Skin cancer

For the book, see Skin Cancer: Recognition and Management.

Skin cancer
A basal-cell skin cancer. Note the pearly appearance and telangiectasia.
SpecialtyOncology and dermatology
SymptomsBasal-cell: painless raised area of skin that may be shiny with small blood vessel running over it or ulceration[1]
Squamous-cell: hard lump with a scaly top[2]
Melanoma: mole that has changed in size, shape, color, or has irregular edges[3]
TypesBasal-cell skin cancer (BCC), squamous-cell skin cancer (SCC), melanoma[1]
CausesUltraviolet radiation from the Sun or tanning beds[4]
Risk factorsLight skin, poor immune function[1][5]
Diagnostic methodTissue biopsy[3]
PreventionDecreasing exposure to ultraviolet radiation, sunscreen[6][7]
TreatmentSurgery, radiation therapy, fluorouracil[1]
Frequency5.6 million (2015)[8]
Deaths111,700 (2015)[9]

Skin cancers are cancers that arise from the skin. They are due to the development of abnormal cells that have the ability to invade or spread to other parts of the body.[10] It occurs when skin cells grow uncontrollably, forming malignant tumors. The primary cause of skin cancer is prolonged exposure to ultraviolet (UV) radiation from the sun or tanning devices. Skin cancer is the most commonly diagnosed form of cancer in humans.[11][12][13] There are three main types of skin cancers: basal-cell skin cancer (BCC), squamous-cell skin cancer (SCC) and melanoma.[1] The first two, along with a number of less common skin cancers, are known as nonmelanoma skin cancer (NMSC).[5][14] Basal-cell cancer grows slowly and can damage the tissue around it but is unlikely to spread to distant areas or result in death.[5] It often appears as a painless raised area of skin that may be shiny with small blood vessels running over it or may present as a raised area with an ulcer.[1] Squamous-cell skin cancer is more likely to spread.[5] It usually presents as a hard lump with a scaly top but may also form an ulcer.[2] Melanomas are the most aggressive. Signs include a mole that has changed in size, shape, color, has irregular edges, has more than one color, is itchy or bleeds.[3]

More than 90% of cases are caused by exposure to ultraviolet radiation from the Sun.[4] This exposure increases the risk of all three main types of skin cancer.[4] Exposure has increased, partly due to a thinner ozone layer.[5][15] Tanning beds are another common source of ultraviolet radiation.[4] For melanomas and basal-cell cancers, exposure during childhood is particularly harmful.[6] For squamous-cell skin cancers, total exposure, irrespective of when it occurs, is more important.[4] Between 20% and 30% of melanomas develop from moles.[6] People with lighter skin are at higher risk[1][16] as are those with poor immune function such as from medications or HIV/AIDS.[5][17] Diagnosis is by biopsy.[3]

Decreasing exposure to ultraviolet radiation and the use of sunscreen appear to be effective methods of preventing melanoma and squamous-cell skin cancer.[6][7] It is not clear if sunscreen affects the risk of basal-cell cancer.[7] Nonmelanoma skin cancer is usually curable.[5] Treatment is generally by surgical removal but may, less commonly, involve radiation therapy or topical medications such as fluorouracil.[1] Treatment of melanoma may involve some combination of surgery, chemotherapy, radiation therapy and targeted therapy.[3] In those people whose disease has spread to other areas of the body, palliative care may be used to improve quality of life.[3] Melanoma has one of the higher survival rates among cancers, with over 86% of people in the UK and more than 90% in the United States surviving more than 5 years.[18][19]

Skin cancer is the most common form of cancer, globally accounting for at least 40% of cancer cases.[5][20] The most common type is nonmelanoma skin cancer, which occurs in at least 2–3 million people per year.[6][21] This is a rough estimate; good statistics are not kept.[1] Of nonmelanoma skin cancers, about 80% are basal-cell cancers and 20% squamous-cell skin cancers.[14] Basal-cell and squamous-cell skin cancers rarely result in death.[6] In the United States, they were the cause of less than 0.1% of all cancer deaths.[1] Globally in 2012, melanoma occurred in 232,000 people and resulted in 55,000 deaths.[6] White people in Australia, New Zealand and South Africa have the highest rates of melanoma in the world.[6][22] The three main types of skin cancer have become more common in the last 20 to 40 years, especially regions where the population is predominantly White.[5][6]

