Prior Basal Cell Carcinoma Is Main Predictor of Future BCC

Sunburn, baseline sun exposure, and sun protective measures do not independently predict risk

MONDAY, July 30 (HealthDay News) -- Prior basal cell carcinoma (BCC) is the greatest predictor of future incidence of BCC, according to a study published online July 19 in the Journal of Investigative Dermatology.

In a prospective six-year trial, Robert K. Dyer, M.D., from the VA Medical Center Providence in Rhode Island, and colleagues examined predictors of new BCCs on the face and ears among those at very high risk.

The researchers found that the number of BCCs in the previous five years was the most important predictor of future BCC. Other independent predictors included age; sensitivity to sun; occupational sun exposure before, but not after, the age of 30 years; lower educational level; history of eczema; the use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers; and increased sunscreen use in the week, but not the six months, prior to enrollment. Sunburns; baseline sun exposure; and other sun-protective measures, other skin cancers, and actinic keratosis were not independent predictors. At five years there was a 55 percent cumulative risk of BCC.

"The substantial population of patients with multiple skin cancers and their very high risk of subsequent BCCs underscores the importance of addressing the needs of this population," the authors write. "Although the conclusions from this one study cannot be definitive, we found no effect of sunscreen use or even sun exposure in recent decades on BCC risk, which underscores the importance of potential chemopreventive approaches to reducing the burden of disease in this population."

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