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Registry improvements reveal U.K. cSCC rates 3.5x higher than earlier estimates

Data from a newly established skin cancer database in the U.K. has revealed rates of cutaneous squamous cell carcinoma (cSCC) more than three times higher than the previous estimate.

The database was developed by experts at Queen Mary University of London and Public Health England, and funded by the British Association of Dermatologists, with the goal of filling gaps in the process of recording skin cancer cases, to ensure accurate counts of the three most common forms—melanoma, basal cell carcinoma (BCC), and cSCC.

Published in JAMA Dermatology (Nov. 28, 2018, online ahead of print), the new findings from the database show that age-standardized rates for the first registered cSCC from 2013 through 2015 were 77.3 per 100,000 person-years in men and 34.1 per 100,000 person-years in women. This amounts to more than 45,000 cSCC annually—approximately 350% more than previous estimates.

As well, after a maximum follow-up of 36 months, 1.1% of women and 2.4% of men with a cutaneous squamous cell carcinoma developed metastatic cutaneous squamous cell carcinoma.

The discrepancy from earlier estimates is attributed to how rarely cases of these skin cancers were being registered, due to the sheer number of cases and the complexity of accurately registering multiple tumours per patient.

In a press release, Professor Irene Leigh of Queen Mary University of London, the lead author on the study, said: “Due to their frequency, the healthcare burden of squamous cell carcinoma is substantial, with high-risk patients requiring at least two to five years clinical follow-up after treatment and patients often developing multiple tumours. With poor three-year survival once cSCC has metastasized, earlier identification of these high-risk patients and improved treatment options are vital.”

Higher risk of cSCC was associated with being older, male, white, and of lower socioeconomic deprivation, which the press release notes matches the consensus that the increase in SCCs in the U.K. is as a result of an aging population, trends in tanning use, and easier access to foreign vacations, which results in greater cumulative UV exposure.

Nina Goad, Head of Communications at the British Association of Dermatologists, said: “This database is an important national milestone in the treatment of skin cancer, the U.K.’s most common cancer. Previously, researchers and policy makers have been working on a puzzle without all the pieces. Now they know how many cases are being treated every year, better decisions can be made about treatment, prevention, and screening. This is a real step forward.”

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