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Patients With Nonmelanoma Skin Cancers Have Good Chance of Remaining Free of Subsequent Tumors

There are currently more than 13 million people with a history of at least one nonmelanoma skin cancer. Screening patients with a history of one tumor could alone account for more than one-third of visits to dermatologists. In a study published in JAMA Dermatology, authors provide data to help to identify patients at highest risk for subsequent tumors. Identifying the characteristics of those at the highest risk will help clinicians allocate resources to screen those most in need.

Patients diagnosed with basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (SCC) (often termed nonmelanoma skin cancer or keratinocyte carcinoma [KC]) often develop new KCs, but the study results show that a subset may not develop another KC after their first tumor.

Authors followed 1,284 patients for an average of five years after diagnosis with a single KC. These patients had no history of KC before enrollment and were enrolled with an initial single KC. The relative risk of developing another KC increased with each additional lesion: risks for a second KC after a first lifetime KC are significantly lower over time than the risks for a third KC after a second, a fourth after a third, a fifth after a fourth, and a sixth after a fifth. Based on the data, the authors projected that at 10 years, approximately 40% of patients diagnosed as having a first lifetime KC will not develop another tumor. When patients who enrolled with a first lifetime KC developed at least 1 subsequent KC, however, they had substantially higher risks for subsequent tumors.

The authors conclude that the risk for subsequent new KC over time is substantially lower after a first lifetime KC diagnosis than after a nonfirst KC diagnosis. The authors suggest that patients presenting with their first lifetime KC may be the group most likely to benefit from preventive counseling. Patients presenting with a history of KC, and those that develop a subsequent tumor by 2 or 4 years may benefit from more aggressive or more frequent screening for subsequent tumors.

By: Wendy Meltzer, MPH

Source: JAMA

Adapted from the original article.

[image by Brenda Clarke]




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