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Is History of Squamous-Cell Skin Cancer a Marker of Poor Prognosis in Patients with Cancer?

Johan Askling, MD; Per Sørensen, MSc; Anders Ekbom, MD, PhD; Morten Frisch, MD, PhD; Mads Melbye, MD, PhD; Bengt Glimelius, MD, PhD; and Henrik Hjalgrim, MD, PhD
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From Karolinska Institute, Stockholm, Sweden; Statens Serum Institut, Copenhagen, Denmark; Harvard School of Public Health, Boston, Massachusetts; National Cancer Institute, Rockville, Maryland; and Uppsala University Hospital, Uppsala, Sweden.

Grant Support: By a grant from the Danish Cancer Society (#KB 97 100 07).

Requests for Reprints: Johan Askling, MD, Department of Medical Epidemiology, Karolinska Institute, Box 281, S-171 77 Stockholm, Sweden; e-mail, Johan.Askling@mep.ki.se. For reprint orders in quantities exceeding 100, please contact the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints@mail.acponline.org.

Current Author Addresses: Drs. Askling and Ekbom: Department of Medical Epidemiology, Karolinska Institute, Box 281, S-171 77, Stockholm, Sweden.

Mr. Sørensen and Drs. Melbye and Hjalgrim: Department of Epidemiology Research, Statens Serum Institut, Artillerivej 5, DK 2300 Copenhagen S, Denmark.

Dr. Frisch: Viral Epidemiology Branch, National Cancer Institute, Bethesda, MD 20852.

Dr. Glimelius: Department of Oncology, Uppsala Academic Hospital, S-751 85 Uppsala, Sweden.

Ann Intern Med. 1999;131(9):655-659. doi:10.7326/0003-4819-131-9-199911020-00004
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Squamous-cell skin cancer (16) and basal-cell skin cancer (78), collectively referred to as nonmelanoma skin cancer, are associated with an increased incidence of subsequent cancer, particularly non-Hodgkin lymphoma (1). Nonmelanoma skin cancer is also associated with increased risk for death from cancer (9), but it is unclear whether this increased risk is caused by increased incidence of subsequent cancer, decreased chance of surviving subsequent cancer, or a combination of the two. We hypothesized that previous squamous-cell skin cancer may indicate poor prognosis in persons who receive a subsequent diagnosis of cancer. A recent study from Denmark (10) found evidence to support this theory in patients with non-Hodgkin lymphoma. We used the population-based Swedish Cancer Registry to determine whether history of squamous-cell skin cancer has prognostic significance in patients with non-Hodgkin lymphoma and patients with the four most common types of cancer in Sweden.

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Kaplan-Meier plots showing cumulative survival after diagnosis of cancer in patients with previous squamous-cell skin cancer (dashed lines) and those without (solid lines). A.B.C.D.E.F.

Patients with non-Hodgkin lymphoma. Patients with chronic lymphocytic leukemia. Patients with colon cancer. Patients with breast cancer. Patients with prostate cancer. Patients with lung cancer who survived for at least 1 year after diagnosis.

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Summary for Patients

The Outlook in Cancer Patients Who Previously Had Skin Cancer

The summary below is from the full report titled “Is History of Squamous-Cell Skin Cancer a Marker of Poor Prognosis in Patients with Cancer?.” It is in the 2 November 1999 issue of Annals of Internal Medicine (volume 131, pages 655-649). The authors are J. Askling, P. Sørensen, A. Ekbom, M. Frisch, M. Melbye, B. Glimelius, and H. Hjalgri.


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