This paper by Carsin et al. in the current issue of BJD is the first to look at the important issues of geographical, urban/ rural and socioeconomic variations in incidence of non-melanoma skin cancers (NMSCs). As the authors note, NMSCs are the commonest cancers in white populations yet few cancer registries comprehensively record data on them. This has significantly hampered epidemiological study of these cancers which are rarely fatal, but because of their great number, impose a significant burden on both primary and secondary care services. Moreover, a clinically important proportion of patients will need extensive and cosmetically challenging surgery. The setting is ideal: a fairly homogeneous fair-skinned population with a cancer registry which registers all NMSCs. The study is an ecological study which cannot provide definitive aetiological answers. However, it makes some interesting discoveries.
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