The Development of Non-Melanocytic Skin Cancers in People with a History of Skin Cancer

Abstract

Objective: To determine the incidence of new skin cancer formation in people who have had skin cancer removed. Study Design: A prospective study of Melbourne out-patients with histologically confirmed non-melanoma skin cancer (NMSC). All patients with NMSC seen by one author (D.C.) between November 1988 and November 1989 were entered into the study and reviewed regularly. New skin cancers were removed and recorded. Results: Four hundred and eighty-one patients were entered and 420 followed for at least 3 years. New NMSC developed in 60% (adjusted for losses) by the end of 3 years. A multivariate analysis determined that the main risk factor for new NMSC formation was the number of previous skin cancers that a patient had. Those who had had multiple skin cancers (3 or more) were at significantly greater risk than those with less than 3. Age, sex and type of NMSC were not risk factors for new skin cancer formation. Conclusion: Patients with NMSC require long-term follow-up because of the risk of new skin cancer formation. Those with multiple NMSC need more careful follow-up, and possibly more frequent examinations, because they are at greater risk.

Risk of Developing a Subsequent Nonmelanoma Skin Cancer in Patients With a History of Nonmelanoma Skin Cancer

“…Based on reading these 60 articles and agreement by both of us, 17 studies were selected as providing data relevant to the study topic. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] The remaining 43 articles were excluded more frequently because they provided data only on the incidence of the first tumor or recurrent tumors, but not on the risk of a subsequent tumor. The 17 selected studies were 6 prospective cohort studies, 17-19.21,25,26 1 retrospective cohort study, and 10 retrospective record-linkage studies.…”

“…The 17 selected studies were 6 prospective cohort studies, 17-19.21,25,26 1 retrospective cohort study, and 10 retrospective record-linkage studies. 20,23,24,[27][28][29][30][31][32][33] Table 1 provides a summary of the characteristics of the patient populations in these 17 studies, [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] including study type, number of patients enrolled, average du-…”

“…The 3-year cumulative risk ranged from 35% to 60% (mean risk, 47%). In an Australian study by Czarnecki et al, 18 an increased risk of developing a subsequent NMSC was not associated with age or sex, but there was a strong association between risk and the number of previous NMSCs. For patients with fewer than 3 previous NMSCs, the 3-year cumulative risk was 38%.…”

“…We identified 4 studies 17,18,20,23 that assessed the risk of developing an NMSC of any type after the first NMSC ( Table 5). The 3-year cumulative risk ranged from 35% to 60% (mean risk, 47%).…”

“…20 Because BCC is the predominant type of NMSC (Ͼ85% of all NMSCs), it is not surprising that the available analyses of the risk of a second NMSC after an NMSC of either type provide results similar to those observed for BCC. [17][18][19][20]23 Few studies systematically assessed risk factors for the development of a subsequent NMSC. The number of previous skin tumors seems to be the only consistent and strongly associated risk factor for an increased risk for the development of subsequent skin cancers.…”