1. ¹Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy
2. ²Centro Studi GISED, Ospedali Riuniti di Bergamo, Bergamo, Italy
3. ³Istituto di Statistica Medica e Biometria, Università degli Studi di Milano, Milan, Italy

Correspondence: Dr Claudio Pelucchi, Istituto di Ricerche Farmacologiche "Mario Negri", Via Eritrea 62, 20157 Milano, Italy. E-mail: pelucchi@marionegri.it

Received 3 March 2006; Revised 30 August 2006; Accepted 5 September 2006; Published online 19 October 2006.

Abstract

Different clinico-pathologic subtypes and anatomic sites of basal-cell carcinoma (BCC) may display distinct characteristics and mechanisms of development. However, scanty information exists on potential differences in etiological factors for BCC according to histotype and anatomic location. Thus, we analyzed data from an Italian case–control study, including 528 subjects with newly diagnosed, histologically confirmed BCC and 512 controls admitted to the same hospitals with acute conditions. The multivariate odds ratio (OR) of nodular (OR=1.53) but not superficial (OR=0.71) BCC was increased for occupational exposure to sunlight. Considering the anatomic site of BCC, the corresponding values were 1.46 for head/neck and 0.74 for truncal location. Direct associations were observed with recreational sunlight exposure, eye color, red hair, and number and early age of severe sunburn episodes, along with some differences in risk between histotypes and anatomic sites. This study confirmed the role of (intermittent) sun exposure and phenotypic characteristics as risk factors for BCC, and suggested etiological differences between nodular and superficial histotypes and between head/neck and truncal locations.