157a682694a6d_***_Matt Jovic
8c210736c07c6aa2514e0f6b3cfd9764_***_Stephen Ali
681cf87df3796a68ef3da257db7a0a3f_***_John Gibson
381464f639f98bd388c29326ca7f862c_***_Rowena Griffiths
d18101ae0b4e72051f735ef68f45e1a8_***_Thomas Dobbs
aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari
bdf5d5f154d339dd92bb25884b7c3652_***_Hayley Hutchings
830074c59291938a55b480dcbee4697e_***_Iain Whitaker
author Nader Ibrahim
Matt Jovic
Stephen Ali
John Gibson
Rowena Griffiths
Thomas Dobbs
Ashley Akbari
Hayley Hutchings
Iain Whitaker
author2 Nader Ibrahim
Matt Jovic
Stephen Ali
Namor Williams
John Gibson
Rowena Griffiths
Thomas Dobbs
Ashley Akbari
Ronan A Lyons
Hayley Hutchings
Iain Whitaker
format Journal article
container_title British Journal of Dermatology
container_volume 188
container_issue 3
container_start_page 380
publishDate 2023
institution Swansea University
issn 0007-0963
1365-2133
doi_str_mv 10.1093/bjd/ljac090
publisher Oxford University Press (OUP)
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
url http://dx.doi.org/10.1093/bjd/ljac090
document_store_str 1
active_str 0
description BackgroundBasal Cell Carcinoma (BCC) represents the most commonly occurring cancer worldwide within the Caucasian population. Reports predict 298 308 cases of BCC in the UK by 2025, at a cost of £265-366 million to the National Health Service (NHS). Despite the morbidity, societal and healthcare pressures that manifest, routinely collected healthcare data and global registration remains limited.ObjectivesTo calculate the incidence of BCC in Wales between 2000-2018 and to establish the healthcare utilisation and estimated cost of care.MethodsThe Secure Anonymised Information Linkage (SAIL) Databank is one of the largest and most robust health and social care data repositories in the UK. Cancer registry data was linked to routinely collected healthcare databases between 2000-2018. Pathological data from Swansea Bay University Health Board (SBUHB) was used for internal validation.Results61,404 histologically proven BCC were identified during the study period within the SAIL databank. The European age standardised incidence (EASR) for BCC in 2018 was 224.6 per 100,000. Based on validated regional data a 45% greater incidence was noted within SBUHB pathology versus matched regions within SAIL between 2016-2018. A negative association between deprivation and incidence was noted with a higher incidence in the least socially deprived and rural dwellers. Approximately 2% travelled 25-50 miles for dermatological services in comparison to 37% for plastic surgery. Estimated NHS costs of surgically managed lesions 2002-2019 equated to £119.2-164.4 million.ConclusionRobust epidemiological data which are internationally comparable, and representative is scarce within non-melanoma skin cancer despite cases of individual improvement. The rising global incidence coupled with struggling healthcare systems in the post Covid-19 recovery period serves to intensify the societal and healthcare impact. This study is the first to demonstrate the incidence of BCC in Wales and one of a small number in the UK using internally validated large cohort datasets, and further demonstrates one of the highest published incidences within the UK and Europe. In the modern era of health informatics and advanced analytics it is imperative that we capitalise on routinely collected healthcare data. Therefore, it must be accurate, comprehensive, and accessible otherwise services will under-deliver.
published_date 2023-02-22T15:46:06Z
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