B o o k r e v i e w s I II Illl I II Illl

Incidence of nonmelanoma skin cancer in the United States J. Scotto, T. R. Fears, and J. F. Fraumeni, Jr., Washington, DC, 1983, U.S. Government Print- ing Office, National Institutes of Health Publica- tion No. 83-2433. 113 pages. No charge.

This report on the incidence of nonmelanoma skin cancer in the United States presents the re- sults of the most detailed study of skin cancer ever performed.

It shows that nonmelanoma skin cancer (i.e., basal cell and squamous cell carcinoma; NMSC) represents the most common malignancy found in white persons in the United States, with an age- adjusted incidence for white people of 232.6 per 100,000 population, while the corresponding rate among black people is only 3.4 per 100,000 popu- lation. The report gives details of incidence in the United States based on special surveys performed by the Biometry Branch of the National Cancer Institute in eight locations spanning the United States from North to South.

The most salient findings, in addition to the re- markable overal! incidence (400,000 new cases of NMSC estimated per year) are:

Over 80% of all cases are basal cell carcinoma. The risk for male is greater than that for female indi-

viduals, especially for squamous cell carcinoma. Eighty percent of all lesions occur on the face, back,

and neck. NMSC is extremely rare among black persons and less

frequent in Hispanics, consistent with a protective effect of skin pigmentation on skin cancer risk.

A latitudinal and UVB gradient is clearly evident, and this relationship is greater for squamous cell than for basal cell carcinoma.

Skin cancer incidence appears to be increasing over time.

The relative effect of ultraviolet B (UVB) exposure on the incidence of squamous cell carcinoma is almost double that of basal cell carcinoma for both men and women.

This report, obtainable from the National Cancer Institute, is of particular interest because the epidemiologic data have been evaluated ac-

cording to actual, long-term measurements of UVB radiation and have allowed the development of mathematical models relating chronic UVB ex- posure to human skin carcinogenesis.

It is a most valuable source document for any- one interested or working in the field of pho- tocarcinogenesis and is highly recommended as the best source for data on skin cancer in the United States existing at this time.

Frederick Urbach, M.D. Philadelphia, PA

Experimental and clinical photoimmunology Vol. 1: Raymond A. Daynes, Ph.D., and John D. Spikes, Ph.D., editors; vol. 2: Raymond A. Day- nes, Ph.D., and Gerald Krueger, M.D., editors, Boca Raton, FL, 1983, CRC Press Inc. Vol. 1, 210 pages; vol. 2, 196 pages. $61; $71.

Photoimmunology is a relatively new and excit- ing discipline that addresses itself to the effects of radiant energy upon immune responses. An ex- plosion of knowledge has occurred in recent years indicating that exposure of the skin to solar radia- tion can evoke major changes in a variety of im- munologic mediators. These hitherto unsuspected consequences of environmental exposure to non- ionizing radiation have helped to sharpen the focus of an ever-growing number of gifted investigators upon the skin as an active arena of immunologic activity.

These two volumes have as their stated aim the development of a working understanding of basic photobiologic principles so that investigators knowledgeable in immunology can do important work in photoimmunology. An additional aim is to introduce the photobiologist to contempor~y immunobiology. In both cases the aims are achieved rather admirably.

Volume I is edited by Raymond Daynes and John Spikes. Section I is devoted to photobiology. Chapter 1 by Spikes is an excellent overview of fundamental principles of photobiology with some emphasis on artificial light sources. Chapters 2 to

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