Perfil epidemiológico do carcinoma espinocelular cutâneo de um hospital referência em oncologia do Estado da Paraíba, entre os anos 2009 a 2011

Abstract

The Cutaneous Squamous Cell Carcinoma (SCC) is the second most common form of skin cancer in the white population worldwide. This carcinoma has shown steady increase in incidence worldwide. Thus, becoming an important public health problem because of its high morbidity and high health service costs. There are few studies evaluating the epidemiological profile of the SCC in the brazilian population and none has specifically been done in the state of Paraíba. OBJECTIVE: To verify the clinical and epidemiological profile of the SCC cases of patients treated at the main referral hospital for cancer treatment in the state of Paraiba from 2009 to 2011, taking into consideration peculiarities of the behavior of this tumor in males and females, as well as the regions the state is divided in. METHODS: A crosssectional study was conducted using secondary data such as sex, age, origin, degree of invasion and tumor differentiation, affected part of the body and largest tumor diameter. It was done a descriptive analysis and used the chi-square test, test to compare two percentages, U Mann-Whitney, Kruskal-Wallis and Dunn's multiple comparison tests. Association analyses were performed and comparison of percentages. The significance level was 5%. RESULTS: There were 1225 cases of SCC, with a 2:1 ratio between men and women (p<0,05), respectively. The average age was 69 years old and the majority of the cases ¿ 940 (77%) - occurred in patients over 60 years old. The sun-exposed regions of the body were the most affected ones with 996 (81,3%) tumors. The head and neck area was the most common place of SCC, with 900 (73,5%) lesions. Most of the identified tumors, i.e. 942 (77%), were of the invasive type; among these, 558 (59%) had moderate grade of differentiation. Men showed SCC in average four years earlier than women (68 vs 72 years). Their SCC was also more aggressive than those identified in women with a higher percentage of poorly differentiated tumors (8,0% vs. 4,2%) (p = 0,02). Besides, men showed a higher proportion of tumors than women when located in the ear (6,9% vs 3,1%) (p=0,048) and chest (15,9% vs 6,7%) (p<0,001). Women had a higher proportion of tumors than men in the lower limbs (7,0% vs 2,1%) (p <0,001). Most patients with tumors, i.e. 643 (52%), came from Zona da Mata ¿ the coastal area of the state. However, considering the regions of the state of Paraíba, there were no statistically significant differences regarding the size of tumors or the degree of invasion and histological differentiation. CONCLUSION: This study has a pioneer character considering it evaluated the profile of the SCC separately from Basal Cell Carcinoma (BCC) in the state of Paraíba. By doing this, it was possible to highlight clinical and epidemiological particularities of the SCC. Doctors and healthcare managers in the state of Paraiba may find the data produced through this study useful in order to take preventive, diagnostic and precocious treatment measures that may contribute to diminish the incidence and morbidity of this malignancy.