From the Guidelines
Basal cell carcinoma (BCC) is the most common skin cancer in Australia and worldwide. This type of skin cancer develops in the basal cells of the epidermis, the outermost layer of skin, and accounts for approximately 70-80% of all skin cancers 1. BCCs typically appear as pearly or waxy bumps, flat flesh-colored or brown lesions, or bleeding or scabbing sores that heal and then return. The primary cause of BCC is cumulative exposure to ultraviolet (UV) radiation from the sun or tanning beds, which damages DNA in skin cells, leading to uncontrolled growth. People with fair skin, light-colored eyes, and those who sunburn easily are at higher risk. While BCC rarely metastasizes to other parts of the body, it can be locally invasive and destructive if left untreated.
Early detection and treatment are crucial, with options including surgical excision, Mohs surgery, radiation therapy, cryotherapy, photodynamic therapy, or topical medications like imiquimod or 5-fluorouracil for superficial lesions. Regular skin self-examinations, annual dermatologist visits, and consistent sun protection with broad-spectrum sunscreen, protective clothing, and avoiding peak sun hours are essential preventive measures. According to the NCCN Guidelines for Basal Cell Skin Cancer 1, the overall management of BCC primarily consists of surgical approaches, with radiation therapy as an alternate or adjuvant option.
Some key points to consider include:
- BCC is the most common cancer in Europe, Australia, and the U.S.A., and is showing a worldwide increase in incidence 1
- The most significant aetiological factors appear to be genetic predisposition and exposure to ultraviolet radiation 1
- Increasing age, male sex, fair skin types I and II, immunosuppression, and arsenic exposure are other recognized risk factors 1
- Multiple BCCs are a feature of basal cell naevus (Gorlin’s) syndrome (BCNS) 1
From the Research
Most Common Skin Cancer in Australia and Worldwide
- The most common skin cancer in Australia is basal cell carcinoma (BCC), with an age-standardized incidence rate of 2,058.3 for men and 1,194.5 for women per 100,000 person-years 2.
- BCC is also the most common skin cancer worldwide, with the highest incidence rates found in Australia and New Zealand 3.
- In terms of non-melanoma skin cancers (NMSCs), BCC is the most prevalent form, while squamous cell carcinoma (SCC) is the most aggressive form, causing more deaths 3.
- The incidence of NMSC in Australia has steadily increased over the years, with an estimated incidence of 2448 per 100,000 person-years in 2011 4.
- Risk factors for skin cancer include exposure to ultraviolet radiation, fair skin, and advanced age, with outdoor occupation not being a significant risk factor due to self-selection bias 5.
Incidence Rates of Skin Cancer
- Age-standardized incidence rates of BCC in Australia are 2,074 and 1,579 per 100,000 per year for men and women, respectively 5.
- Incidence rates of SCC in Australia are half the rate of BCC among men and about one third the rate among women 5.
- The incidence of melanoma in Australia is approximately 50 cases per 100,000 persons, with a mortality rate of 9% 6.
Global Prevalence of Skin Cancer
- Skin cancer is one of the most prevalent cancers worldwide, with increasing incidence and mortality rates, particularly in regions with white-skinned inhabitants 3.
- The prevalence of skin cancer varies across continents, with Australia and New Zealand having the highest incidence and mortality rates of BCC and melanoma 3.