CUTANEOUS squamous cell carcinoma incidence continued to increase in England between 2013–2022, while non melanoma skin cancer mortality also rose, highlighting a growing burden of keratinocyte cancers and the importance of accurate cancer registration.
Basal cell carcinoma and cutaneous squamous cell carcinoma are collectively known as keratinocyte cancers and represent the most common cancers in White populations. However, these malignancies are frequently underreported, limiting understanding of their true incidence and impact on healthcare services. Researchers therefore analysed national data to examine trends in keratinocyte cancer incidence and mortality over a 10 year period.
The study included all newly diagnosed basal cell carcinoma and cutaneous squamous cell carcinoma cases recorded in England between 2013–2022 using National Disease Registration Service data. Tumours were counted using a per patient per annum methodology, allowing each individual to contribute one basal cell carcinoma and one cutaneous squamous cell carcinoma diagnosis per year. Age standardised incidence and mortality rates were calculated, while joinpoint regression was used to assess changes over time.
Incidence and Mortality Increased
Compared with the traditional first all time registration method, the per patient per annum approach identified 67% more basal cell carcinomas and 42% more cutaneous squamous cell carcinomas during the study period.
In 2022, the age standardised incidence rate was 295 per 100,000 person years for basal cell carcinoma and 102 per 100,000 person years for cutaneous squamous cell carcinoma. Basal cell carcinoma incidence increased initially before stabilising from 2015 onwards. In contrast, cutaneous squamous cell carcinoma incidence rose rapidly between 2013–2015 before continuing to increase through 2019.
Non melanoma skin cancer mortality also increased significantly throughout the study period. Mortality rates rose approximately twice as quickly in males as in females, with an annual percentage increase of 4.4% compared with 2.2%, respectively.
Younger and Older Age Groups Drove Trends
Age specific analyses showed that cutaneous squamous cell carcinoma incidence plateaued among middle aged adults after 2015. However, incidence continued to increase in people younger than 60 years and those aged 80 years or older.
The authors concluded that accurate tumour counting methods are essential for understanding the true burden of keratinocyte cancers and supporting healthcare planning. They noted that the continued rise in cutaneous squamous cell carcinoma incidence alongside increasing non melanoma skin cancer mortality underscores the need for strengthened prevention strategies, earlier diagnosis, and timely access to high quality care.
Reference
Mistry K et al. Trends in keratinocyte cancers in England, 2013–2022: basal cell carcinoma incidence, cutaneous squamous cell carcinoma incidence, and non-melanoma skin cancer mortality. Br J Dermatology. 2026;DOI: 10.1093/bjd/ljag315.
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