Type of skin cancer is three and half times more common than thought

A type of skin cancer occurs in the UK three and a half times more often than previously thought and it could be down to tanning trends and easier access to holidays abroad.

Pioneering data from the new UK skin cancer database found more than 45,000 cases of cutaneous squamous cell carcinomas (cSCC) every year, the second most common form of skin cancer in this country.

Older white men with lower living standards were found to be at higher risk, which tallied with the theory that is linked to an ageing population, tanning trends, and easier access to foreign holidays, resulting in cumulative UV exposure.

The important data enables researchers and policy makers to evaluate how effective prevention initiatives are as well as screening, staging and treatments for what is a very common cancer.

Public Health England experts developed the cutting edge technology which fills in enormous gaps in the recording of skin cancer and is the largest of its kind in the world.

It ensures accurate numbers for the three most common types of skin cancer, including melanoma, are available for the whole of the UK.

It also includes non-melanoma skin cancers called keratinocyte cancers which are the most common forms of the disease in the UK, made up of cSCCs and basal cell carcinoma (BCC).

Lead study author professor Irene Leigh, from the Queen Mary University of London who also developed the database, said the healthcare burden of cSCCs ‘is substantial.’

She 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 metastasised, earlier identification of these high-risk patients and improved treatment options are vital.

“This study presents the first national study of the incidence of mcSCC.

“With limited health care resources and an ageing population, accurate epidemiologic
data are essential for informing future health care planning, identifying high-risk patients, and evaluating skin cancer prevention policies.”

Previous data on non-melanoma skin cancers has been very poor and were rarely registered by cancer registries due to the sheer number of cases and the complexity of registering multiple tumours accurately.

But changes in cancer registration processes in England in 2013, including the introduction of nationalised and automated cSCC registration, led to the creation of this population-based nationwide dataset.

Researchers were also able to use the new data to ascertain the number of cases of metastatic cSCC in England – to determine if it has spread to other parts of the body.

More than 1,550 patients were diagnosed with metastatic SCC for the first time between 2013 and 2015, 85 per cent of whom were diagnosed two years after their initial SCC diagnosis.

Until the end of 2016, almost 13,500 patients died out of almost 77,000 diagnosed with their first cSCC during the same period.

The three-year survival was 65 per cent among men and 68 per cent among women.

Of the 836 patients who subsequently developed a metastatic SCC, the three-year survival was 46 per cent in men and 29 per cent in women.

Nina Goad, from the British Association of Dermatologists who funded the technology, said: “This database is an important national milestone in the treatment of skin cancer, the UK’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.”

The study was published in the journal JAMA Dermatology.

By Laura Sharman

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