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526 Epidemiology and survival of primary cutaneous extramammary Paget’s disease by sex in the United States

2023; Elsevier BV; Volume: 143; Issue: 5 Linguagem: Inglês

10.1016/j.jid.2023.03.532

1523-1747

Rachel Lim, S.D. Ragi, I. Moseley, Emmeline Lin, F.N. Mirza, S. Yumeen, L. Robinson-Bostom, O. Wisco,

Nonmelanoma Skin Cancer Studies

Extramammary Paget's disease (EMPD) is a rare, cutaneous malignancy with a known female predominance. It has not yet been established if tumor presentation, age of presentation, or prognosis vary between males and females. We used data from the Surveillance, Epidemiology, and End Results (SEER) Program to elucidate epidemiological and survival differences in EMPD by sex. Data for EPMD, was extracted from SEER-17 (2000-2019), including the number of total cases, incidence, age, race, ethnicity, primary tumor location, staging, tumor size, cause-specific death, and sequence number of reportable malignancies. Traditional chi-squared or Fisher exact tests were utilized to compare the aforementioned variables between the sexes. Rates are reported per 100,000 individuals and age-adjusted to the 2000 US Std Population. In SEER-17, EMPD was more common in women (incidence of 0.1744 vs. 0.1234 in men). Significant differences by sex were observed for: age at presentation (p<0.0001), race (p<0.0001), ethnicity (p<0.0001), primary tumor location (p=0.0021), disease-specific mortality (p=0.0419), and lymph node involvement (p=0.0195). Notably, the incidence of EMPD among Asian/Pacific Islanders was nearly twice that observed in Whites (incidence of 0.2855 vs. 0.1461). Despite the significant difference in the distribution of primary tumor sites between sexes, the most common primary tumor site was the skin of the trunk in both men and women. The majority of cases had no lymph node involvement, though more women had no lymph node involvement (incidence 0.1424 vs 0.1004). The rate of disease-specific mortality was higher in women than in men (0.0120 vs. 0.0115). Stage and household income did not differ significantly between sexes. We report an overall higher incidence of EPMD in women and found that women with EMPD experience worse prognoses with a higher rate of disease-specific mortality. Our results offer new insights into sex based differences in EMPD survival warranting further investigation.