BCC (or rodent ulcer) is the most common malignant cutaneous neoplasm found in humans.1-3 For example, over 30 000 new cases are reported each year in the UK. This is likely to be an underestimate because of inconsistencies in registration of BCCs at regional cancer registries.4 Many registries only register a person's first skin cancer, thus further underestimating the real burden of the problem.

The tumour may occur at any age but the incidence of BCC increases markedly after the age of 40 years. The incidence of BCC appears to be increasing in younger people, probably as a result of increased sun exposure.5 The incidence rate (standardised using the European standard population) for new BCCs in the Trent Cancer Registry (UK) increased from 36-8 in 1985 to 71-3 for men, and from 25-6 to 52-0 in women (Trent Cancer Registry, written communication, September 2001). A total of 3826 new BCCs were registered in Trent in 2000 (80% of all non-melanoma skin cancers). A sustained rise in the incidence of BCC has been documented using a validated register in South Wales, UK.6 Reliable national figures for BCC incidence are impossible to obtain because some cancer registries in the UK do not register BCCs. In the US, the incidence of BCC has doubled approximately every 14 years7 and similar changes have occurred in Australia.8

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