Review of the clinical features of skin cancer: A study of 1,048 cases from a hospital in West China

Sun Dong-Jie, Qi Xian-Long, Liu Zhi, Xi Ya-Guang, Liu Ling, Gao Jian, Li Chun-Ying, Li Miao, Zhang Yan-Guo, Gao Tian-Wen


Background Skin cancer (SC) is a group of malignancies which include primary and
metastatic tumors which involve the skin and its appendages. Up to the present, only a
few studies on the clinical features and the trend of SC have been reported but the
status in West China is still undetermined.
Patients and methods The SC cases were from a major hospital in West China. A total
of 1048 cases from 1981 to 2006 were included in our study. The clinical features of SC
including age, gender, lesion location and pathological diagnosis were analyzed. In
order to illustrate the trend of SC incidence, the patients from 1981-1993 and 1994-
2006 were assigned to group A and B, respectively. The percentage of SC in all
malignancies (Ms), including all kinds of internal carcinomas and skin cancers, and the
percentage of SC in inpatients and outpatients (IOPs) between group A and B were
separately compared to illustrate the trend in SC incidence in this area.
Results (1) Of the 1048 SCs included, 308 (29.4%) were squamous cell carcinoma
(SCC), 293 (28.0%) basal cell carcinoma (BCC) and 168 (16.0%) cutaneous malignant
melanoma (CMM). Ratio of male to female was 1.5: 1.0. Median age was 54.0±23.0
years. 40.8% of the SCs occurred on the head, 35.0% on the trunk and 24.2% on the
extremities. Median age of CMM (53.0±22.5) was less than those of BCC (58.0±18.3
years) and SCC (57.0±20.0 years). 83.6% of the BCCs, 49.8% of the SCCs and 13.5%
of the CMMs occurred on the head. (2) Of the 168 CMMs, 106 (63.1%) occurred on the
acral, 23 (13.7%) on the head, 24 (14.3%) on the trunk and 15 (8.9%) on the limbs. Of
the 106 acral melanoma (AM), 41 (38.7%) occurred on the plantar skin, 19 (17.9%) on
the heel, 15 (14.2%) on the subungual skin of thumbs, 13 (12.3%) on the subungual
skin of big toes and 18 (17.0%) on other acra. (3) The percentages of SC in IOPs
(SCs/IOPs) in Group A and B were 0.0038% (325/8,457,672), 0.0066%
Address for correspondence
Dr. Sun Dong-Jie, MD, PhD
Center of Dermatology of Chinese PLA Xijing
Hospital, Fourth Military Medical University,
Xi’an, Shaanxi, China, 710032
Journal of Pakistan Association of Dermatologists 2007; 17: 141-148.
(723/11,037,720), an increase of by 74%. The percentages of SC in all Ms (SC/Ms)
were 2.1% (325/15,363) and 3.1% (723/23,364), an increase of 48%. During the same
period, the percentages of Ms in IOPs (Ms/IOPs) were 0.18% (15,363/8,457,672) and
0.21% (23,364/11,037,720), increased only by 17%.
Conclusions In our study, SCC, BCC and CMM were major SC types. The head and
trunk are the main sites for SC occurring. AM is the most common CMM. In past 26
years, the percentages of SC in all malignancies and in inpatients and outpatients have
increased in this hospital. The finding in our study provides a clue for understanding of
the trend of SC in West China.


Skin cancer; squamous cell carcinoma; basal cell carcinoma; cutaneous malignant melanoma; acral melanoma

Full Text:



Diepgen TL , Mahler V. The

epidemiology of skin cancer. Br J

Dermatol 2002; 146 (Suppl 61): 1-6.

Armstrong BK, Kricker A. Cutaneous

melanoma. Cancer Surv 1994; 19-20:


Clark WH Jr , From L, Bernardino

EA, Mihm MC. The histogenesis and

biologic behavior of primary human

malignant melanomas of the skin.

Cancer Res 1969; 9: 705-27.

