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

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

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.

Abstract

Background: Nonmelanoma skin cancer is associated with increased occurrence of subsequent cancer and death from cancer, but it is not known whether a history of skin cancer is associated with poor prognosis after a second diagnosis of cancer.

Objective: To determine whether history of squamous-cell skin cancer is a marker of poor prognosis in patients with cancer.

Design: Population-based cohort study.

Setting: Sweden, 1958 to 1996.

Patients: All patients in the Swedish Cancer Registry with or without a first diagnosis of squamous-cell skin cancer and a subsequent or first diagnosis of non-Hodgkin lymphoma (including chronic lymphocytic leukemia) or cancer of the colon, breast, prostate, or lung.

Measurements: Relative risk (RR) for death determined by using Cox proportional-hazards regression analysis.

Results: Patients with a history of squamous-cell skin cancer had a significantly greater risk for death than those with no such history after receiving a diagnosis of non-Hodgkin lymphoma (RR, 1.33), colon cancer (RR, 1.24), breast cancer (RR, 1.19), or prostate cancer (RR, 1.17). Patients with lung cancer and a history of squamous-cell skin cancer who survived for 1 year after diagnosis of lung cancer also had an increased risk for death (RR, 1.29).

Conclusion: Patients with a registered history of squamous-cell skin cancer have a poor prognosis after diagnosis of subsequent cancer and warrant careful medical attention.

Article and Author Information

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{at}mep.ki.se. For reprint orders in quantities exceeding 100, please contact the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints{at}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.