Non-melanoma skin cancer (NMSC) – introduction

Carsten Sauer Mikkelsen | Apr 2020 | Dermatologi | Onkologi /hematologi |

Carsten Sauer Mikkelsen
Specialist in Dermato-venereology,
Private Practice in Dermato-venereology,
Brønderslev, Denmark
& Research lab.
Department of Dermato-venereology,
Aalborg University Hospital,
Denmark

Kristian Bakke Arvesen
Specialist in Dermato-venereology,
Research lab.
Department of Dermato-venereology,
Aalborg University Hospital,
Denmark

Luit Penninga
Specialist in Surgery,
Ilulissat Hospital,
Avannaa Region,
Ilulissat, Greenland

Peter Bjerring
Specialist in Dermato-venereology,
Research lab.
Department of Dermato-venereology,
Aalborg University Hospital,
Denmark

Skin cancer is an abnormal growth of skin cells andcan be categorized broadly into cutaneous melanoma and non-melanoma skin cancer (NMSC)1. NMSC is more common than any other malignancy in the fair-skinned population globally2,3. The incidence of NMSC is 18–20 times higher than that of malignant melanoma. Basal cell carcinoma and squamous cell carcinoma Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) of the skin make up 99% of all NMSC, with BCC being 3 to 5 times more common than SCC2,4-7. BCC alone accounts for 80% of cases of NMSCand the most common site is the head and neck region (80%).Well-known risk factors for developing NMSC include exposure to ultraviolet radiation (especially during childhood), fair complexion, advancing age, and immunosuppression.8,9 The incidence of metastatic BCC and SCC ranges between 0.00281–0.05% and 0.5–16%, respectively, whilst the age-adjusted mortality rate is estimated to be 0.12 per 100,000 for BCC and 0.3 per 100,000 for SCC10-12. However, despite its relatively low metastatic potential, NMSC is associated with significant morbidity and substantial cost13,14. Local invasion causes destruction of the skin and surrounding tissues. During the last 30 years, the incidence of SCC has been rising by 3–10% per year15. Over the same period, it is estimated that the BCC incidence rate has risen by 20–80% in the US15.The incidence of NMSC in Denmark averaged 20,000 in the period 2008–2012 according to the Danish Cancer Register. Approximately 10–20% of these new cases were SCC. In 2014, the incidence of BCC alone was 12,043 in Denmark16. But since 1978, the Danish Cancer Register’s coding process has unfortunately been programmed not to accept more than one tumour within the same histology group within one organ. The skin is considered one single organ. A special code indicates whether a person has multiple skin cancers but not...