Keratinocyte Carcinoma: A Review

Area of Science:

• Dermatology and Oncology
• Cancer Research
• Public Health

Background:

• Keratinocyte carcinomas, comprising basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), are the most prevalent cancers in the US, with 5.4 million annual diagnoses.
• These skin cancers predominantly affect sun-exposed areas like the head and neck, with UV exposure and lighter skin types being primary risk factors.
• Additional risk factors include advanced age, male sex, indoor tanning, history of actinic keratoses, prior keratinocyte carcinomas, and immunosuppression.

Purpose of the Study:

• To provide an overview of keratinocyte carcinoma epidemiology, risk factors, clinical presentation, and treatment modalities.
• To highlight the recurrence rates associated with different surgical treatments and the significant risk of secondary skin cancers in affected patients.
• To emphasize the importance of evidence-based prevention strategies, such as sunscreen use, and the need for regular dermatological follow-up.

Main Methods:

• Review of epidemiological data on keratinocyte carcinoma incidence and prevalence.
• Analysis of clinical presentation, risk factors, and etiological associations, primarily UV radiation.
• Evaluation of treatment outcomes, including recurrence rates for surgical excision, curettage and electrodessication, and Mohs surgery.
• Assessment of secondary cancer risk and the impact of preventive measures like sunscreen use.

Main Results:

• Keratinocyte carcinomas are the most common cancers in the US, with a high annual incidence.
• Surgical treatments demonstrate varying recurrence rates: surgical excision (3% BCC, 5% cSCC), curettage and electrodessication (6% BCC, 2% cSCC), and Mohs surgery (4% BCC, 3% cSCC).
• Patients treated for keratinocyte carcinoma have a substantial risk (approx. 40% within 5 years) of developing new keratinocyte carcinomas; daily sunscreen use is shown to decrease cSCC risk.

Conclusions:

• Keratinocyte carcinoma is a highly prevalent malignancy effectively managed by dermatologists through various in-office surgical procedures.
• The significant risk of recurrence and secondary malignancies underscores the necessity for lifelong, at least annual, skin examinations for affected individuals.
• Sunscreen use represents a key evidence-based preventive measure against keratinocyte carcinoma development.