Risk Factors for Basal Cell Carcinoma in Men Younger Than 40 Years: A Case–Control Study

BACKGROUND Basal cell carcinoma (BCC) is the most common malignancy in the United States and is more prevalent in older populations. OBJECTIVE The aim of this study was to investigate BCC risk factors in male patients younger than 40 years. MATERIALS AND METHODS A consecutive series of male patients with pathology-proven BCC and younger than 40 years at time of diagnosis were retrospectively identified along with matched controls. Phone interviews were conducted using a structured questionnaire, and differences between patients with and without BCC were investigated. RESULTS A total of 50 patients with BCC and 27 controls were included in this study. Compared with controls, patients with BCC worked outdoor jobs for longer lengths of time (43.2 vs 15.6 months; p = .04), were more likely to have a family history of skin cancer (66% vs 44%; p = .02), and were more likely to use sunscreen heavily after biopsy (p = .02). Patients with multiple BCCs (n = 20) were more likely to have a history of substantial recreational sun exposure (p = .01) than patients with solitary lesions (n = 30). CONCLUSION The authors conclude that outdoor sun exposure in patients with underlying genetic susceptibility is the most likely mechanism of BCC formation in young male patients. Address correspondence and reprint requests to: Alan S. Boyd, MD, Division of Dermatology, Departments of Internal Medicine and Pathology, Vanderbilt University Medical Center, 719 Thompson Lane, Suite 26300, Nashville, TN 37204, or e-mail: alan.boyd@vanderbilt.edu The authors have indicated no significant interest with commercial supporters. This study was exempt from review by the Vanderbilt University Institutional Review Board. © 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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