A recent study from a comprehensive Dutch national cancer registry showed that almost 30% of patients diagnosed with a first pathologically confirmed basal cell carcinoma will develop one or more additional primary basal cell carcinomas within 5 years. During 5 years of prospective follow-up in PALGA, the Dutch nationwide network and registry of histology and cytopathology, 29.2% of the patients (2483 patients were studied) were diagnosed with one or more additional primary basal cell carcinomas. More than one-third of patients who developed a second primary basal cell carcinoma within 5 years did so during the first 6 months after diagnosis of the first.
These results would seem to indicate that aggressive annual follow-up with full body examinations should continue for a minimum of 3 years after a patients first basal cell carcinoma diagnosis.
The cumulative risk during the first 6 months of follow-up was extraordinarily high at 11.2%, as compared with 13.9% through 1 year, 18.5% after 2 years, 22.1% at 3 years, 25.5% after 4 years, and 29.2% after 5 years. This translates into an incidence rate of 25,318 cases per 100,000 person-years during the first half-year after diagnosis of a first primary tumor. In an analysis of this study, men had an adjusted 30% increased risk of developing one or more subsequent basal cell skin cancers, and patients aged 65-79 years had an 81% greater risk than those under age 50.
How the results of this study translates to Los Angeles skin cancer patients remains to be seen. In the meantime, continue to wear your sunscreen and maintain close follow-up with your doctor. If you think you have a suspicious skin lesion, contact your dermatologist or Dr. Brenner.
*photos on this post are not actual patients of Dr. Brenner.