Squamous, Basal Cell Carcinoma Top Skin Cancers Among Persons With Albino Skin

Previous study results on incidence of skin cancers in persons with albino skin who live in Africa have been inconsistent, despite this population having a known higher risk for the disease.

There are high rates of squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) among persons with albino skin who live in Africa, with SCC being the most prevalent outcome following surgical excision and BCC predominating results from albino skin surveillance programs.

These findings were recently published in Journal of Skin Cancer, with the study authors noting that previous study results have been mixed, with some showing that SCC is more common than BCC, while others finding the reverse among African albinos.

"With these reported discrepancies in view, we undertook a systematic review and meta-analysis of all existing studies reporting on skin cancers in African albinos aiming to establish the prevalence of the various types of keratinocyte carcinomas (SCC and BCC) among African albinos with skin cancer," the authors explained.

They searched African Journals Online, Google Scholar, PubMed, and Europe PMC, for studies published until September 2020, using the terms skin cancer in African albinos, cutaneous malignancy in African albinos, and skin cancer in Africans. Twenty-three articles were included in the final analysis, and of them, 10 covered persons with albino skin only, 4 covered persons with albino skin only and reported on skin cancers and other skin diseases, and 9 covered persons with albino skin and nonalbino skin. Most study participants were male (274 male patients; 241 female patients; 24 patients with no sex indicated).

All of the individuals included in the studies of the authors’ analysis had histologically confirmed skin cancers, for 695 skin cancer lesions from 540 study participants. A dominant feature of skin cancer in persons of African ethnicity with albino skin is multifocal tumors or multiple tumors, the authors wrote. These lesions comprised mostly SCC (n = 419) and BCC (n = 249). Other skin cancers found were adenoid cystic carcinoma (n = 10), basosquamous carcinoma (n = 9), cutaneous melanoma (n = 5), and malignant adnexal tumor, sarcoma, and unspecified histology (n = 1 each).

Among the studies included, 64% (95% CI, 50%-77%) reported on the prevalence of SCC and 31% (95% CI, 19%-41%) reported on the prevalence of BCC. The investigators highlighted high heterogeneity across all of the studies included (I2 = 89%; τ2 = 0.0903; χ222 = 194.98; P < .01) regarding prevalence estimates, and results of an Egger’s test indicated “a lack of publication bias in the present review.”

The authors added that the heterogeneity they saw was not explainable by sensitivity or moderator analysis, but that “the estimated prevalence figures appear valid, because, by crude unweighted pooling of the individual study proportions, the proportion of SCC among all histologically confirmed skin cancer lesions in African albinos would be 60.2% (419/695) and that of BCC, 35.8% (249/695).”

The strength of their findings include this being the first meta-analysis, and largest study to date, of skin cancer in African persons with albino skin. Further, results echo previously reported epidemiologic trends of skin cancer, particularly the presence of SCC and BCC in cancerous lesions. Limitations to generalizability include the small sample sizes of the studies included and lack of studies focused exclusively on albino skin–related skin cancers.

Reference

Onyishi NT, Ohayi SR. Prevalence of squamous and basal cell carcinomas in African albino skin cancer lesions: a systematic review and meta-analysis of proportion.J Skin Cancer. Published online August 30, 2022. doi:10.1155/2022/5014610