Incidence of Metastatic Cutaneous Squamous Cell Carcinoma in England
Changes to the National Cancer Registration and Analysis Service (NCRAS) in England have allowed more accurate data analysis of primary and metastatic cutaneous squamous cell carcinoma (SCC) since 2013. Developed by experts at Queen Mary University of London and Public Health England, and funded by the British Association of Dermatologists, the new database fills in gaps in the recording of skin cancer, ensuring that accurate UK numbers are available for the three most common types of skin cancer: melanoma, basal cell carcinoma, and SCC. Data on these malignancies were published by Venables et al in JAMA Dermatology.
Previously, the data on nonmelanoma skin cancers cancers in England had been very poor, as they were rarely included in cancer registries due to the sheer number of cases and the complexity of accurately registering multiple tumors per patient.
Irene Leigh, CBE, FRSE, DSc, FRCP, FMedSci, of Queen Mary University of London, lead author of the study, said in a statement, “Due to their frequency, the health-care burden of squamous cell carcinoma is substantial, with high-risk patients requiring at least 2 to 5 years [of] clinical follow-up after treatment and patients often developing multiple tumors. With poor 3-year survival once [cutaneous] SCC has metastasized, earlier identification of these high-risk patients and improved treatment options are vital.”
Study Findings
The study found that a higher risk of cutaneous SCC was associated with being older, male, white, and in lower deprivation quintiles. Primary cutaneous SCC located on the ear and lip were at highest risk of metastasis.
The age-standardized rates for the first registered cases of cutaneous SCC in England from 2013 through 2015 were 77.3 per 100,000 person-years (95% confidence interval [CI] = 76.6–78.0) in male patients and 34.1 per 100,000 person-years (95% CI = 33.7–34.5) in female patients. The 3-year survival was 65% among men and 68% among women. After a maximum follow-up of 3 years, the cumulative incidence of metastatic cutaneous SCC was 1.1% of women and 2.4% of men with a primary cutaneous SCC.
The researchers also found that between 2013 and 2015, there were 1,566 patients diagnosed with metastatic SCC for the first time. For 85% of these patients, this occurred within 2 years of their initial SCC diagnosis.
The authors concluded, “This study presents the first national study of the incidence of [metastatic cutaneous] SCC. With limited health-care resources and an aging population, accurate epidemiologic data are essential for informing future health-care planning, identifying high-risk patients, and evaluating skin cancer prevention policies.”
Disclosure: See the study authors’ full disclosures at jamanetwork.com.
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