Nonmelanoma Skin Cancer and the Risk of Second Primary Cancers: a Systematic Review

Abstract

Background: Based on empirical evidence, a personal history of nonmelanoma skin cancer (NMSC) has been hypothesized to be a risk factor for other cancers. Others hypothesize that NMSC may be a marker of high cutaneous vitamin D synthesis and therefore inversely associated with risk of other malignancies. To reconcile these divergent views, we carried out a systematic review to determine the association between NMSC and subsequent risk of other cancers.Methods: Bibliographic databases were searched through March 2009. Studies were included if sufficient information was presented to estimate the risk of developing other cancers following NMSC. Studies were reviewed and data were abstracted independently in duplicate with disagreements resolved by consensus.Results: Of the 21 included studies, 15 reported the association between NMSC and risk of all other cancers combined. NMSC was significantly associated with increased risk of another malignancy among cohort studies based on cancer registries [summary random-effects relative risk (SRR), 1.12; 95% confidence interval (CI), 1.07-1.17; n = 12 studies) and those with individual-level data (SRR, 1.49; 95% CI, 1.12-1.98; n = 3). In stratified analyses of registry studies, this association held true for both squamous (SRR, 1.17; 95% CI, 1.12-1.23; n = 7) and basal cell carcinoma (SRR, 1.09; 95% CI, 1.01-1.17; n = 7), and both men (SRR, 1.14; 95% CI, 1.09-1.20; n = 12) and women (SRR, 1.10; 95% CI, 1.04-1.15; n = 12).Conclusions: Strong, consistent evidence indicates that a personal history of NMSC is associated with increased risk of developing other malignancies.Impact: For unknown reasons, NMSC may be a risk factor for other cancers. Cancer Epidemiol Biomarkers Prev;

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.…”

“…Methods: We followed 91 846 women in the Nurses' Health Study (NHS; 1984-2010, 114 918 women in the NHSII , and 48 946 men in the Health Professionals Follow-up Study (1986-2010 for diagnoses of KC and melanoma biennially. Cox proportional hazards models were used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) of melanoma associated with history of KC, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC).…”

Guidelines of care for the management of basal cell carcinoma

“…116 More recently Wehner et al found in their prospective cohort that the 5-year probability of another NMSC after diagnosis of a first was 40.7%, and 82% after more than 1. 117 At 10 years, the chances increased to 59.6% of another NMSC after the first and 91.2% after diagnosis of a nonfirst NMSC.…”

“…[116][117][118][119]123,[125][126][127][128][129][130][131][132][133][134][135][136][137][138][139][140][141] …”

Subsequent Primary Malignancies in Patients with Nonmelanoma Skin Cancer in England: A National Record-Linkage Study

“…The two key known mechanisms of cutaneous carcinogenesis are UV-induced genetic damage and suppression of skin immune tumor surveillance responses (3). UV exposure is considered to account for an increased risk of subsequent NMSC and melanoma in individuals after a first NMSC (4,5).…”