Controversies in the public health approach to keratinocyte carcinomas

Keratinocyte carcinomas are very common cancers in fair-skinned populations throughout the world. The term 'keratinocyte carcinoma' includes basal and squamous cell carcinoma of the skin, but not other cancers that may be included under the more ambiguous term 'nonmelanoma skin cancer'. Incidence and mortality are important for assessing impact and recent research suggests that these cancers are increasing in incidence in young adults. There is evidence to suggest that this trend may be due, in part, to the popularity of ultraviolet exposures in commercial tanning facilities. Mortality from keratinocyte carcinoma reveals distinct patterns suggestive of an important role of human papilloma virus infection. Ultimately, our aim is to reduce mortality and morbidity from these cancers, and to that end several large-scale trials of public health interventions have been conducted that may help point the way forward.