Panorama do câncer da pele em uma comunidade de Pomeranos do estado do Espírito Santo

Abstract

Introduction: Skin cancer is a public health problem that requires continuous evaluation of results and actions taken, in order to design new strategies to combat this disease. The state of Espírito Santo has a dermatological assistance program to skin cancer in pomeranian communities, which are composed of descendants of european immigrants. This program operates in 11 counties for 25 years and during this period its outcome was never evaluated. Objective: To evaluate the outlook of skin cancer in the pomeranian community according to histological type and prevalence of tumors, tumor size, patient age at diagnosis, and gender. Method: We analyzed histopathological exams of 3781 patients operated between 2000 and 2010, at the 11 communities served, who were diagnosed with skin cancer, melanomas and carcinomas, of which 4881 lesions were resected. The analysis was performed considering one injury per person,chosen randomly. Histological diagnosis and gender were analyzed by simple frequency. The size of the lesion in its largest diameter was categorized by intervals of 5mm and evaluated according to the mean, median, standard deviation and linear regression. The age of patients was categorized by intervals of 10 years and evaluated according to the mean, median, standard deviation and linear regression. For correlation between variables we used the Kruskal-Wallis test, Dunn test, Mann-Whitney test and Spe arman correlation coefficient. Results: Histopathological examination revealed basal cell carcinoma and its variations in 3159 (83.5%) patients, squamous cell carcinoma in 415 (11%) patients, and melanoma in 64 (1.7%) patients; 143 (3.8%) patients had BCC and SCC at the same time. Regarding to the size of the tumors, 47.1% measured between 5.1 and 10mm. Throughout the trial period there was a trend to increase the average size of tumors. The ages between 61 and 70 years-old suffered the greatest number of surgical procedures, which was 23.7%. There were more females (53.6%, n = 2027) than males (46.4%, n = 1754), but with no significance. The linear regression analysis showed a trend to increasing diagnosis of skincancer in men and decreasing in women; the correlation between variables showed that, as age increases, lesion size also increases. The size of the lesions were greater in men (median 9 mm) than in women (median 8 mm). Conclusion: Basal cell carcinoma is the most frequent skin cancer and the prevalence of squamous cell carcinoma and melanoma are decreasing; although the size of tumors is increasing, they remain smaller than 2 cm; the diagnosis occurs in older patients; and the incidence and size of skin tumors in the male population has increased.