Bowen Disease and Risk of Subsequent Malignant Neoplasms

Abstract
FOLLOWING A 1959 report by Graham and Helwig,1 which suggested an association between Bowen disease (squamous intraepidermal neoplasia) and noncutaneous malignant neoplasms, several studies2-5 were conducted before 1980 that confirmed this finding and another6 that did not. Arbesman and Ransohoff7 later criticized studies completed before 1983 for having methodologic flaws and concluded that the published clinical data did not provide convincing evidence of an association between Bowen disease and subsequent internal malignant neoplasms. The largest study to date was a Danish hospital-based study8 of 581 patients diagnosed from 1943 to 1982 as having Bowen disease and followed up for occurrence of subsequent cancer. No significant excess risk of internal cancer was found among these patients (50 cancers observed, 40 cancers expected; standardized incidence ratio [SIR]=1.3; 95% confidence interval [CI], 0.9-1.6).

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