Sunburn and Cutaneous Squamous Cell Carcinoma: A Meta-Analysis

Area of Science:

• Dermatology and Oncology
• Epidemiology
• Public Health

Background:

• Ultraviolet (UV) radiation is a known carcinogen linked to cutaneous squamous cell carcinoma (cSCC).
• The specific contribution of sunburn history to cSCC risk requires quantitative assessment.

Purpose of the Study:

• To quantitatively evaluate the association between sunburn history and the risk of developing cSCC.
• To synthesize evidence from multiple studies to provide a robust estimate of this association.

Main Methods:

• A systematic literature search was conducted across Embase, PubMed, and Cochrane Library (CENTRAL) up to May 2025.
• Meta-analysis of 17 studies (321,473 participants) using random effects modeling (DerSimonian-Laird method).
• Outcome: Risk of cSCC. Measures: Ordinal sunburn frequency (none, low, medium, high) and history of painful, blistering, or severe sunburns.

Main Results:

• Medium and high frequencies of lifetime painful, blistering, or severe sunburns were significantly associated with increased cSCC odds (ORs 1.51 and 1.69, respectively).
• High frequencies of childhood sunburns showed a strong association with increased cSCC odds (OR 3.11).
• Any history of painful, blistering, or severe sunburn was linked to higher cSCC odds (OR 1.38).

Conclusions:

• This meta-analysis provides strong evidence supporting an association between painful, blistering, or severe sunburns and an increased risk of cSCC.
• Findings underscore the importance of minimizing severe sunburns throughout life for cSCC prevention.