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Epidemiology of invasive ocular surface squamous neoplasia in Canada during 1992–2010
  1. Rami Darwich1,2,
  2. Feras M Ghazawi3,4,
  3. Michelle Le2,
  4. Elham Rahme5,
  5. Nebras Alghazawi2,
  6. Andrei Zubarev2,
  7. Linda Moreau6,
  8. Denis Sasseville6,
  9. Miguel N Burnier Jr7,
  10. Ivan V Litvinov6
  1. 1 Department of Ophthalmology & Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
  2. 2 Department of Medicine, McGill University, Montreal, Quebec, Canada
  3. 3 Division of Dermatology, University of Ottawa, Ottawa, Ontario, Canada
  4. 4 Cancer Therapeutics Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
  5. 5 Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada
  6. 6 Division of Dermatology, McGill University Health Centre, Montreal, Quebec, Canada
  7. 7 The Henry C Witelson Ocular Pathology Laboratory, McGill University, Montreal, Quebec, Canada
  1. Correspondence to Dr Ivan V Litvinov, Division of Dermatology, McGill University Health Centre, Montreal, QC R4A 3J1, Canada; ivan.litvinov{at}


Background Ocular surface squamous neoplasia (OSSN) is the most common non-pigmented ocular surface malignancy. It is classified as invasive OSNN (IOSSN) when the underlying stroma are infiltrated by dysplastic squamous epithelial cells through the basement membrane. Here, we present the descriptive epidemiology and geographical distribution of IOSSN in Canada.

Methods We determined the incidence and geographical distribution of IOSSN cases diagnosed between 1992 and 2010 using two independent population-based cancer registries: the Canadian Cancer Registry and Le Registre Québécois du Cancer.

Results The mean annual age-standardised incidence rate (WHO 2000–2025) of IOSSN for 1992–2010 was 0.45 cases per million individuals per year with an average annual percent increase in incidence of 4.5%. IOSSN localisation to the conjunctiva was documented in at least 57% of the reported cases. IOSSN exhibited a male predilection ratio of 3.3:1.0 with a mean age at diagnosis of 69 years. Incidence rates of IOSSN across Canadian provinces and cities showed no significant differences from the crude national average.

Conclusions Our results, particularly concerning IOSSN patient age and male predilection, corroborate with data reported from the USA. Additional studies are needed to determine whether the observed increase in incidence rate over the study period (1992–2010) is significant.

  • epidemiology
  • neoplasia
  • cornea

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  • Contributors RD: analysed data, prepared figures and cowrote the paper; FMG and ML: obtained and analysed the data; ER: performed statistical analyses; NA: performed literature review and analysed the data; AZ: performed statistical analyses; LM: analysed the data and prepared figures; DS: analysed the data, designed and supervised the project; MNBJ and IVL: analysed the data, designed and supervised the project and cowrote the paper.

  • Funding This work was supported by the Cole Foundation grant to IVL, Canadian Dermatology Foundation research grants to DS and IVL, and the Fonds de la recherche en santé du Québec (FRSQ# 34753 and 36769) research grants to IVL.

  • Disclaimer No funding bodies had any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was conducted in accordance with the CISS-RDC-668035 and 13-SSH-MCG-3749-S001 protocols approved by the Social Sciences and Humanities Research Council of Canada and the Québec Inter-University Centre for Social Statistics, respectively. In accordance with institutional policy, this study received an exemption from the McGill University Research Ethics Board review.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository. All data are freely available from public sources (Statistics Canada, Canadian Cancer Registry and Le Registre Québécois du Cancer).