Non-Melanoma Skin Cancer Assessment and Management

Non-melanoma skin cancers comprise primarily basal cell carcinoma and cutaneous squamous cell carcinoma, accounting for the majority of dermatological malignancies worldwide. Effective assessment begins with clinical examination supported by dermoscopy and, where indicated, reflectance confocal microscopy to identify suspicious lesions. Definitive diagnosis relies on skin biopsy and histopathological subtyping, which informs risk stratification and guides therapy. Standard management includes surgical excision or Mohs micrographic surgery for high-risk lesions, complemented by radiotherapy when surgery is contraindicated. Topical treatments, photodynamic therapy and emerging systemic agents, such as Hedgehog pathway inhibitors for basal cell carcinoma and immune checkpoint inhibitors for advanced squamous cell carcinoma and rare neuroendocrine variants, have expanded therapeutic options. Prevention through sun-protection measures and early detection remains critical, as the global burden of disease continues to rise with ageing populations and increased ultraviolet exposure. Ongoing challenges include treatment resistance, optimisation of surveillance intervals, and equitable access to specialised care.

Research from Nature Portfolio

Recent epidemiological analyses have quantified the rising incidence of basal and squamous cell carcinomas across diverse populations, revealing distinct patterns by age, sex and anatomical site. High-resolution incidence data support the refinement of screening strategies in high-risk cohorts. Whole-exome studies have elucidated the genomic drivers of cutaneous squamous cell carcinoma, identifying ultraviolet-induced mutational signatures and novel drug-associated signatures in immunosuppressed patients, thereby highlighting targets for precision therapies. Consensus reviews of neuroendocrine skin tumours have synthesised current understanding of viral and ultraviolet-driven pathogenesis, and underscored the transformative impact of immune checkpoint inhibitors while delineating outstanding questions in basic and translational research.

Non-Melanoma Skin Cancer Assessment and Management publication trend

The graph below shows the total number of articles in non-melanoma skin cancer assessment and management across all publications each year (not limited to Nature Index journals).

Technical terms

Basal cell carcinoma (BCC): The most common epidermal malignancy arising from basal keratinocytes, characterised by local invasiveness and rare metastasis.

Squamous cell carcinoma (SCC): A keratinocyte-derived cancer with potential for local aggression and distant spread, often linked to ultraviolet light exposure.

Mutational signature: A characteristic pattern of DNA alterations reflecting specific endogenous or exogenous mutagenic processes.

Hedgehog pathway inhibitor: A targeted agent that blocks Hedgehog signalling, a key driver of basal cell carcinoma proliferation.

Immune checkpoint blockade: A therapeutic strategy that enhances antitumour immunity by inhibiting regulatory pathways such as PD-1/PD-L1.

Nanotechnology-mediated drug delivery: The use of nanoscale carriers to improve targeting, bioavailability and efficacy of anticancer agents.

References

1. Skin cancer: understanding the journey of transformation from conventional to advanced treatment approaches. Molecular Cancer (2023).
2. Mutational Landscape of Aggressive Cutaneous Squamous Cell Carcinoma. Clinical Cancer Research (2014).
3. Long-term safety and efficacy of vismodegib in patients with advanced basal cell carcinoma: final update of the pivotal ERIVANCE BCC study. BMC Cancer (2017).
4. The biology and treatment of Merkel cell carcinoma: current understanding and research priorities. Nature Reviews Clinical Oncology (2018).
5. The genomic landscape of cutaneous SCC reveals drivers and a novel azathioprine associated mutational signature. Nature Communications (2018).
6. The incidence and clinical analysis of non-melanoma skin cancer. Scientific Reports (2021).