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Females vastly outnumber males in basal cell carcinoma of the upper lip. A peculiar subset of high risk young females is described.

BACKGROUND
It was noted that females, particularly young females, outnumbered males with basal cell carcinoma (BCC) of the upper lip among patients treated by Mohs micrographic surgery in Vancouver, British Columbia.


OBJECTIVE
To investigate female-to-male ratios for BCC of the upper lip at the Vancouver Mohs micrographic surgery service, and to compare this with data from the provincial-wide registry as well as with worldwide data in the literature.


METHODS
The female-to-male ratios by age group were determined for 136 upper lip lesions treated at the Mohs service from 1983 to 1992. Similar data were obtained from 731 perioral BCCs recorded at the provincial-wide registry from 1982 to 1989. The literature was reviewed for comparative data worldwide.


RESULTS
At the Mohs service females outnumber males 3.5:1 for upper lip BCCs. Young females 30-39 years old outnumber males 16:1. Regional data from the British Columbia Cancer Registry confirm that females outnumber males 2:1 for the lip region (including upper lip, lower lip, nasolabial fold). This is significant when compared with all BCCs diagnosed in the province (ie, all sites), in which males outnumber females 1.3:1. Data from the literature worldwide confirm this relationship.


CONCLUSION
BCC of the upper lip is a female-predominated disease. Young females are at a much higher risk for this disease than young males.