Geospatial analyses demonstrate variation of cutaneous T-cell lymphomas across Australia, providing insights into possible causes
- Author(s)
- Campbell, BA; Baade, PD; Dasgupta, P; Cameron, JK; Porceddu, SV; Prince, HM; Thursky, K;
- Details
- Publication Year 2025-05-19,Volume 192,Issue #6,Page 1018-1028
- Journal Title
- British Journal of Dermatology
- Publication Type
- Research article
- Abstract
- BACKGROUND: Cutaneous T-cell lymphomas (CTCLs) are rare with distinct diagnostic challenges. Equitable access to cancer care is a recognized priority, internationally. To date, the geospatial distribution of CTCL has not been definitively studied. Understanding the incidence and geographical distribution of patients with CTCL are critical first steps towards the ultimate goal of equity of care. Geospatial analyses also allow the opportunity to explore environmental causative factors: for CTCL, the contribution of solar ultraviolet (UV) radiation on causation remains unclear. OBJECTIVES: We investigate geospatial patterns of CTCL incidence across Australia, compare with all rare cancers, and consider solar UV exposure on causality and diagnosis rates. METHODS: All CTCL diagnoses (1 January 2000 to 31 December 2019) were obtained from the nationwide dataset. Areas of residence were collected according to nationally approved definitions. Bayesian spatial incidence models were applied. Geospatial distributions were visually analysed. RESULTS: The CTCL age-standardised incidence rate was 7.7 (95% confidence interval 7.4-7.9) per million people per year in Australia. Diagnostic disparity was seen between Australian states/territories, with lower diagnosis rates in rural/remote and socioeconomically disadvantaged areas. Incidence exceeded the national average within more densely populated capital cities. Visual comparisons of the geospatial distribution of CTCL revealed marked discordances with the geospatial patterns of all rare cancers and solar UV in Australia. CONCLUSIONS: Geographical heterogeneity in CTCL exists across Australia. Incidence reflects population density. Geospatial patterns of CTCL differ substantially from all rare cancers, with implications for the unique diagnostic challenges and unmet needs of this patient population. The distribution of CTCL across Australia does not support a causative link with UV exposure. Further global evaluation of geospatial patterns is warranted.; Cutaneous T-cell lymphomas (CTCLs) are rare skin malignancies that are challenging to diagnose and treat. Equal access to cancer care is a recognized priority, worldwide. To achieve this goal for people with CTCL, we first need to understand the incidence and geographical distribution of CTCL. Using a complete national dataset for a 20-year period (2000–2019, inclusive), we analysed the incidence and geographical distribution of CTCL diagnoses across Australia. We found substantial variation in the distribution of CTCL diagnoses. In particular, CTCL was diagnosed less often in rural/remote and socioeconomically disadvantaged areas. We compared the geographical distribution of CTCL with that of all rare cancers in Australia. Striking differences were seen. These findings suggest location-based challenges to diagnosis and care that are unique to patients with CTCL. Presently, the contribution of ultraviolent (UV) radiation on causation of CTCL is unclear. We compared the geographical distribution of CTCL diagnoses with annual solar UV exposure. Our findings did not support a causative link with UV exposure.; eng
- Publisher
- Oxford University Press
- Keywords
- Humans; Australia/epidemiology; Incidence; *Skin Neoplasms/epidemiology/etiology/diagnosis; *Lymphoma, T-Cell, Cutaneous/epidemiology/etiology/diagnosis; Male; Female; *Ultraviolet Rays/adverse effects; Middle Aged; Adult; Aged; Spatial Analysis; Sunlight/adverse effects; Environmental Exposure/adverse effects; Bayes Theorem
- Department(s)
- Radiation Oncology; Haematology; Health Services Research
- Publisher's Version
- https://doi.org/10.1093/bjd/ljae476
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2025-01-07 03:38:10
Last Modified: 2025-05-27 04:30:40