Fighting nonmelanoma skin cancers: AAD releases basal cell, cutaneous squamous cell carcinoma guidelines

The American Academy of Dermatology (AAD) has released two new evidence-based care guidelines for basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (SCC), both published online in the Journal of the American Academy of Dermatology.

From 1976 to 2010, the incidences of BCC and SCC have increased by 145% and 263%, respectively.¹

Currently, nonmelanoma skin cancer (NMSC), including BCC and SCC, is the most common skin cancer in the United States, affecting more than 3 million Americans annually.^2,3

“These two guidelines will help doctors provide the best possible care for patients with BCC and SCC,” said board-certified dermatologist Christopher K. Bichakjian, MD, FAAD, co-chair of the work group that developed the guidelines. “If they are left untreated, some NMSCs may grow and spread, potentially leading to disfigurement and even death. When detected early, however, these skin cancers are highly treatable.”

The guidelines include recommendations for the treatment and prevention of both types of NMSC.

For most NMSCs, the most effective option is surgical treatment, including excision, Mohs surgery, or curettage and electrodessication. In other cases, options may include cryotherapy, radiation, or topical therapy. Recommendations for using laser therapy or electronic brachytherapy were not included in the guidelines due to the lack of evidence available for these treatment modalities.

The guideline authors, led by Christian Baum, MD, Mayo Clinic, Rochester, MN, wanted to specifically highlight the importance of considering the patient perspective in making these treatment decisions. They included patient advocate Kristi Schmitt Burr in the work group charged with developing the guidelines. Burr has Gorlin-Goltz syndrome (basal cell nevus syndrome), and has been coping with NMSCs for more than 50 years. She stressed the importance of patients being knowledgeable and understanding all available treatment options and having input into their medical care.

“I sincerely appreciate the AAD’s including patient engagement as an integral component in developing these guidelines, as it is vital for patients and their families to have a voice in their care,” said Burr. “Over the decades, trained dermatologists have provided my family with ample resources and counseling to help us achieve optimal outcomes. I hope these guidelines encourage further dialogues between expert doctors, their skilled staff, and the patients in their care.”

Follow-up recommendations specify that patients with a diagnosis of BCC or SCC be checked for new skin cancers annually, and specify that they should proactively work to prevent future skin cancers by wearing protective clothing, using broad-spectrum water-resistant sunscreens with an SPF of 30 or greater, and seeking shade to avoid the sun.

“Prevention and early detection are the first steps in the fight against skin cancer, so it’s important to protect your skin from the sun and keep an eye out for new, changing, or suspicious spots,” says board-certified dermatologist Henry W. Lim, MD, FAAD, president of the AAD.

References

1. Muzic JG, et al. Incidence and Trends of Basal Cell Carcinoma and Cutaneous Squamous Cell Carcinoma: A Population-Based Study in Olmstead County, Minnnesota, 2000-2010. Mayo Clin Proc. Published Online May 15, 2017. http://dx.doi.org/10.1016/j.mayocp.2017.02.015
2. American Academy of Dermatology/Milliman. Burden of Skin Disease. aad.org/BSD.
3. Rogers HW, et al. Incidence estimate of nonmelanoma skin cancer (keratinocyte carcinomas) in the US population. JAMA Dermatol. Published online April 30, 2015.