Study Highlights Skin Cancer Rates in England

Research Overview

A recent study published in JAMA Dermatology examined skin cancer rates in England from 2013 to 2015. The findings shed light on the underreported incidence of skin cancers, particularly non-melanoma types, including keratinocyte cancers. Among these, squamous cell carcinoma (SCC) has historically lacked comprehensive data, despite its potential to metastasize.

Skin Cancer Types and Statistics

Skin cancer arises from malignant skin growths, with the most prevalent types being basal cell carcinoma, squamous cell carcinoma, and melanoma. The American Academy of Dermatology reports that skin cancer is the most commonly diagnosed cancer in the United States, affecting approximately 9,500 individuals daily. Each year, more skin cancer cases are identified than all other cancers combined.

Common Risk Factors

Several factors increase the risk of developing skin cancer, including:
– Excessive exposure to ultraviolet light
– A compromised immune system (e.g., due to HIV)
– Other forms of cancer
– Medications like corticosteroids or chemotherapy
– Environmental exposure to harmful chemicals (e.g., arsenic, asbestos, benzene)
– Advanced age

Basal Cell Carcinoma

Basal cell carcinoma is the most frequent type of skin cancer. It typically remains localized and rarely spreads to other body parts. Conversely, melanoma is the most aggressive skin cancer type, with a high propensity for metastasis. The American Cancer Society estimates that around 91,270 individuals are diagnosed with melanoma annually, leading to approximately 9,320 fatalities.

Squamous Cell Carcinoma

Squamous cell carcinoma ranks as the second most common skin cancer. Unlike basal cell carcinoma, it has a greater likelihood of infiltrating deeper skin layers and metastasizing. In addition to standard risk factors, squamous cell carcinoma may arise from chronic ulcers, burn scars, or ongoing inflammatory processes, particularly in the legs and feet.

New Findings on Squamous Cell Carcinoma

Researchers from Queen Mary University of London and Public Health England conducted a study to evaluate the incidence rates of both metastatic squamous cell carcinoma (mcSCC) and non-metastatic cutaneous squamous cell carcinoma (cSCC) in England. They found that the average age of initial diagnosis for cSCC was 78 for men and 80 for women, with common sites being the ears, scalp, and neck for men, and the legs for women—areas often exposed to sunlight.

Metastatic Risk Analysis

The study revealed that the risk of metastasis was twice as high in men compared to women. After two years, 2.4% of men and 1.1% of women progressed to the metastatic form of squamous cell carcinoma. The most frequently affected areas for metastatic cancer included the lymph nodes in the head and neck, as well as the parotid gland. The highest risk of mcSCC was observed in patients aged 80 to 89, particularly in males, those who are immunosuppressed, and individuals in higher deprivation levels.

Significant Findings on Skin Cancer Rates

This research marks the first national investigation into the incidence of mcSCC in England. Utilizing the National Cancer Registration and Analysis Service (NCRAS), the study found that the rates of cSCC are 350% higher than previously estimated, with over 45,000 cases reported annually. These findings underscore the critical need for early detection and intervention to manage and prevent the spread of cutaneous squamous cell carcinoma.

References

– Venables Z.C., Autier P., et al. Nationwide Incidence of Metastatic Cutaneous Squamous Cell Carcinoma in England. JAMA Dermatology, November 28, 2018.
– American Academy of Dermatology, “Skin Cancer” (2018).
– American Cancer Society, “Key Statistics for Melanoma Skin Cancer” (2018).
– “Skin Cancer (Nonmelanoma Skin Cancer or Keratinocyte Cancer)” (2018).