Overview of Non-Melanoma
In the United States, more than 1 million cases of non-melanoma skin cancer are detected each year. Of these cases, between 800,000 and 900,000 are basal cell carcinomas and 200,000 to 300,000 are squamous cell carcinomas. True incidence of these cancers is unknown. According to the American Cancer Society, approximately 2000 non-melanoma skin cancer-related deaths occur each year in the United States. Overall, non-melanoma skin cancers account for less than 0.1% of cancer-related deaths.
Like melanoma, non-melanoma skin cancer frequently develops on areas of the skin that are exposed to the sun. It often occurs on the neck, face, back, forearms, and the backs of the hands. Basal cell carcinoma and squamous cell carcinoma are the most common non-melanoma skin cancers. Unlike basal cell cancers, squamous cell carcinomas can metastasize. Despite this, the 5-year survival rate for squamous cell carcinoma is greater than 95%.
Early detection is important to increase the chance for successful skin cancer treatment. Regular self-examination, as well as periodic, thorough examinations by a dermatologist are the best ways to detect skin cancer when it is most treatable.
To diagnose skin cancer, dermatologists evaluate the skin closely (e.g., using a magnifying device) and perform a biopsy to examine suspicious lesions. Newer diagnostic techniques include computer imaging, lasers, and other tools (e.g., a hand-held device called a dermascope). Dermascopy allows physicians to visualize pigment of the skin and detect subtle changes.
Many experts suggest a monthly skin self-exam, especially in people who have fair skin and those who have a family or personal history of skin cancer (i.e., high-risk patients). This involves examining the skin closely, including the skin of the underarms, the backs of the legs and feet, between the buttocks, the genital area, the soles of the feet, the spaces between the toes, and the scalp, in a bright room using a full-length mirror. A hand-held mirror can be used to examine hard-to-see areas, and a blow dryer can be used to move hair to examine the scalp.
The location, size, shape, number, and color of all familiar moles, birthmarks, scars, and blemishes should be noted, as well as any new or unusual changes in the skin. For example, a sore that does not heal, a mole that has grown or changed color, or any other change in the skin should be reported to a physician as soon as possible. Because BCC rarely invades and spreads, it is rarely life threatening; however, early detection and treatment is necessary to mimimize tissue destruction and scarring.