Sebaceous carcinoma epidemiology, associated malignancies and Lynch/Muir-Torre syndrome screening in England from 2008 to 2018

J Am Acad Dermatol. 2023 Dec;89(6):1129-1135. doi: 10.1016/j.jaad.2023.03.046. Epub 2023 Apr 7.

Abstract

Background: Sebaceous carcinomas (SC) may be associated with the cancer predisposition syndrome Muir-Torre/Lynch syndrome (MTS/LS), identifiable by SC mismatch repair (MMR) screening; however, there is limited data on MMR status of SC.

Objective: To describe the epidemiology of SC, copresentation of other cancers, and population level frequency of MMR screening in SC.

Methods: A population-based retrospective cohort study of SC patients in the National Cancer Registration and Analysis Service in England.

Results: This study included 1077 SC cases (739 extraocular, 338 periocular). Age-standardized incidence rates (ASIR) were higher in men compared with women, 2.74 (95% CI, 2.52-9.69) per 1,000,000 person-years for men versus 1.47 person-years (95% CI, 1.4-1.62) for women. Of the patients, 19% (210/1077) developed at least one MTS/LS-associated malignancy. MMR immunohistochemical screening was performed in only 20% (220/1077) of SC tumors; of these, 32% (70/219) of tumors were MMR deficient.

Limitations: Retrospective design.

Conclusions: Incorporation of MMR screening into clinical practice guidelines for the management of SC will increase the opportunity for MTS/LS diagnoses, with implications for cancer surveillance, chemoprevention with aspirin, and immunotherapy treatment targeted to MTS/LS cancers.

Keywords: Lynch syndrome; Muir-Torre syndrome; dermatopathology; epidemiology; genetics; mismatch repair deficiency; sebaceous carcinoma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma, Sebaceous*
  • Carcinoma, Basal Cell*
  • Colorectal Neoplasms*
  • Female
  • Humans
  • Male
  • Muir-Torre Syndrome* / diagnosis
  • Muir-Torre Syndrome* / epidemiology
  • Muir-Torre Syndrome* / metabolism
  • Neoplasms, Adnexal and Skin Appendage*
  • Retrospective Studies
  • Sebaceous Gland Neoplasms* / diagnosis
  • Sebaceous Gland Neoplasms* / epidemiology