A local perspective on basal cell carcinoma : frequency of subsequent skin tumours

Abstract

Background: Basal cell carcinoma (BCC) is the commonest skin malignancy with a significant risk of recurrence and new primaries. The major risk factor is ultraviolet (UV) radiation, which is relevant to Malta, where the UV index is high for most of the year.

Objective: The aim of this study was to follow up a group of patients diagnosed with BCC and analyse the occurrence of subsequent malignant and pre-malignant skin tumours, to obtain a local perspective and aid screening methods and follow-up protocols.

Method: All patients registered with BCC in the Malta National Cancer Registry in 2007 were included in our study. This cohort was followed up by searching for histology results showing subsequent skin tumours until the end of 2014. Results: A total of 382 patients were diagnosed with BCC in 2007. The majority of patients were males older than 60. Almost one third of these patients (30.1%) had at least another skin tumour biopsied on follow up; 71.7% of these tumours were BCCs. Squamous cell carcinomas and actinic keratoses were also commonly biopsied. Nine patients developed malignant melanoma. The commonest location for BCCs and other non-melanoma skin tumours was the face. Males and the elderly had significantly higher risks to develop further skin tumours, reflected by the Chi^2 test for Independence and hazard ratios.

Conclusion: Our results are consistent with most international data. Since BCC fulfils most criteria for screening, regular follow-up in high risk patients is recommended.