  1. ^ a b c d e f g h i j "Skin Cancer Treatment (PDQ®)". NCI. 25 October 2013. Archived from the original on 5 July 2014. Retrieved 30 June 2014.
  2. ^ a b Dunphy LM (2011). Primary Care: The Art and Science of Advanced Practice Nursing. F.A. Davis. p. 242. ISBN 978-0-8036-2647-8. Archived from the original on 20 May 2016.
  3. ^ a b c d e f "General Information About Melanoma". NCI. 17 April 2014. Archived from the original on 5 July 2014. Retrieved 30 June 2014.
  4. ^ a b c d e Gallagher RP, Lee TK, Bajdik CD, Borugian M (2010). "Ultraviolet radiation". Chronic Diseases in Canada. 29 (Suppl 1): 51–68. doi:10.24095/hpcdp.29.S1.04. PMID 21199599.
  5. ^ a b c d e f g h i Cakir BÖ, Adamson P, Cingi C (November 2012). "Epidemiology and economic burden of nonmelanoma skin cancer". Facial Plastic Surgery Clinics of North America. 20 (4): 419–422. doi:10.1016/j.fsc.2012.07.004. PMID 23084294.
  6. ^ a b c d e f g h i World Cancer Report 2014. World Health Organization. 2014. pp. Chapter 5.14. ISBN 978-9283204299.
  7. ^ a b c Jou PC, Feldman RJ, Tomecki KJ (June 2012). "UV protection and sunscreens: what to tell patients". Cleveland Clinic Journal of Medicine. 79 (6): 427–436. doi:10.3949/ccjm.79a.11110. PMID 22660875.
  8. ^ Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, Brown A, et al. (GBD 2015 Disease Injury Incidence Prevalence Collaborators) (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
  9. ^ Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, et al. (GBD 2015 Mortality Causes of Death Collaborators) (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/s0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
  10. ^ "Defining Cancer". National Cancer Institute. 17 September 2007. Archived from the original on 25 June 2014. Retrieved 10 June 2014.
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  12. ^ Hu W, Fang L, Ni R, Zhang H, Pan G (July 2022). "Changing trends in the disease burden of non-melanoma skin cancer globally from 1990 to 2019 and its predicted level in 25 years". BMC Cancer. 22 (1): 836. doi:10.1186/s12885-022-09940-3. PMC 9339183. PMID 35907848.
  13. ^ Lyakhov PA, Lyakhova UA, Kalita DI (2023). "Multimodal Analysis of Unbalanced Dermatological Data for Skin Cancer Recognition". IEEE Access. 11: 131487–131507. doi:10.1109/ACCESS.2023.3336289. ISSN 2169-3536. To date, skin cancer is the most frequently diagnosed form of oncopathology in humans and represents a wide range of malignancies. More than 40% of the total number of diagnosed cancers in the world are skin cancer.
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  15. ^ Maverakis E, Miyamura Y, Bowen MP, Correa G, Ono Y, Goodarzi H (May 2010). "Light, including ultraviolet". Journal of Autoimmunity. 34 (3): J247–J257. doi:10.1016/j.jaut.2009.11.011. PMC 2835849. PMID 20018479.
  16. ^ Leiter U, Garbe C (2008). "Epidemiology of Melanoma and Nonmelanoma Skin Cancer—The Role of Sunlight". Sunlight, Vitamin D and Skin Cancer. Advances in Experimental Medicine and Biology. Vol. 624. pp. 89–103. doi:10.1007/978-0-387-77574-6_8. ISBN 978-0-387-77573-9. PMID 18348450.
  17. ^ Chiao EY, Krown SE (September 2003). "Update on non-acquired immunodeficiency syndrome-defining malignancies". Current Opinion in Oncology. 15 (5): 389–397. doi:10.1097/00001622-200309000-00008. PMID 12960522. S2CID 33259363.
  18. ^ "SEER Stat Fact Sheets: Melanoma of the Skin". NCI. Archived from the original on 6 July 2014. Retrieved 18 June 2014.
  19. ^ "Release: Cancer Survival Rates, Cancer Survival in England, Patients Diagnosed 2005–2009 and Followed up to 2010". Office for National Statistics. 15 November 2011. Archived from the original on 17 October 2014. Retrieved 30 June 2014.
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  22. ^ Harris RE (2013). Epidemiology of Chronic Disease. Jones & Bartlett Publishers. p. 271. ISBN 978-0-7637-8047-0.