Non Melanoma Skin Cancer and Subsequent Cancer Risk

Abstract

IntroductionSeveral studies have shown an increased risk of cancer after non melanoma skin cancers (NMSC) but the individual risk factors underlying this risk have not been elucidated, especially in relation to sun exposure and skin sensitivity to sunlight.PurposeThe aim of this study was to examine the individual risk factors associated with the development of subsequent cancers after non melanoma skin cancer.MethodsParticipants in the population-based New Hampshire Skin Cancer Study provided detailed risk factor data, and subsequent cancers were identified via linkage with the state cancer registry. Deaths were identified via state and national death records. A Cox proportional hazard model was used to estimate risk of subsequent malignancies in NMSC patients versus controls and to assess the potential confounding effects of multiple risk factors on this risk.ResultsAmong 3584 participants, risk of a subsequent cancer (other than NMSC) was higher after basal cell carcinoma (BCC) (adjusted HR 1.40 [95% CI 1.15, 1.71]) than squamous cell carcinoma (SCC) (adjusted HR 1.18 [95% CI 0.95, 1.46]) compared to controls (adjusted for age, sex and current cigarette smoking). After SCC, risk was higher among those diagnosed before age 60 (HR 1.96 [95% CI 1.24, 3.12]). An over 3-fold risk of melanoma after SCC (HR 3.62; 95% CI 1.85, 7.11) and BCC (HR 3.28; 95% CI 1.66, 6.51) was observed, even after further adjustment for sun exposure-related factors and family history of skin cancer. In men, prostate cancer incidence was higher after BCC compared to controls (HR 1.64; 95% CI 1.10, 2.46).ConclusionsOur population-based study indicates an increased cancer risk after NMSC that cannot be fully explained by known cancer risk factors.

History of Keratinocyte Carcinoma and Risk of Melanoma: A Prospective Cohort Study

“…reports, except that the risk estimate tended to be lower in the present study (multivariable-adjusted HR ¼ 2.22) than those reported in previous case-control or registry-based studies (HR/ meta-analysis relative risk > 2.70) (6)(7)(8) and in a prospective study with a total of 19 174 individuals and a 16-year follow-up (multivariable-adjusted relative risk ¼ 7.94) (9). The modest associations reported in our study may be partly explained by the adjustment for a number of potential risk factors.…”

Incidence of eyelid basal cell carcinoma in England: 2000–2010

“…This is in contrast to the incidence rates reported across the body as a whole, which have shown an upward trend over time 5 6. The primary risk factor for NMSC is ultraviolet radiation22 and because of increased sun exposure caused by changed sunlight-related behaviour and general ageing populations, the incidence of NMSC is expected to increase 17. It is possible that idiosyncratic factors influence the eyelids differently to the rest of the body, for example, sunglass wear but we do not have data on risk factors, and analysis of the risk factors leading to this trend is beyond the scope of this particular report.…”

Guidelines of care for the management of basal cell carcinoma

“…A smaller study including 3548 people found the relative risk for MM to be 3.28 after diagnosis of BCC. 119 Patients who have had BCC should be counseled regarding the risk for new primary skin cancers, the need for in-office screening, and the potential benefits of self-screening. Concurrent patient selfsurveillance for BCC and other skin cancers may be of additional utility in detecting new primary tumors while they are still small and easily treated.…”

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