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Posted: September 16, 2008

Some Skin Cancers Increase Risk of Developing Other Types of Cancer

With more than one million Americans diagnosed with non-melanoma skin cancer each year, medical researchers are warning that this less serious skin cancer actually may increase the risk of developing other non-skin cancers.

Previous studies have documented that people who have had non-melanoma skin cancer were at increased risk for developing more-serious melanoma, but it is less well-established whether they were also at risk for cancers that do not involve the skin.

According to the American Cancer Society, most of the more than one million cases of non-melanoma skin cancer diagnosed yearly in the United States are considered to be sun-related. Melanoma, the most serious type of skin cancer, accounted for about 59,940 cases of skin cancer in 2007 and most of the 10,850 deaths due to skin cancer each year.

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Non-melanoma cancer develops in cells located at the base of the outer layer of the skin or which cover the internal and external surfaces of the body. Most non-melanoma skin cancers develop on the face, ear, neck, lips, or the backs of the hands. Depending on the type, they can be fast or slow growing, but they rarely spread to other parts of the body.

In the current study, Anthony Alberg, Ph.D., of the Medical University of South Carolina, and colleagues analyzed data from a prospective cohort study called CLUE II, which was established in Washington County, Maryland, in 1989.

According to a report published online in the Journal of the National Cancer Institute, Alberg's team compared the risk of malignancies in 769 people who had been diagnosed with non-melanoma skin cancer and 18,405 individuals with no history of the disease during a 16-year follow-up period.

The overall incidence of cancers was 293.5 cases per 10,000 person-years among study participants with a history of non-melanoma skin cancer and 77.8 per 10,000 in those individuals without a history of skin cancer. After adjusting for other known variables associated with cancer risk, including age, sex, body mass index, smoking status, and education level, the researchers found that individuals with a history of non-melanoma skin cancer had a two-fold increase in the risk of subsequent cancers compared with individuals with no skin cancer history.

The increased risk remained statistically high when the researchers removed melanoma from the list of subsequent cancers, indicating that the elevated risk was not restricted to melanoma. The association was observed for both types of non-melanoma skin cancer, basal cell and squamous cell carcinoma.

The strongest association between a history of skin cancer and subsequent malignancies was seen in the youngest study participants, aged 25 to 44 years.

"The fact that there's an early age of onset observed in our study is consistent with the fact that there may be an underlying genetic predisposition to skin cancer and other cancers as well,” Alberg told the Ivanhoe news service.

"What makes this scientifically really exciting is if this association's true, it could provide a clue for some underlying mechanism that relates to many different cancers -- and that would be potentially a clue as to causes of human cancer," he added.

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