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New Types of Cancer after Basal-Cell Cancer
- Morten Frisch, MD, PhD;
- Henrik Hjalgrim, MD; and
- Mads Melbye, MD, DMSc
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
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IN RESPONSE:
Primary care physicians, like other physicians, truly face overwhelming amounts of scientific information every day. As stated in our article, we agree with Dr. Stewart that breast and scrotal symptoms and lymph node enlargement should always prompt serious evaluation. However, we believed that, because of the substantial evidence that this applies even more so in the large group of patients with a history of basal-cell carcinoma, it was appropriate to further stress the importance of vigilance in examining noncutaneous symptoms in these patients.
The clinical impression described by Dr. Shimm-that the incidence of cancer is elevated over the background rate in patients with keratoacanthoma-may well be true. However, unlike the population-based data we and others have presented for patients with basal-cell carcinomas [1] and squamous-cell carcinomas [2, 3] and the elevated risk for subsequent extracutaneous cancer in these patients, the impression that keratoacanthoma is also followed by higher rates of extracutaneous cancer is not founded on evidence from unselected population-based follow-up studies of patients with this skin disorder. Cohort studies that distinguish sharply between cancer preceding the keratoacanthoma and those occurring after are needed to clarify whether the impression by Dr. Shimm and others is correct.
Morten Frisch, MD, PhD
Henrik Hjalgrim, MD
Mads Melbye, MD, DMSc
Danish Epidemiology Science Centre; Copenhagen, Denmark
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
