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Rates of squamous cell skin cancer in England higher than previously estimated

Data from the National Cancer Registration and Analysis Service in England have revealed that there are more than 45,000 cases of cutaneous squamous cell carcinomas (cSCC) every year in England, 350% more than previously estimated.

The national population-based study identified a cohort of patients with cSCC and metastatic cSCC (mcSCC) in England from 1 January 2013 through 31 December 2015.

Among 76,977 patients with first primary cSCC, the age-standardised rates for the first registered cSCC were 77.3 (95% CI, 76.6-78.0) per 100,000 person-years (PYs) in men and 34.1 (95% CI, 33.7-34.5) per 100,000 PY in women. Increased primary cSCC tumour count was observed in older, white men in lower deprivation quintiles.

After a maximum follow-up of 36 months, cumulative incidence of mcSCC was 1.1% in women and 2.4% in men with a primary cSCC.

Significant increases in the risk for metastasis were observed in patients who were aged 80-89 years (HR, 1.23; 95% CI, 1.07-1.43), 90 years or older (HR, 1.35; 95% CI, 1.09-1.66), men (HR, 1.79; 95% CI, 1.52-2.10), immunosuppressed (HR, 1.99; 95% CI, 1.64-2.42), and in higher deprivation quintiles (HR for highest quintile,1.64; 95% CI 1.35-2.00). Primary cSCC located on the ear (HR, 1.70; 95% CI, 1.42-2.03) and lip (HR, 1.85; 95% CI, 1.29-2.63) were at highest risk for metastasis.

By the end of 2016, total of 13,453 deaths occurred among patients with their first cSCC, equating to a 3-year survival rate of 65% among men and 68% among women. In 836 patients who subsequently developed mSCC, a 3-year survival was 46% in men and 29% in women.

The research is published in JAMA Dermatology.


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