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Incidence was obtained from the International Agency for Research on Cancer. We searched PubMed, EMBASE<\/jats:styled-content>, Web of Science and the reference lists of articles retrieved. Meta\u2010analyses were conducted using a fixed\u2010effects model for HIV<\/jats:styled-content> and cigarette smoking and random effects for human papilloma virus (HPV<\/jats:styled-content>).<\/jats:p><\/jats:sec>Results<\/jats:title>The incidence of OSSN<\/jats:styled-content> is highest in the Southern Hemisphere (16\u00b0 South), with the highest age\u2010standardised rate (ASR<\/jats:styled-content>) reported from Zimbabwe (3.4 and 3.0 cases\/year\/100\u00a0000 population for males and females, respectively). The mean ASR<\/jats:styled-content> worldwide is 0.18 and 0.08 cases\/year\/100\u00a0000 among males and females, respectively. The risk increases with exposure to direct daylight (2\u20134\u00a0h, OR<\/jats:styled-content>\u00a0=\u00a01.7, 95% CI<\/jats:styled-content>: 1.2\u20132.4 and \u22655\u00a0h OR<\/jats:styled-content>\u00a0=\u00a01.8, 95% CI<\/jats:styled-content>: 1.1\u20133.1) and outdoor occupations (OR<\/jats:styled-content>\u00a0=\u00a01.7, 95% CI<\/jats:styled-content>: 1.1\u20132.6). Meta\u2010analysis also shows a strong association with HIV<\/jats:styled-content> (6 studies: OR<\/jats:styled-content>\u00a0=\u00a06.17, 95% CI<\/jats:styled-content>: 4.83\u20137.89) and HPV<\/jats:styled-content> (7 studies: OR<\/jats:styled-content>\u00a0=\u00a02.64, 95% CI<\/jats:styled-content>: 1.27\u20135.49) but not cigarette smoking (2 studies: OR<\/jats:styled-content>\u00a0=\u00a01.40, 95% CI<\/jats:styled-content>: 0.94\u20132.09). The effect of atopy, xeroderma pigmentosa and vitamin A deficiency is unclear.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Africa has the highest incidence of OSSN<\/jats:styled-content> in the world, where males and females are equally affected, unlike other continents where male disease predominates. African women probably have increased risk due to their higher prevalence of HIV<\/jats:styled-content> and HPV<\/jats:styled-content> infections. As the survival of HIV<\/jats:styled-content>\u2010infected people increases, and given no evidence that anti\u2010retroviral therapy (ART<\/jats:styled-content>) reduces the risk of OSSN<\/jats:styled-content>, the incidence of OSSN<\/jats:styled-content> may increase in coming years.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12203","type":"journal-article","created":{"date-parts":[[2013,10,30]],"date-time":"2013-10-30T13:03:29Z","timestamp":1383138209000},"page":"1424-1443","source":"Crossref","is-referenced-by-count":190,"title":["Epidemiology of ocular surface squamous neoplasia in A<\/scp>frica"],"prefix":"10.1111","volume":"18","author":[{"given":"Stephen","family":"Gichuhi","sequence":"first","affiliation":[{"name":"Department of Ophthalmology University of Nairobi Nairobi Kenya"},{"name":"London School of Hygiene and Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandeep S.","family":"Sagoo","sequence":"additional","affiliation":[{"name":"Moorfields Eye Hospital London UK"},{"name":"UCL Institute of Ophthalmology University College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen A.","family":"Weiss","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Burton","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine London UK"},{"name":"Moorfields Eye Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,10,30]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.4314\/gmj.v45i2.68927"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-387-88443-1"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)90870-6"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/mutage\/geh048"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6601743"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605466"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-005-0025-4"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-13-27"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003226-200310000-00015"},{"key":"e_1_2_6_11_1","first-page":"827","article-title":"The induction of keratinization in the corneal epithelium. 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