Cutaneous T-cell lymphoma on the rise, VA/Brown research shows

July 16, 2007

Cutaneous T-cell lymphoma, a rare and mysterious cancer, is on the rise, according to the first nationwide study of the disease in a decade.

The study, conducted by researchers at the Providence VA Medical Center and The Warren Alpert Medical School of Brown University, found that 4,783 new cases of cutaneous T-cell lymphoma were diagnosed between 1973 and 2002, the period under review. The number of new cases grew substantially each decade, with incidence more than tripling.

“This disease is substantially more common than it was only a generation ago,” said Martin Weinstock, M.D., head of the Dermatoepidemiology Unit at the Providence VA and professor of dermatology and community health at Alpert Medical School. “The cause of the increase is unknown – like so much about this enigmatic cancer. But the numbers themselves are alarming.”

Cutaneous T-cell lymphoma is caused by the uncontrolled growth of a type of white blood cell within the skin. This cancer spreads slowly, and may start as a rash. The cause of this form of cancer is unknown. While there are treatments, there is no cure.

Vincent Criscione, a second-year Alpert Medical School student, conducted the research with guidance from Weinstock and is lead author of the journal article published in the July issue of Archives of Dermatology.

Criscione used data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute to describe cutaneous T-cell lymphoma trends:

  • Incidence has been climbing steadily for 30 years

    • Men were nearly twice as likely to be diagnosed as women

      • Blacks were much more likely to be diagnosed than whites or Asians

        • This cancer is most common among the elderly, but occurs at other ages

          • People living in areas with high concentrations of physicians, and with higher socioeconomic status, were more likely to be diagnosed

            Incidence varies geographically, Criscione and Weinstock found. San Francisco had the highest annual rates – 9.7 newly diagnosed cases per million for whites and 10.8 new cases per million for blacks – while Iowa had the lowest, with 3.7 new cases per million for whites and 5.8 new cases per million for blacks.

            “These geographic differences were surprising,” Criscione said. “Why does the Bay Area have such a high incidence, for example, when Los Angeles doesn’t" This study wasn’t designed to come up with answers. But having basic information on how the disease is distributed is an important first step to understanding how to prevent and treat it.”

            Stuart Lessin, M.D., a senior researcher at the Fox Chase Cancer Center in Philadelphia and a member of the board of directors of the Cutaneous Lymphoma Foundation, which funded the study, wrote an editorial to accompany the research paper.

            “The current population study by Criscione and Weinstock,” Lessen said, “and patient population involvement provide new power and promise to solving the 200-year-old puzzle of the etiology of cutaneous T-cell lymphoma.”

            Source: Brown University

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