Basal cell carcinoma risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saarah T. Alkhairy, M.D.

Overview

There are many causes associated with basal cell carcinoma such as sunlight, gene mutations, and other conditions, for example, xeroderma pigmentosum.

Basal Cell Carcinoma Risk Factors

There are some environmental and genetic risk factors that may predispose to basal cell carcinoma.

The following table summarizes the causes of basal cell carcinoma (BCC):

Risk Factor Description
Radiation exposure Sunlight (UV light), tanning beds, and x-rays exposure are associated with basal cell carcinoma formation[1]
Gene mutations TP53 gene mutations and the inappropriate activation of the hedgehog signaling pathway (loss-of-function mutations in tumor-suppressor protein patched homologue 1 (PTCH1) and gain-of-function mutations in sonic hedgehog (SHH), smoothened (SMO), and Gli) are associated with basal cell carcinoma[2]
Physical features Red/blonde hair, blue/green eyes, freckling, and skin types I and II (skin that always burns and never/only sometimes tans)[3]
Albinism Albinism is associated with an increased risk for basal cell carcinoma[3]
Gender The male gender is associated with an increased risk for basal cell carcinoma[3]
Xeroderma pigmentosum This an autosomal recessive disorder; it results in the inability to repair ultraviolet-induced DNA damage; pigmentary changes are seen early in life, followed by the development of basal cell carcinoma, squamous cell carcinoma, and malignant melanoma; other features include corneal opacities, eventual blindness, and neurological deficits[3]
Epidermodysplastic verruciformis Epidermodysplastic verruciformis is an autosomal recessive disorder characterized by the development of basal cell carcinoma and squamous cell carcinoma from warts (human papillomavirus infection)[4]
Nevoid basal cell carcinoma syndrome This is an autosomal dominant disorder that can result in basal cell carcinomas, multiple odontogenic keratocysts, palmoplantar pitting, intracranial calcification, and rib anomalies[5]
Bazex Syndrome The features of Bazex syndrome include follicular atrophoderma, multiple basal cell carcinomas, and local anhidrosis[6]
Rombo syndrome Rombo syndrome is an autosomal dominant condition distinguished by basal cell carcinoma and atrophoderma vermiculatum, trichoepitheliomas, hypotrichosis milia, and peripheral vasodilation with cyanosis[7]

Other risk factors for the development of basal cell carcinoma are the following[8]:

  • Current immunosuppressive therapy after organ transplantation
  • Personal history of skin cancer
  • Two or more first-degree relatives with melanoma
  • Total of 100 nevi or at least five atypical (dysplastic) nevi
  • More than 250 treatments with psoralen plus ultraviolet A (UVA) therapy for psoriasis
  • Radiation therapy for cancer as a child

References

  1. Lim JL, Stern RS (2005). "High levels of ultraviolet B exposure increase the risk of non-melanoma skin cancer in psoralen and ultraviolet A-treated patients". J Invest Dermatol. 124 (3): 505–13. doi:10.1111/j.0022-202X.2005.23618.x. PMID 15737190.
  2. de Zwaan SE, Haass NK (2010). "Genetics of basal cell carcinoma". Australas J Dermatol. 51 (2): 81–92, quiz 93-4. doi:10.1111/j.1440-0960.2009.00579.x. PMID 20546211.
  3. 3.0 3.1 3.2 3.3 Lear, J. T.; Smith, A. G. (1997). "Basal cell carcinoma". Postgraduate Medical Journal. 73 (863): 538–542. doi:10.1136/pgmj.73.863.538. ISSN 0032-5473.
  4. Harwood CA, Surentheran T, Sasieni P, Proby CM, Bordea C, Leigh IM; et al. (2004). "Increased risk of skin cancer associated with the presence of epidermodysplasia verruciformis human papillomavirus types in normal skin". Br J Dermatol. 150 (5): 949–57. doi:10.1111/j.1365-2133.2004.05847.x. PMID 15149508.
  5. Cohen MM (1999). "Nevoid basal cell carcinoma syndrome: molecular biology and new hypotheses". Int J Oral Maxillofac Surg. 28 (3): 216–23. PMID 10355946.
  6. Centers for Disease Control and Prevention (CDC). Sunburn prevalence among adults--United States, 1999, 2003, and 2004. MMWR Morb Mortal Wkly Rep. 2007 Jun 1. 56(21):524-8
  7. Michaëlsson G, Olsson E, Westermark P (1981). "The Rombo syndrome: a familial disorder with vermiculate atrophoderma, milia, hypotrichosis, trichoepitheliomas, basal cell carcinomas and peripheral vasodilation with cyanosis". Acta Derm Venereol. 61 (6): 497–503. PMID 6177160.
  8. http://www.cancercare.on.ca/pdf/pebc15-1s.pdf