June 27, 2012
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UV light exposure poses major risk to albinos in Africa

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With squamous cell carcinoma of the head and neck being the most frequently diagnosed skin cancer among albinos in Tanzania, albinism and exposure to ultraviolet light appear to be the most important risk factors, a study has found.

Using descriptive statistics, researchers analyzed data from March 2001 to February 2010 in a retrospective study of albinos with African heritage and a histopathical diagnosis of skin cancer seen at a teaching hospital in northwestern Tanzania.

The study included 64 patients (mean age, 29.9 years; 38 men); 58 were aged 40 years and younger; 54 worked outdoors; and 60 patients lived in rural areas.

The mean duration of illness at presentation was 26.6 months, with most patients presenting ulcers and fungating fleshy lesions. Sixty patients listed financial burden as the most common reason for late presentation.

The most frequent site afflicted was the head and the neck in 46 patients, followed by the trunk in 12 patients.

Forty-eight patients were diagnosed with squamous cell carcinoma, 15 had basal cell carcinoma, and one patient had malignant melanoma. The overall mortality rate was 6.3%, which was strongly associated with delayed presentation (P=.018), HIV status (P=.001) and related complications (P=.015).

Sixty patients underwent surgical excisions, while 27 patients did not complete their treatment or follow-up. Researchers explained that radiotherapy was not available at the study center, requiring 24 patients to travel to receive treatment. They also said 13 additional patients could have benefited from the modality.

“Registering all albinos early in life, educating them to prevent the damaging effect of the sun [protective clothing, sun-screening agents and indoor occupations], detecting and treating premalignant and malignant lesions are of great importance,” the researchers concluded. “Providing free annual skin checkups would improve early detection and treatment, hence reducing the morbidity and mortality of skin cancers in these patients.”