Squamous cell carcinoma of the skin (cutaneous squamous cell carcinoma; cSCC) is the second most common type of skin cancer in the United States, behind basal cell carcinoma (BCC), and accounts for approximately 20 percent of non-melanoma skin cancers1. The incidence of cSCC has increased over the past 20 years in the United States and other countries. This increase may be related to higher levels of sun exposure, tanning bed use, an increase in the aging population, and/or improved skin cancer surveillance. A meta-analysis estimated that the number of new cSCC cases in the United States white population was between 186,000 and 419,000 in 20122.
cSCC generally invades locally and is highly curable; however, surgical removal of advanced lesions on sun exposed areas (e.g. head and neck) may be disfiguring. Although metastases develop in less than 5 percent of cases, it has been estimated that deaths from cSCC are as common in the central and southern United States as deaths from many other common cancers including melanoma, leukemia, non-Hodgkin lymphoma, renal cancer, and bladder cancer2.
The main initial diagnostic tool is still skin biopsy. Radiographic techniques (e.g. computed tomography [CT] and magnetic resonance [MRI]) are reserved for assessment of local tissue, regional lymph node, and distant spread.
Low risk localized cSCC is often be cured with surgical techniques including excision, electrodessication with curettage, or Mohs surgery. Higher risk lesions may require more extensive surgery with local lymph node removal. Radiation therapy is often recommended as adjuvant to surgery or for treatment of patients who cannot undergo surgery. Chemotherapy may be considered as adjuvant therapy in select highest-risk cases of cSCC and in metastatic disease3.
- Karia PS, Han J, Schmults CD. Cutaneous squamous cell carcinoma: estimated incidence of disease, nodal metastasis, and deaths from disease in the United States, 2012. J Am Acad Dermatol 2013; 68:957.