Non-Melanoma Skin Cancer in Young Adults Presenting at Three Academic Hospitals in Johannesburg: A 5-Year Audit

Background: The incidence of Melanoma and Non-Melanoma Skin Cancers (NMSC) is increasing globally. The South Africanpopulation is exposed to many risk factors associated with the development of skin cancer, particularly UVR exposure and HIV.Aim: The aim of the study was to compare the prevalence and location of NMSC in Adolescent and Young Adults (AYA) versusthe pattern in older adults.Patients and Methods: An audit based on histopathology reports of patients who were above 15 years of age and were diagnosedwith skin cancer at three academic hospitals in Johannesburg over a 5-year period was conducted. The project was approved bythe Wits Human Research Ethics Committee (M200960). Categorical data was presented as total counts and percentages. Thesignificance of the difference between categorical data was tested using the chi-square test and the two tailed Student t-test forcontinuous data. A value of p < 0.05 was considered statistically significant.Results: A total of 385 records of patients from the 16 to 40 years and 198 (51.4%) were women. Of the 373 NMSC 148 (38.4%)were Squamous Cell Carcinoma (SCC), 133 (34.6%) basal cell carcinoma (BCC) and 56 (14.6%) Kaposi’s sarcoma (KS) (n=56,14.55%). Significant association was found between SCC and female sex (p<0.001) and BCC and male sex (p<0.001). HIV statuswas significantly associated with KS (p<0.001), BCC (p=0.005) and SCC (p=0.006). In the older adults 56.7% (605/1067) of skincancers were BCC, 31.5% (336/1067) SCC and 2.5% (27/1067) KS.Conclusion: Squamous cell carcinoma was the most common skin cancer in AYA whereas BCC was the leading tumour in olderadults. Basal cell carcinoma was more prevalent in men while SCC was predominately diagnosed in women.