A prospective study of the incidence, associations and outcomes of ocular surface squamous neoplasia in the United Kingdom

• Published in: Eye (London) Vol. 33; no. 2; pp. 283 - 294
• Main Authors: Kiire, Christine A., Stewart, Rosalind M. K., Srinivasan, Sathish, Heimann, Heinrich, Kaye, Stephen B., Dhillon, Baljean
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.02.2019; Nature Publishing Group
• Subjects: 692/1807/1482; 692/499; 692/53/2423; 692/699/3161/3162; 692/699/3161/3163; Accreditation; Acuity; Adult; Aged; Aged, 80 and over; Antibiotics, Antineoplastic - therapeutic use; Carcinoma in Situ - epidemiology; Carcinoma in Situ - pathology; Carcinoma in Situ - therapy; Carcinoma, Squamous Cell - epidemiology; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - therapy; Conjunctival Neoplasms - epidemiology; Conjunctival Neoplasms - pathology; Conjunctival Neoplasms - therapy; Cryotherapy; Disease management; Female; Follow-Up Studies; Glucocorticoids - therapeutic use; Health education; Humans; Incidence; Interferon; Laboratory Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Ophthalmologic Surgical Procedures; Ophthalmology; Pain; Patients; Pharmaceutical Sciences/Technology; Prospective Studies; Risk Factors; Squamous cell carcinoma; Surgery; Surgical Oncology; Surveys and Questionnaires; Treatment Outcome; United Kingdom - epidemiology; United Kingdom; United Kingdom > UK
• ISSN: 0950-222X; 1476-5454; 1476-5454
• DOI: 10.1038/s41433-018-0217-x

Learning Objectives Upon completion of this activity, participants will be able to: Assess the incidence and demographic profile of patients presenting with OSSN in the United Kingdom during a 12-month period, based on a prospective observational study. Evaluate the clinical presentation of and risk factors associated with OSSN in the United Kingdom during a 12-month period, based on a prospective observational study. Determine management and prognosis of OSSN in the UK during a 12-month period, based on a prospective observational study. Continuing Medical Education In support of improving patient care, this activity has been planned and implemented by Medscape, LLC and Springer Nature. Medscape, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. Medscape, LLC designates this Journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit(s). Physicians should claim only the credit commensurate with the extent of their participation in the activity. All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 75% minimum passing score and complete the evaluation at www.medscape.org/journal/eye; (4) view/print certificate. Credit hours 1.0 Release date: 28 December 2018; Expiration date: 28 December 2019 Post-test link: https://medscape.org/eye/posttest902113 Authors/Editor disclosure information Sobha Sivaprasad has disclosed the following relevant financial relationships: Served as an advisor or consultant for Allergan, Bayer, Boehringer Ingelheim, Novartis, Heidelberg, Optos. Served as a speaker or a member of a speakers bureau for Bayer, Allergan, Novartis, Optos. Received grants for clinical research from Bayer, Boehringer Ingelheim, Allergan, Novartis, Optos. H.H. has disclosed the following relevant financial relationships: Served as a speaker or a member of a speakers bureau for Alcon, Alimera, Bausch and Lomb, Bayer AG. C.A.K., R.M.K.S., S.S., S.B.K., and B.D. have disclosed no relevant financial relationships. Journal CME author disclosure information Laurie Barclay has disclosed the following relevant financial relationships: Owns stock, stock options, or bonds from: Pfizer Inc. Purpose To describe the incidence, associations and outcomes of ocular surface squamous neoplasia (OSSN) in the United Kingdom. Methods Prospective, observational study of every new case of OSSN reported via the British Ophthalmological Surveillance Unit reporting scheme over a 12-month period. Cases were followed up for 12 months. Results The reported incidence of OSSN was 0.53 cases/million/year (conjunctival intraepithelial neoplasia: 0.43 cases/million/year; squamous cell carcinoma: 0.08 cases/million/year). Eighty-five per cent of affected patients were male, 97% were Caucasian, and the mean age at presentation was 67.9 (±12.8) years. Information on potential underlying risk factors was frequently unknown. The most commonly affected sites were the limbus and the nasal and temporal bulbar conjunctivae. Most patients presented with a visual acuity of 6/9 or better, without symptoms of pain or visual loss. Excision (with or without additional treatment) was the most common first-line treatment and interferon (with or without additional treatment) was the most common second-line treatment, although management varied widely. Complications of treatment were rare but occasionally severe. Recurrence within 12 months of follow-up occurred in at least 6% of patients. Conclusion Although subject to reporting bias, these data suggest that there has not been a significant change in the incidence of OSSN in the United Kingdom, or its demographic profile, since 1996. The broad range of management approaches identified in this study reflect a lack of consensus as to the optimal referral and treatment pathways.