Basal cell cancer (basal cell carcinoma) and squamous cell cancer (squamous cell carcinoma) are often collectively referred to as non-melanoma skin cancer. This is to distinguish them from melanomas, which often look like dark moles. Basal cell cancer and squamous cell cancer are far more common than melanomas. But they can usually be fully removed and only rarely spread to other parts of the body.
Many people automatically think of malignant (cancerous) melanoma when they hear the words “skin cancer.” This is probably because some melanomas can be particularly dangerous.
Non-melanoma cancer can take on very different forms so it can have a number of different symptoms too: the affected area of skin may become scaly, lumpy, or change color. This makes it difficult to tell the difference between non-melanoma skin cancer and normal spots or blotches on your skin.
Apart from these typical small skin changes, non-melanoma skin cancer does not usually cause any other symptoms.
Causes and risk factors
Various factors can increase your risk of developing non-melanoma skin cancer. Overexposure to sunlight is the main risk factor, but people with certain skin types or medical conditions are more prone too.
Basal cell cancer and squamous cell cancer are among the most common types of cancer. According to rough estimates for Germany in 2010, about 78,000 men and 74,000 women developed basal cell cancer, and about 22,000 men and 15,000 women developed squamous cell cancer.
The risk of getting non-melanoma skin cancer increases with age. Whereas squamous cell cancer is often diagnosed in people over the age of 60, basal cell cancer is already quite common in people between the ages of 40 and 50.
Basal cell cancer grows slowly and rarely spreads to other organs (metastasis). But it can enter deeper layers of tissue if it goes unnoticed for a long time, and is then more difficult to treat. About 1 out of 1,000 people who develop basal cell cancer die of it.
Squamous cell cancer is more aggressive than basal cell cancer. It also grows in the area where it develops, gradually destroying tissue near to it. If left untreated, there is a danger that the cancer might spread to other parts of the body. About 40 to 50 out of 1,000 people with squamous cell cancer die of it.
Screening is aimed at large numbers of seemingly healthy people. In Germany, skin cancer screening focuses on people aged 35 and over. The idea is to detect tumors before they invade other tissue or metastatic tumors develop, with the aim of being able to provide better treatment and increase the chances of a full recovery.
In skin cancer screening, a doctor takes a close look at your skin from head to toe with their naked eye. For the examination to be thorough, he or she should also look at skin folds and mucous membranes. You can look out for abnormal areas of skin yourself too.
There is no surefire way to prevent non-melanoma skin cancer. It is generally sensible to avoid overexposure to ultraviolet (UV) light. This mainly means not spending too much time in the sun without sun protection, and not using sunlamps and tanning beds.
Basal cell cancer and squamous cell cancer can often be fully removed in a minor operation, particularly when discovered at an early stage. If skin cancer can no longer be surgically removed, radiotherapy or medication are considered. If the tumor has invaded deeper layers of tissue, more major interventions are necessary.
Squamous cell cancer has been an officially recognized work-related disease ("Berufskrankeit") in Germany since early 2015. People who spend a lot of time being exposed to UV light because they work outdoors are more likely to develop non-melanoma cancer.
You can find information about using tanning beds on the website of the German Federal Office for Radiation Protection (Bundesamt für Strahlenschutz, or BfS).
Bundesamt für Strahlenschutz (BfS). Hinweise für Solariennutzer. September 19, 2014.
Dellavalle R (Ed. of section 2). Section 2: Skin cancer, moles, and actinic keratosis. In: Williams, H, Bigby M, Herxheimer A, Naldi L, Rzany B, Dellavalle RP et al. (Ed). Edvidence-based dermatology. London: BMJ Books; 2014. S. 223-319.
Deutsche Gesetzliche Unfallversicherung (DGU). Hautkrebs durch arbeitsbedingte UV-Strahlung.
Gemeinsamer Bundesausschuss (G-BA). Hautkrebsscreening. Zusammenfassende Dokumentation des Unterausschusses „Prävention“ des Gemeinsamen Bundesausschusses. March 31, 2008.
Krebsinformationsdienst (KID). Hautkrebs: Basaliome, Plattenepithelkarzinome, maligne Melanome. February 2013.
Robert Koch-Institut (RKI), Gesellschaft der epidemiologischen Krebsregister in Deutschland e.V. (GEKID). Krebs in Deutschland 2009/2010. Berlin: RKI; 2013.
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