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Nov 1, 2021

One in five people in England will develop a non-melanoma skin cancer in their lifetime

This is a blog post about the world’s most common cancer, a cancer that most people have never heard of; it’s called keratinocyte cancer. New research, published in the medical journal Skin Health and Disease, gives us a much better idea of its number of cases in the UK – almost a quarter of a million a year.

What is keratinocyte cancer?

When it comes to skin cancers, melanoma tends to get the headlines, and is certainly more well known amongst the general public. In fact, until recently, keratinocyte cancers were more commonly called non-melanoma skin cancers in the UK, defined by what they were not.

Keratinocyte cancers are named as such because they form in keratinocyte cells in the skin. Keratinocytes are the main type of cell that forms the outer layer of the skin. Depending on the type of keratinocyte cell the cancer originates in, it is typified as basal cell carcinoma (BCC) or cutaneous squamous cell carcinoma (cSCC). In contrast, melanoma forms in skin cells called melanocytes.

There are perhaps two main reasons why keratinocyte cancer isn’t particularly well known about.

Firstly, compared to other cancers, keratinocyte cancer is very unlikely to kill you, with a death rate of less than 1%. While this may be low in percentages, with a quarter of million cases a year, the total number of deaths attributed to this cancer is still uncomfortably high.

Not only that, but these cancers often appear on exposed areas such as the face or hands. As surgical removal is the main treatment, it can lead to visible scarring, which can be worse the longer it is left untreated.

Additionally, the treatment of such a vast number of cancers every year also requires considerable NHS resource.

Importance of keeping accurate records

Keratinocyte cancers are so common that records tend to be very poor. Even if a case is recorded properly, often the first diagnosis for a patient is the only one that is documented. Recording the first case in a patient is currently the agreed method amongst the different nations, however, as patients can often have multiple keratinocyte cancers in one year, let alone in their lifetimes, this changes the data.

The good news is that the new research published in Skin Health and Disease gives us better data than ever and this can be used to improve planning and delivering skin cancer services.

The bad news is that it’s even more common than initially thought, with the research finding that one in five people in England will develop a keratinocyte cancer in their lifetime. Comparatively, the estimated lifetime risk of melanoma in the UK is 1 in 36 for males and 1 in 47 for females. If you apply this statistic to the population of England, this would mean over 11 million people receiving a diagnosis of keratinocyte cancer at some point in their lifetime.

Reported cases and trends

The published research estimated that there were 234,861 cases of keratinocyte cancers in the UK annually, including 184,280 basal cell carcinomas and 50,582 cutaneous squamous cell carcinomas. This yearly figure is almost five times higher than any other cancer in the UK, including common cancers such as breast (55,920), prostate (52,254) and lung (48,549).

Alongside the estimated annual cases, the research found that rates of the disease are increasing in all parts of the UK. The number of people diagnosed with an cSCC for the first time rose by 25.5% in England, 20.8% in Scotland and 12% in Northern Ireland over a six-year period, and in Wales cases rose by 12.2% in the two-year period of available data. This increase in cases was even greater when taking into account every new diagnosis a patient receives each year, rather than just their first diagnosis. 

Prevention and early detection are important

This rapid increase in the number of cases of keratinocyte cancers in recent years highlights the importance of early prevention strategies. The best ways to prevent keratinocyte cancers is to reduce ultraviolet exposure and practice sun safety. You can find out more about this on our Sun Awareness page.

Early detection is also important. Skin cancers take up a huge proportion of a dermatologist’s workload; the sheer number of cases means that dermatology has more urgent cancer referrals than any other specialty. Research in this area is much needed as it can assist in cancer service planning and delivery.  

If you have concerns and suspect you may have a keratinocyte skin cancer, you should always speak to your GP. Below are the signs to look out for:

How to spot the signs of keratinocyte cancer

Cutaneous squamous cell carcinoma (cSCC):

  • cSCC can appear as a red or skin-coloured scabbed or crusted lump or ulcer (broken skin) which can be sore or bleed.
  • They tend to grow relatively quickly over a few weeks or months.
  • They can appear on any part of the body but are common on sun exposed sites like the face, scalp, neck, back of the hands and arms.

Basal cell carcinoma (BCC):

  • BCCs can appear as a scabbed or crusted area which can be lumpy or make an ulcer (broken skin) which does not heal.
  • They are often painless although they can be itchy or bleed.
  • They tend to grow slowly over a few months or longer.
  • They can appear on any part of the body but are common on sun exposed sites like the face, scalp, neck and upper back or chest.

For more information, check our pages on BCC and cSCC on our patient hub.