Identifying Risk Factors for skin cancer

Risk

We know from Welsh data people from less deprived areas are more likely to get melanoma. However, there is no specific data to determining NMSC incidence alongside deprivation scales.

People with the following characteristics have a 10-fold increased likelihood of melanoma, >100moles, red hair, atypical moles, >2 first degree family members with diagnosed melanoma. (9)

 SCC is more common in people with fair skin, sun-damaged skin, albinism and xeroderma pigmentosum.

Those with impaired immunity secondary to immunosuppressive drugs, lymphoma, leukaemia are at increased risk of SCC. GPs are managing more and more patients on biological therapies with emerging evidence showing increased reactivation of SCC in patients with a previous history of SCC. SCC can also develop as a result of arsenic, ionising radiation, chronic wounds, scars, burns, ulcers or sinus tracts. It can also develop from pre-existing lesions such as Bowens.  SCCs can be associated with HPV infection. There is increasing evidence relating the use of tanning devices to SCCs. It is important all people follow safe sun advice, in particular people on long term immunosuppressive medication. (10)

BCCs are largely secondary to sun exposure. Occurring on aspects of the body exposed to the sun the most. BCCs also arise in people with the genetic predisposition Gorlin syndrome and should be managed within secondary MDT care. Once diagnosed with a BCC some studies show an increased likelihood of being diagnosed with a further BCC. A study in Scotland showed the risk of developing a second BCC within 3 years of the first presentation is approximately 44%. (3)


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