Seiji M , Takematsu H, Hosokawa M,

Obata M, Tomita Y, Kato T,

Takahashi M, Mihm MC Jr. Acral

melanoma in Japan. J Invest Dermatol

; 80 (Suppl): 56s-60s.

Barnhill RL, Crowson AN, Busam

KJ, Granter SR. Textbook of

Dermatopathology. Philadelphia:

McGraw-Hill; 1994. p. 493-801

Feibleman CE , Stoll H, Maize JC.

Melanomas of the palm, sole, and

nailbed: a clinicopathologic study.

Cancer 1980; 46: 2492-504.

Silverberg E , Boring CC, Squires TS.

Cancer statistics, 1990. CA Cancer J

Clin 1990; 40: 9-26.

Sturm RA . Skin color and skin

cancer-MC1R, the genetic link.

Melanoma Res 2002; 12: 405-16.

Chang BZ, Li GZ. The cases with

skin cancer in Taizhou of Jiangsu

province. Chinese J Dermatol 1991;

: 205-6.

Ma ZX, Yang CY. Analysis of 236

cases of skin cancer. J China Med

University 1882; 11: 78-9.

Zhu WX, Wang QJ, Li L. Analysis of

Cancer Incidence in Urban Beijing

during 1993-1997. Chin J Cancer

Prev Treat 2003: 10; 785-7.

Chen JG, Xiang YB, Chen KX. A

comparative study of cancer

incidence among Qidong, Shanghai

and Tianji. J Chin Oncol 2006; 15:


Fears TR. Estimating increase in skin

cancer morbidity due to increase in

ultraviolet radiation exposure. Cancer

Invest 1983; 1: 119-26.

Kelfkens G, de Gruijl FR, van der

Leun JC. Ozone depletion and

increase in annual carcinogenic

ultraviolet dose. Photochem Photobiol

; 52: 819-23.

Kaskel P , Kind P, Sander S, Peter

RU, Krahn G. Trauma and melanoma

formation: a true association? Br J

Dermatol 2000; 143: 749-53.

Collins RJ . Melanoma in the Chinese

of Hong Kong. Emphasis on volar

and subungual sites. Cancer 1984; 54:


Men BY, Li SY, Wang Y. A

comparison between the results of

cancer incidence in 1972-1975 and in 1992-1994 in a rural area of Shanxi

province, China. Chin J

Epidemiol1997; 18: 160-3.

Wang AP, Yu ZX. An analysis of

inpatients with cancer in

Shanxi province. J Chin Oncol 2002;

; 307-8.

Tan DY, Dai XQ, Yang G. The

pathological statistics and analysis of

Uygur and Han patients with

malignant tumor in Kashgar area of

Xinjiang. Prac J Cancer1995; 10:


Ichihashi M , Naruse K, Harada S et

al. Trends in nonmelanoma skin

cancer in Japan. Recent Results.

Cancer Res 1995; 139: 263-73.

Ohtsuka H , Nagamatsu S. Changing

trends in the number of deaths from

nonmelanoma skin cancer in Japan,

-2000. Dermatology 2005; 210:


Lee HP , Duffy SW, Day NE,

Shanmugaratnam K. Recent trends in

cancer incidence among Singapore

Chinese. Int J Cancer 1988; 42: 159-

Ramos J, Villa J, Ruiz A et al. UV

dose determines key characteristics of

nonmelanoma skin cancer. Cancer

Epidemiol Biomarkers Prev 2004; 13:


Kripke ML.Impact of ozone depletion

on skin cancers. J Dermatol Surg

Oncol 1988; 14: 853-7.

Tang XY. Meet to the challenge from

the new century. Chinese Environ Sc

Press 1996; 258.

Zhong GM, Tang ZZ. Environmental

cadmium, lead and arsenic pollution

and health impact-research progress

in China. J Environ Health 2006: 23;


Zhang XL, Wang JD, Wang WJ.

Distribution of environmental arsenic

and its health impact on residents in

west China. J Environ Health 2004;

: 275-8.


  • There are currently no refbacks.

ISSN: 1560-9014