Have There Been More Cases of Skin Cancer in Recent Years?
by Lisa DiFalco
There are two forms of skin cancer that appear to be on the rise in certain populations. This is according to findings from a team of researchers led by the Mayo Clinic.
Incidence and Trends of Basal Cell Carcinoma and Cutaneous Squamous Cell Carcinoma was published recently in Mayo Clinic Proceedings and relies upon medical records made available through the Rochester Epidemiology Project. Incidences of both basal cell carcinoma and squamous cell carcinoma are compared from the period of 2000 and 2010 to diagnosed cases in previous years.
Learn more about basal cell carcinoma, squamous cell carcinoma, and the initial findings from this paper.
Basal Cell Carcinoma
Basal cell carcinoma is a skin cancer that starts within the basal cells. Often appearing as a somewhat transparent bump on the surface of the skin, it generally develops on skin that has been exposed to the sun. Basal cell carcinomas are often found on the head and neck. It is believed that this form of skin cancer is due to long-term exposure to damaging UV rays when individuals are outdoors. The use of sunscreen and avoiding the sun may help reduce the risk of developing this type of skin cancer. Symptoms of basal cell carcinoma include:
- A waxy, white, and scar-like lesion;
- A pearly white, pink, or skin-colored bump;
- A lesion that is either blue, black, or brown in color, or one with dark spots; and
- A reddish patch that is flat and scaly with a raised edge.
It is important to schedule an appointment with a doctor when a new growth, recurring sore, or an alteration to a previous growth occurs. Available treatments include freezing, surgical excision, and Mohs surgery. Drugs that may be recommended include fluorouracil (Fluoroplex, Efudex and others) and imiquimod (Aldara) for low-risk basal cell carcinomas. Skin cancers that do not respond to other treatments or spread to other areas may be treated with sonidegib (Odomzo) or vismodegib (Erivedge).
Squamous Cell Carcinoma
As for squamous cell carcinoma, another nonmelanoma skin cancer, development begins in the squamous cells found in the skin’s middle and outer layer. This form of skin cancer is generally not life-threatening but can be aggressive, spreading to other parts of the body without treatment. The belief is that this form of skin cancer is a result of excessive exposure to UV rays, either from tanning beds, lamps, or from sunlight. Squamous cell carcinoma can develop on the skin anywhere on the body. It is often found on the ears, lips, back of the hands, or the scalp but has been known to develop on the genitals, anus, and inside the mouth. Symptoms of squamous cell carcinoma include:
- A flat, sore and scaly crust;
- A firm, red nodule; and
- A raised area on an ulcer or old scar.
It is important to seek a doctor’s attention for scabs or sores that fail to heal within a two-month period. Surgical treatments include freezing, laser therapy, simple excision, and medicated lotions or creams.
What New Research Reveals
Incidences of both squamous cell carcinoma and basal cell carcinoma appear to have significantly increased. When the 2000-2010 period was compared to the 1976-1984 period and that of 1985-1992, researchers found:
- A 263 percent increase in squamous cell carcinoma; and
- A 145 percent rise in basal cell carcinoma.
There were differences seen based on gender and age. Women of 30-49 years of age appeared to have an increased rate in basal cell carcinoma. Women in the 40-59 and 70-79 age group appeared to have the most significant increase in squamous cell carcinoma diagnoses.
As for the men in the earliest two periods, studies had shown that they had an increase in diagnoses of squamous cell carcinomas and had a slight decline in the most recent periods. The rate of diagnoses of basal cell carcinomas appeared to be similar throughout all three periods.
In addition, the areas where cancer tumors were found appear to have shifted. This may be in part due to the use of tanning beds and other devices. Earlier periods showed more diagnoses on the head and neck, but in the 2000-2010 period there are records indicating an increase of basal cell tumors found on the torso and squamous cell carcinomas on participant’s arms and legs. Christian Baum, M.D., the study’s senior author and a Mayo Clinic dermatologist said:
“We know that the sun and some artificial sunlight sources give off skin-damaging ultraviolet or UV rays. This skin damage accumulates over time and can often lead to skin cancer.”
He continued, saying:
“Despite the fact that sunscreens and cautionary information have been widely available for more than 50 years, we saw the emergence of tanning beds in the 1980s, and tanning—indoors or out—was a common activity for many years.”
Dr. Baum supports the use of sunscreen, even on cloudy days. UV rays can damage exposed skin on drivers and lead to more skin damage.
The Rochester Epidemiology Project is a unique resource and of great use to researchers. As Dr. Baum shared:
“There is no tumor registry for these types of cancer. So, it is difficult to have accurate estimates of the national or worldwide impact of these cancers. However, because the Rochester Epidemiology Project contains health care information for virtually all residents of Olmsted County since 1966, it provides a good proxy for information on many global population health concerns.”
Today and Every Day
It is never too late to take steps to avoid prolonged exposure to UV rays. Patients, families, case managers, educators, nurses, and healthcare professionals should be aware of the simple ways to protect skin while outdoors and when driving, as well as becoming knowledgeable about the symptoms of basal cell carcinoma and squamous cell carcinoma.