Bowen's disease and internal cancer

Article Abstract:

In the early 1960s, reports began to appear in the medical literature indicating a link between Bowen's disease and other cancers. Bowen's disease is a form of skin cancer with specific structural properties, and the evidence suggested that people with this cancer were far more likely to develop cancer in the internal organs than were members of the general population. Since that time, some reports have confirmed the initial findings, while others have failed to do so. In all cases, there was some flaw or oversight in the published data that prevented any conclusions from being drawn. In the August 14, 1991 issue of The Journal of the American Medical Association, researchers report on a large number of cases of Bowen's disease from the population of Rochester, Minnesota. The researchers were unable to identify any association between Bowen's disease and other cancers. Unfortunately, this is not yet the final word on Bowen's disease. Although the data do suggest that patients with Bowen's disease need not receive an elaborate work-up for other cancer, significant questions remain. Perhaps a subset of patients with Bowen's disease have a genetic predisposition to cancer, but that many Bowen's patients do not. Perhaps a predisposition to cancer would be seen if the only patients considered were those whose skin cancers developed in locations not exposed to sun. Indeed, large disparities are observed between the statistics on Bowen's disease in the US and those in Europe. There may be many environmental differences that greatly alter the development of the disease. Indeed, in the US, men seem to be affected with Bowen's disease more often than women, while in Europe women are affected more than men. Clearly, factors of sex, geography, and environmental exposure must all be taken into account if a coherent and reliable picture of Bowen's disease is to be drawn. (Consumer Summary produced by Reliance Medical Information, Inc.)

editorial

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The subsequent risk of internal cancer with Bowen's disease: a population-based study

Article Abstract:

Bowen's disease is a special form of squamous cell carcinoma, which is limited to the epidermal layer of the skin. This form of skin cancer often occurs simultaneously in several parts of the body. The condition is of special interest, since various studies have suggested that Bowen's disease is very likely an indicator of cancer in some internal organ as well. However, these suggestions have been regarded as inconclusive, since much of the data is based on uncontrolled or poorly controlled studies. For this reason, a population-based study was conducted to determine if Bowen's disease correlates with the occurrence of internal cancer. From 1976 through 1984, a total of 897 cases of skin cancer (excluding melanoma) were identified among the permanent residents of Rochester, Minnesota. Seventy-one of these cases were diagnosed as Bowen's disease. This suggests that the incidence of Bowen's disease in the American white population in 1980 was about 14.9 new cases per year per 100,000 people. For comparison, the incidence of squamous cell carcinoma and the incidence of basal cell carcinoma (both are other forms of skin cancer), was 38.8 and 146 per 100,000 per year, respectively. The data, however, were unable to support the hypothesis that Bowen's disease is an indicator of increased likelihood of internal cancer. However, the average follow-up in the present study was five years; the rate of internal cancers diagnosed after this time period was not investigated. Nevertheless, the current evidence suggests that Bowen's disease is most likely not associated with an increased risk of other cancers. Currently, there is no reason to provide and exhaustive examination for other cancers to patients who are diagnosed with Bowen's disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects

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Incidence of prostate cancer diagnosis in the eras before and after serum prostate-specific antigen testing

Article Abstract:

The increase in the incidence of prostate cancer in the late 1980s and early 1990s may be partly due to the increased use of prostate-specific antigen (PSA) as a diagnostic test. Prostate cancer is the second cause of cancer death in men and is expected to cause 44,000 deaths in 1995. Researchers at the Mayo Clinic in Rochester, MN compared the use of PSA testing in the community beginning in 1987 with the incidence of prostate cancer. The use of PSA testing increased steadily after 1987, especially in men older than 60. The incidence of prostate cancer more than tripled between 1983 and 1992, from 64 cases per 100,000 to 215 per 100,000. The incidence doubled between 1987 and 1988. The incidence of prostate cancer in many age groups began to decline after 1990, indicating that most of the men with prostate cancer have been diagnosed. PSA testing detected prostate cancer earlier, which could lead to higher survival rates.

Prostate cancer, Prostate-specific antigen, Prostate specific antigen

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