Incidence of Invasive Cancers Following Squamous Cell Skin Cancer

Abstract

The authors describe the incidence of new primary cancers among 4,639 cases of squamous cell skin cancer (SCC) diagnosed between 1974 and 1994 in the cancer registries of the Swiss cantons of Vaud and Neuchatel (total person-years at risk = 23,152). Overall, 729 metachronous cancers were observed versus 527.6 expected, corresponding to a standardized incidence ratio (SIR) of 1.4 (95% confidence interval (Cl) 1.3-1.5). After exclusion of skin cancers, however, 384 second primary neoplasms were observed versus 397.2 expected (SIR = 1.0). Excesses were observed for cancers of the lip (SIR = 3.1) and lung (SIR = 1.3), for basal cell (SIR = 4.3) and melanomatous skin cancers (SIR = 3.3), and non-Hodgkin's lymphomas (SIR = 1.7). Rates were elevated for cancers of the salivary glands (SIR = 4.3) and for Hodgkin's disease (SIR = 2.7), and, below age 65 years, for cancers of the lung (SIR = 1.6), breast (SIR = 1.5), and prostate (SIR = 1.8), for Hodgkin's disease (SIR = 15.8), as well as for all neoplasms except skin (SIR = 1.2; 95% Cl 1.0-1.5). The cumulative risk of basal cell skin cancer reached 17% after 15 years. The authors believe that the excesses for basal cell carcinomas and melanomas of the skin following SCC, and possibly of lymphomas, were likely attributable to common phenotypic characteristics and exposure to UV radiation. The elevated rates of lung cancer are suggestive for a role of tobacco as a cause of squamous cell skin cancer. Am J Epidemiol 1997; 146:734-9.

Familial invasive and in situ squamous cell carcinoma of the skin

“…In contrast to the scarcity of familial data on skin SCC, there are many studies published on second cancers following skin SCC (Frisch and Melbye, 1995;Levi et al, 1996Levi et al, , 1997Levi et al, , 1998Wassberg et al, 1999;Dong and Hemminki, 2001b;Hemminki and Dong, 2000b, c;Milan et al, 2000). These have shown a consistent link between SCC and melanoma, while an association between skin and eye cancer has been noted (Milan et al, 2000).…”

Second primary cancers in patients with squamous cell carcinoma of the skin

“…Other dominant risk factors are smoking and immunosuppression. A number of studies have found significantly increased risks of various second primary cancers in SCC patients Levi et al, 1997;Wassberg et al, 1999;Askling et al, 1999;Hemminki and Dong, 2000;Hemminki et al, 2001;Efird et al, 2002). Some general patterns can be seen from these studies.…”

Site-specific occurrence of nonmelanoma skin cancers in patients with cutaneous melanoma

“…Patients with melanoma are known to be at a substantially increased risk of the nonmelanoma skin cancers (NMSC) BCC and SCC (Wassberg et al, 1996;Levi et al, 1997a;Hemminki et al, 2003;Crocetti and Carli, 2004) and the converse is also true (Levi et al, 1997b(Levi et al, , 1998Wassberg et al, 1999;Bower et al, 2000;Maitra et al, 2005). However, it is not known whether the association between melanoma and NMSC varies according to the anatomical site.…”