The Etiology and Epidemiology of Merkel Cell Carcinoma
Section snippets
Epidemiology of First Primary Merkel Cell Carcinoma
To study the epidemiology and survival of MCC, Agelli and Clegg analyzed the population covered by the Surveillance Epidemiology and End Results (SEER) Program24, 25 of the National Cancer Institute. The SEER population included in these studies, and corresponding to 10%-14% of the US population, was studied as a prospective cohort from 1973 to 19991 and from 1992 to 2001.9 Cases were identified using the 2nd edition of the International Classification of Diseases for Oncology (ICD-O-2),26 as
Epidemiology of Merkel Cell Carcinoma Presenting at Mucosal Anatomic Sites
About 5% of all cases of first primary MCC present at mucosal anatomic sites. In 1992 through 2001, the total number of cases of first primary MCC was 1,027, with 50 cases presenting at mucosal anatomic sites.9
Etiology
Little is known about specific etiologic factors in the pathogenesis of MCC. Recent population-based studies,1, 9 the analysis of the largest case series, and the careful compilation of the many case reports and case series published in the literature since MCC's first description34, 35, 36, 37, 38 have pointed to possible and probable risk factors. Concurrently, advanced molecular biology techniques have allowed the identification of molecular and genetic alterations that may be in the
Conclusion and Future Directions
Primary MCC appears to be multifactorial in origin and to occur in elderly whites after a lifelong accumulation of environmental mutagenic insults to the skin, when the efficiency of their immune system decreases because of immunosenescence and inflam-aging.98, 100, 101, 130, 131, 132 Further studies are needed to understand the etiology of this rare and lethal cancer and to identify risk factors and factor associated with survival.
Individuals with HIV infection, the subpopulation of solid
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