We used the updated nation-wide Swedish Family-Cancer Database to examine familial risks in data from 1961 to 1998 on 1252 invasive and 2474 in situ squamous cell carcinoma (SCC) of the skin among offspring, and over 10 times more among parents. In 259 families a parent and an offspring had skin SCC. The familial standardised incidence ratios (SIRs) were 2.72 for invasive and 2.40 for in situ skin cancers in offspring. Multiple skin cancers in parents were associated with increased SIRs for invasive SCC in offspring, being 2.55 for one and up to 14.93 for two invasive and two in situ cancers in parents; the corresponding in situ SCC risks were 2.28 and 7.49. The population attributable fraction for any familial skin SCC, invasive or in situ, was 4.1%. Melanoma was the only discordant tumour that was associated with invasive and in situ skin SCC. These results provide evidence that there is an underlying hereditary susceptibility for at least a part of the familial clustering for skin SCC. Squamous cell carcinoma (SCC) of the skin is not recorded by most cancer registries and its established risk factors are limited to fair skin, ultraviolet light, arsenic compounds and immunosuppression, while less is known about benign lesions, such as actinic keratosis and in situ carcinoma (intraepidermal SCC, or Bowen's disease) (IARC, 1990(IARC, , 1995English et al, 1997) The Swedish Cancer Registry has recorded both invasive and in situ SCC whose incidence has rapidly increased over the past 20 years (Center for Epidemiology, 2000;Wassberg et al, 2001). Skin SCC is the fourth most common cancer in men and women in Sweden in 1998, and the in situ form is the most common benign/precancerous tumour in men and the second among women after in situ cervical cancer. In situ skin cancer does not appear to be a simple precursor lesion to invasive SCC because the age of onset of the two forms is similar; a true precursor lesion would be expected to show an earlier age of onset, as with cervical in situ and invasive cancers