Is a Personal History of Nonmelanoma Skin Cancer Associated with Increased or Decreased Risk of Other Cancers?

Abstract

Two conflicting hypotheses have been tested concerning the association between a personal history of non-melanoma skin cancer (NMSC) and risk of other malignancies. One hypothesis is that as a marker of extensive sunlight exposure and hence vitamin D status, NMSC should be inversely associated with risk of other cancers. Alternatively, under the multiple primary cancer model, NMSC is postulated to be an informative first cancer to study as marker of increased risk of subsequent primary cancer diagnoses. In this journal issue, Ong and colleagues report the results of a large-scale study in the U.K. with findings that NMSC was significantly associated with increased risk of a broad spectrum of other malignancies, with the associations stronger the younger the age of onset of NMSC. These results are consistent with the larger body of evidence on this topic, which is highly asymmetrical in favor of the multiple primary cancer hypothesis. Two divergent hypotheses have been tested, with the empirical evidence unequivocally indicating NMSC is a marker of a high cancer-risk phenotype. Future research is warranted to better characterize this association, to understand why NMSC is a marker of excess risk of other cancers, and to determine if this association is clinically relevant.

All-cause mortality in patients with basal and squamous cell carcinoma: A systematic review and meta-analysis

“…[28] Estimates from studies that separate BCC and SCC patients suggest SCC is associated with decreased survival whereas BCC has been associated with equal or increased survival compared to the general population. [23, 25, 29] Understanding the risk of death among patients with skin cancer is important for two reasons: 1) a better understanding of disease pathogenesis, in the context of recent studies suggesting that skin cancers may be independent risk factors and markers of cancer-prone genetic phenotypes[30, 31] and 2) improving clinical care and prevention recommendations for these patients.…”

Epidemiology of Keratinocyte Carcinoma

“…This excess cancer risk associated with KC was observed in both males and females and for both BCC and SCC [47]. Since the systematic review was published, the evidence characterizing KC as a marker of increased risk of noncutaneous malignancies has strengthened considerably [45, 46]. Two notable prospective cohort studies with individual-level data, one carried out in Taiwan [48] and the other in the United States [49] were published that provide further evidence of a strong association between NMSC and risk of other cancers.…”

Carcinoembryonic Antigen Serum Levels in Nonmelanoma Skin Cancer

“…Despite such a favourable prognosis, there is evidence that NMSC may be a marker of other adverse health outcomes. An association between NMSC and increased risk of other malignancies has been well documented [ 19 , 20 ].…”