Incidence ratio of basal cell carcinoma to squamous cell carcinoma equalizes with age

To the Editor: In the United States, the incidence ratio of basal cell carcinomas (BCCs) to cutaneous squamous cell carcinomas (SCCs) is traditionally taught as 4:1.1,2 However, the origin of this ratio is unclear, as earlier US-based studies (published before 1989) report an incidence ratio ranging from 1.4:1 to 9:1.3 Recently, Rogers and colleagues4 reported a 1:1 incidence ratio of BCC:SCC using procedural data from the predominantly Caucasian, elderly Medicare fee-for-service population. To evaluate this incidence ratio across all age groups, we performed a retrospective review of BCC and SCC incidence in a northern Californian population.

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