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To the Editor: The study by Dr Christenson and colleagues¹ demonstrated an increased incidence of basal cell and squamous cell carcinomas in a population younger than 40 years. We are concerned about the generalizability of their findings to persons living in other parts of the United States.

Olmsted County, Minnesota, is in a high-latitude area, and residents thus have less direct sunlight exposure compared with other areas, such as California, Texas, and Florida. Regions located in a lower latitude would be expected to have an even higher incidence of basal cell and squamous cell carcinomas in a younger population. Australia, which is very close to the equator, has one of the highest incidences of nonmelanoma skin cancer in the world.² Additional studies are required to examine the effects of latitude (and, consequently, more sunlight exposure) on the development of basal cell and squamous cell carcinomas in younger populations.

Financial Disclosures: . . . [Full Text of this Article]

Jashin J. Wu, MD
jjwu@uci.edu

Shahdad E. Behnam, MD; Douglas J. Fife, MD
Department of Dermatology
University of California, Irvine

David B. Huang, MD, PhD, MPH
Division of Infectious Diseases
Department of Medicine
Baylor College of Medicine
Houston, Tex

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