Skin Cancer: Epidemiology, Disease Burden, Pathophysiology, Diagnosis, and Therapeutic Approaches

Abstract

Skin cancer, including both melanoma and non-melanoma, is the most common type of malignancy in the Caucasian population. Firstly, we review the evidence for the observed increase in the incidence of skin cancer over recent decades, and investigate whether this is a true increase or an artefact of greater screening and over-diagnosis. Prevention strategies are also discussed. Secondly, we discuss the complexities and challenges encountered when diagnosing and developing treatment strategies for skin cancer. Key case studies are presented that highlight the practic challenges of choosing the most appropriate treatment for patients with skin cancer. Thirdly, we consider the potential risks and benefits of increased sun exposure. However, this is discussed in terms of the possibility that the avoidance of sun exposure in order to reduce the risk of skin cancer may be less important than the reduction in all-cause mortality as a result of the potential benefits of increased exposure to the sun. Finally, we consider common questions on human papillomavirus infection.

Epidemiology of Melanoma

“…Annual incidence has risen as rapidly as 4-6% in many fair-skinned populations that predominate regions like North America, Northern Europe, Australia, and New Zealand (10,(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33). Increases in incidence rates vary considerably across populations of different ethnicity and geographical location, and even within populations across age and gender (6,7,9,19,34,35). These differences are important to consider to avoid masking true trends in melanoma incidence.…”

Recent use of medical infrared thermography in skin neoplasms

“…Over the last years, skin cancer incidence has risen to a worrying level, as a consequence of risky behaviours that people are subject to, especially excessive exposure to UV radiation. As the mortality rates associated with these tumours decrease with the early detection, a precise diagnosis is imperative to prevent unnecessary complications . Thermoregulation is one of the main functions of the human skin and is primarily controlled by vasculature alterations that occur when the body is subjected to external or internal stimulus, for example, heat exposure and alterations in the carbon dioxide level respectively .…”

Nicotinamide N‐methyltransferase in nonmelanoma skin cancers

“…Skin cancers represent an emerging clinical need in the white population over 65 years . Nonmelanoma skin cancers (NMSCs), in particular, are the most common human malignancies and their incidence is increasing worldwide, although they are rarely fatal .…”

“…As concerns BCC, it derives from basal keratinocytes and it is the most commonly occurring human cancer. Many histological subtypes have been described, with different clinical features, outcomes and prognosis . There is no specific staging system for BCC and TMN staging is rarely reported, since this tumour usually remains localized…”