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Skin cancer rates are three times higher than previously thought

Published in JAMA Dermatology, researchers recently assessed skin cancer rates across England from 2013 through 2015. 

Skin cancer rates are poorly reported and studied, especially for non-melanoma skin cancers, also called keratinocyte cancers. Among them, squamous cell cancer has usually few data available, despite it being the type of non-melanoma skin cancer that is most prone to or spread to other parts of the body. A recent study on the skin cancer database in the United Kingdom shed a new light on the incidence and risk of developing squamous cell carcinoma.

Skin cancers result from malignant growths of the skin. The most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma. The American Academy of Dermatology states that skin cancer is the most common cancer in the United States, with approximately 9,500 people diagnosed with skin cancer every day. More people are diagnosed with skin cancer each year than all other cancers combined.

The most common risk factors for skin cancer are:

  • excessive exposure to ultraviolet light
  • a suppressed immune system from other diseases such as HIV infection
  • other forms of cancer
  • medications like corticosteroids or chemotherapy
  • environmental exposure to radiation or chemicals (such as arsenic, asbestos, and benzene)
  • old age.

Basal cell carcinoma

Basal cell carcinoma is the most common type of skin cancer, usually limited to the skin and rarely spreading to other parts of the body. The melanoma is the most aggressive type of skin cancer because it tends to become metastatic, spreading the disease to other parts of the body, and even leading to death if not treated early. According to the American Cancer Society, about 91,270 people are diagnosed with melanoma each year, and 9,320 people are expected to die of the disease.

Squamous cell carcinoma

The squamous cell carcinoma is the second most common type of skin cancer, but unlike basal cell carcinoma, it is more likely to grow deeper into the skin and spread. Besides the common risk factors for skin cancer, squamous cell carcinoma can also develop as a specific type of ulcer called Marjolin ulcer. This ulcer arises from chronic ulcers, burn scars, and chronic inflammatory processes, usually located in the legs and feet.

The data registry about this skin cancer is usually poor. This month, researchers from the Queen Mary University of London and Public Health England in the United Kingdom published a study to assess the national skin cancer ratesof the metastatic and non-metastatic forms of the squamous cell carcinoma.  They published their results in JAMA Dermatology.

The researchers identified people with cutaneous squamous cell carcinoma (cSCC) and metastatic squamous cell carcinoma(mcSCC) in England from January 1, 2013, through December 31, 2015. The average age for the first register of cSCC was 78 years of age for men and 80 years of age in women. The cutaneous squamous cell carcinoma’s preferred sites were ears, scalp, and neck in men, and legs in women, making the correlation with the areas of the body most exposed to solar light in each sex.

Metastatic risk was two times greater in men than women

The metastatic risk was two times greater in men than in women. After two years, 2.4% of the men and 1.1% of women developed the metastatic form of squamous cell carcinoma. The most common areas for the metastatic cancer were lymph nodes in the head and neck, and the parotid gland.

Primary cSCC located on the ear and lip were at highest risk of metastasis. The risk of mcSCC was highest in patients who were aged 80 to 89 years or older, male, immunosuppressed, and within the highest level of deprivation.

Skin cancer rates are 350% higher than previously thought

This research was the first national study of the incidence of mcSCC in England. The availability of the nationwide cancer registry, the National Cancer Registration and Analysis Service(NCRAS), provides an important tool for cancer statistics, increasing the quality and cost-efficiency of its prevention, screening, staging, and treatment. The study shows that the skin cancer rates of the cSCC are 350% higher than previously estimated, with over 45,000 cutaneous squamous cell carcinomas occurring every year in England, highlighting the importance of early detection to identify the cutaneous squamous cell carcinoma and to prevent the dissemination of the cancer to other areas of thebody.

Written by Dr. Ana C. Freitas, MD


  1. Venables Z.C.,Autier al. Nationwide Incidence ofMetastatic Cutaneous Squamous Cell Carcinoma in England. JAMA Dermatology.2018 Nov 28.
  2. American Academy of Dermatology, “Skin Cancer”, (2018).
  3. American Cancer Society, “Key Statistics for Melanoma Skin Cancer”,(2018).
  4. “Skin Cancer (Nonmelanoma Skin Cancer orKeratinocyte Cancer)”, (2018).


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