Risk factors for development of new skin neoplasms in patients with past history of skin cancer: A survival analysis

Abstract

We conducted a retrospective study aiming to assess the risk, and associated risk factors, of developing subsequent skin cancers after having a first diagnosis of skin cancer. We included all patients with biopsy-proven skin cancer attending a dermatology clinic between July 2007 and July 2017. We assessed the frequency of new skin cancers, as well as potential demographic and clinical factors significantly associated with occurrence of such neoplasms, that were identified by means of a survival analysis. We analyzed 969 patients with a total of 1584 skin neoplasms (1122 basal cell carcinomas (BCC), 310 squamous cell carcinomas (SCC), 143 melanomas and 9 other neoplasms). 165 patients (17.0%) developed subsequent skin neoplasms. Factors identified in multivariable models to be significantly associated with development of new skin cancers included older age (adjusted HR = 1.04 per year; 95%CI = 1.02–1.05; p < 0.001), and presence of synchronous neoplasms (adjusted HR = 2.25; 95%CI = 1.61–3.14; p < 0.001). Having a history of a BCC was significantly associated with development of new BCC (adjusted HR = 1.63; 95%CI = 1.05–2.54; p = 0.030), while having a previous SCC was associated with occurrence of subsequent SCC (adjusted HR = 3.60; 95%CI = 1.93–6.72; p < 0.001). These findings point to the importance of careful follow-up (e.g., skin self-examination and full body examination) of skin cancer patients.

Environmental factors’ contribution in skin cancer etiology

“…With time, the DNA necessary for solar-induced injuries begins to not function properly and mutations appear, giving rise to malignant/cancerous cell development. [2] The most frequent modifiable risk factor for skin cancer development is ultraviolet radiation (UV) exposure. UV radiation is a well-known physical danger, responsible on one hand for photoaging, photo-allergies, and phototoxic reactions, and on the other hand for carcinogenesis, including melanoma.…”

Metachronous Eyelid Basal Cell Carcinoma on Opposite Eye and Lid: A Case Report

“…Older age increases risk of future lesions; the average age of those with additional lesions being 69 years-old versus an average age of 63 years-old without. 13 When Smedinga et al investigated the risk of metachronous BCC lesions (isolated additional lesions identified later), they found that the greatest prognostic indicator was the number of previous BCC lesions. Other risk factors were skin sensitivity to sunburn (i.e., Fitzpatrick classification), pigmentation of previous lesions, and lesion location.…”

The evolving field of Dermato‐oncology and the role of dermatologists: Position Paper of the EADO, EADV and Task Forces, EDF, IDS, EBDV–UEMS and EORTC Cutaneous Lymphoma Task Force

“…Dermatologists play a central role in the follow‐up of patients with skin cancers, and their role definitely extends beyond skin examination (Table 4). The follow‐up of skin cancer patients is of great importance as its objectives are manifold: to detect the primary tumour's recurrences or relapses as early as possible (which immediately influences the treatment decision), to detect new secondary skin cancers early 60–62 and other possibly subsequent malignancies, 63,64 to monitor and manage the side‐effects of antitumoural therapies, and also to provide patients with education, counselling and support for prevention actions, both for themselves and their families. According to the recent versions of European and other international guidelines for skin cancer from EADO, EDF, EORTC and ESMO as well as the NCCN melanoma guidelines, 37,49,65,66 the frequency and extent of follow‐up visits and tests depend upon the risk of relapse and risk factors for subsequent skin cancers (e.g.…”