Rates of skin cancer far higher than previously thought

Squamous cell carcinoma is the second most common form of skin cancer.

Developed by experts at Queen Mary University of London and Public Health England, and funded by the British Association of Dermatologists, the new database fills in enormous gaps in the recording of skin cancer, ensuring that accurate UK numbers are available for the three most common types of skin cancer: melanoma, basal cell carcinoma (BCC), and cSCC.

‘A substantial healthcare burden’

Along with BCCs, cSCCs make up what are known as non-melanoma skin cancers, which are the most common cancers in the UK. Previously, the data on these cancers has been very poor, as they were rarely registered by cancer registries due to the sheer number of cases and the complexity of accurately registering multiple tumours per patient.

Professor Irene Leigh of Queen Mary University of London, lead author of the study, said: “Due to their frequency, the healthcare burden of squamous cell carcinoma is substantial, with high risk patients requiring at least two to five years clinical follow-up after treatment and patients often developing multiple tumours. With poor three-year survival once cSCC has metastasised, earlier identification of these high-risk patients and improved treatment options are vital.”

The study, published in the journal JAMA Dermatology, found that a higher risk of cSCC was associated with being older, male, white, and of lower socioeconomic deprivation. This tallies with the consensus that the increase in SCCs in the UK is as a result of the ageing population, tanning trends, and easier access to foreign holidays, which results in greater cumulative UV exposure.

The 3-year survival was 65 per cent among men and 68 per cent among women.

‘An important national milestone in the treatment of skin cancer’

The researchers also found that between 2013 and 2015 there were 1,566 patients diagnosed with metastatic SCC for the first time – the cancer having spread to other parts of the body. For 85 per cent of these patients, this occurred within two years of their initial SCC diagnosis.

Nina Goad of the British Association of Dermatologists, said: “This database is an important national milestone in the treatment of skin cancer, the UK’s most common cancer. Previously, researchers and policy makers have been working on a puzzle without all the pieces. Now they know how many cases are being treated every year, better decisions can be made about treatment, prevention, and screening. This is a real step forward.”

More information

• Research paper: ‘Nationwide Incidence of Metastatic Cutaneous Squamous Cell Carcinoma in England’ by Zoë C. Venables, MBChB; Philippe Autier, PhD; Tamar Nijsten, PhD; Kwok F.Wong, PhD; Sinéad M. Langan, PhD; Brian Rous, MD; John Broggio, BsC; Catherine Harwood, PhD; Katherine Henson, PhD; Charlotte M. Proby, FRCP; Jem Rashbass, MBBS; Irene M. Leigh, CBE. JAMA Dermatology. DOI 10.1001/jamadermatol.2018.4219
• Study Medicine MBBS or Dentistry BDS at Barts and The London School of Medicine and Dentistry.