When to suspect a non-melanoma skin cancer

Abstract

### What you need to know Assessing non-melanocytic skin lesions is a routine part of general practice. The key concern for patient and doctor is often whether the lesion may be a basal cell carcinoma or squamous cell carcinoma, collectively termed non-melanoma skin cancer (NMSC). This article aims to help primary care clinicians, who may not routinely have access to dermoscopy and biopsy, to identify possible NMSC lesions, which require further specialist assessment or monitoring. ### How this article was made We searched for relevant journal articles in the British Journal of Dermatology , BMJ , and British Association of Dermatology guidelines. A secondary literature search was conducted using Google Scholar with the key words “basal cell carcinoma,” “squamous cell carcinoma,” “non-melanoma skin cancer” associated with “risk factors,” “treatment,” “management,” “follow-up.” Non-melanoma skin cancer is more commonly diagnosed than all other malignancies combined,1 and the incidence of skin cancer is rising, with rates of NMSC predicted to reach almost 400 000 per year in the UK by 2025.2 This is thought to be due to a combination of people living longer, increased exposure to ultraviolet (UV) light, and improved data collection and diagnostic tools.34 Risk factors are summarised in table 1, with the key environmental risk being UV exposure from tan-seeking behaviour and outdoor activities without adequate sun protection.12 Both basal cell carcinomas and cutaneous squamous cell carcinomas are more common with increasing age, with incidence of cutaneous squamous cell carcinomas peaking at 66 years of age. View this table: Table 1 Risk factors for non-melanoma skin cancer Box 1 summarises the procedure …

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