Prevalence of and Associated Factors for Eyelid Cancer in the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight)

Purpose: To estimate the prevalence of eyelid cancers in the American Academy of Ophthalmology IRIS (R) Registry (Intelligent Research in Sight) and evaluate the associated factors. Design: Retrospective IRIS Registry database study. Participants: All patients in the IRIS Registry between December 1, 2010, and December 1, 2018, with International Classification of Disease, ninth and 10th revisions, codes for eyelid cancers (basal cell carcinoma [BCC], squamous cell carcinoma [SCC], malignant melanoma [MM], sebaceous carcinoma/other specified malignant neoplasm [SBC], melanoma in situ [MIS], and unspecified malignant neoplasm [UMN]). Methods: The prevalence of each eyelid cancer type was estimated overall and by age group, sex, race, ethnicity, and smoking status. The associations between any eyelid cancer (AEC) or each cancer type and possible risk factors were examined using univariate and multivariate logistic regression models. Main Outcome Measures: Prevalence of and associated factors for each eyelid cancer type. Results: There were 82 136 patients with eyelid cancer identified. The prevalence of AEC was 145.1 per 100 000 population. The cancer-specific prevalence ranged from 87.9 (BCC) to 25.6 (UMN), 11.1 (SCC), 5.0 (SBC), 4.1 (MM), and 0.4 (MIS) per 100 000 population. The prevalence of AEC and each cancer type increased with increasing age (all P < 0.0001), and the prevalence of AEC, BCC, SCC, and MM was higher in males (all P < 0.0001), MIS (P = 0.02). The prevalence of BCC, SCC, MM, SBC, and AEC was highest in Whites versus that in patients of any other race (all P < 0.0001). In the multivariate logistic regression model with associated risk factors (age, sex, race, ethnicity, and smoking status), AEC was associated with older age groups ([< 20 years reference {ref.}]; odds ratio [95% confidence interval]: 20-39 years: 3.35 [1.96-5.72]; 40-65 years: 24.21 [14.80-39.59]; and > 65 years: 42.78 [26.18-69.90]), male sex (female [ref.]; 1.40 [1.33-1.48]), White race (inverse associations with African Americans [0.12 {0.09-0.16}], Asians [0.19 {0.13-0.26}], others [0.59 {0.40-0.89}]), and ethnicity (non-Hispanic [ref.]; Hispanic: 0.38 [0.33-0.45]; unknown: 0.81 [0.75-0.88]). Active smoking (never smoker [ref.]) was associated with AEC (1.11 [1.01-1.21]), BCC (1.27 [1.23-1.31]), SCC (1.59 [1.46-1.73]), and MM (1.26 [1.08-1.46]). Conclusions: This study reports the overall and cancer- specific prevalence of eyelid cancers using a large national clinical eye disease database. Smoking was found to be associated with AEC, BCC, SCC, and MM, which is a new observation. This epidemiologic profile of on-eyelid cancers is valuable for identifying patients at a higher risk of malignancy, allocating medical resources, and improving cancer care. (c) 2022 by the American Academy of Ophthalmology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).