Basal cell carcinoma is the most common form of skin cancer, affecting about 2,000,000 Americans each year. In fact, it is the most common of all cancers. One out of every three new cancers is a skin cancer, and the vast majority are basal cell carcinomas, often referred to by the abbreviation BCC. These cancers arise in the basal cells, which are at the bottom of the epidermis (outer skin layer).
Until recently, those most often affected were older people, particularly men who had worked outdoors. Although the number of new cases has increased sharply each year in the last few decades, the average age of onset of the disease has steadily decreased. More women are getting BCCs than in the past; nonetheless, men still outnumber them greatly.
What is the major cause of BCCs?
Chronic exposure to sunlight is the cause of almost all basal cell carcinomas, which occur most frequently on exposed parts of the body—the face, ears, neck, scalp, shoulders, and back. Rarely, however, tumors develop on non-exposed areas. In a few cases, contact with arsenic, exposure to radiation, and complications of burns, scars, vaccinations, or even tattoos are contributing factors.
Who gets it?
While anyone with a history of sun exposure can develop basal cell carcinoma, people who are at highest risk have fair skin, blond or red hair, and blue, green, or grey eyes. Workers in occupations that require long hours outdoors and people who spend their leisure time in the sun are particularly susceptible. Geographic location is also a factor—the closer to the equator, the higher the number of cases, particularly among fair-skinned individuals.
The disease is rarely seen in children, but occasionally a teenager is affected. Skin specialists report that more and more people in their twenties and thirties are being treated for this skin cancer.
What should I look for?
The five most typical characteristics of basal cell carcinoma are shown on the “Skin Cancer Screenings” link at left. Frequently, two or more features are present in one tumor. In addition, basal cell carcinoma sometimes resembles non-cancerous skin conditions such as psoriasis, eczema, or a scar. Only a trained dermatologist, a specialist in diseases of the skin, can decide for sure.
Learn the signs of basal cell carcinoma, and examine your skin regularly—as often as once a month if you are at high risk. Be sure to include the scalp, backs of ears, neck, and other hard-to-see areas. (A full-length mirror and a handheld mirror can be very useful.) If you observe any of the warning signs or some other change in your skin, consult your physician immediately.
The Skin Cancer Foundation advises people to have a total body skin exam by a qualified skin specialist at regular intervals. The physician will suggest the correct time frame for follow-up visits, depending on your specific risk factors, such as skin type and history of sun exposure.
Jeffrey H. Binstock, MD is a Fellow of:
