Treatment of squamous cell carcinoma in situ: a review

Squamous cell carcinoma in situ (SCCIS) is thought to be a precursor to squamous cell carcinoma. It should be treated before invasive cancer develops, especially in transplant recipients, who may develop more aggressive skin cancers. Treatment can involve surgical and nonsurgical methods. OBJECTIVE To review the evidence available in the English medical literature for different treatment options of SCCIS on nongenital skin and evaluate the efficacy of each option.

A Pubmed search of articles describing the treatment of SCCIS was conducted. Keywords were "treatment," "Bowen's disease," and "squamous cell carcinoma in situ." Articles describing the use of surgical excision, curettage and electrodesiccation, cryotherapy, 5-fluorouracil, imiquimod, radiation, photodynamic therapy, lasers, and rarer methods were reviewed.

No single treatment can be said to be superior for any one situation. Most studies are small, limiting the power of each. Further studies are needed to clarify optimal treatment protocols for nonsurgical methods such as cryotherapy, photodynamic therapy, and topical chemotherapy.

There are many methods available to treat SCCIS. Physicians should consider each patient's situation while keeping in mind that treatment protocols have not been fully defined for most options. The authors have indicated no significant interest with commercial supporters.