Narrative review of the epidemiology/biology of basal cell carcinoma: a need for public health consensus.

Basal cell carcinoma (BCC) is the most common skin malignancy afflicting modern Australian society. The most influential response to rising BCC incidence rates has been through public health primary prevention campaigns (PPC) which have persevered since the 1980s. These campaigns are widely heralded a success but clinical data quantifying these benefits are limited due to an absence of legislation around BCC reporting. A non-systematic search of the literature was conducted identifying articles investigating the incidence and clinical characteristics of BCC over the past 40 years, as well as the economic viability of the PPC. There is robust evidence supporting stabilizing rates of BCC incidence in Australia. Similarly, multiple studies have shown the economic benefits of PPC through cost analysis. Anatomical and histological data are reported inconsistently, consequently limiting analysis of changes in BCC clinical characteristics. The consensus throughout the literature is that BCC is a significant public health issue that requires legislative reform. This narrative literature review serves to highlight the need for statutory changes around non-melanocytic skin cancer data collection to enable appropriate analysis and evaluation of current management strategies.

Cytokine/chemokine profiles in squamous cell carcinoma correlate with precancerous and cancerous disease stage.

Actinic Keratosis (AK), Intraepidermal Carcinoma (IEC), and Squamous Cell Carcinoma (SCC) are generally considered to be advancing stages of the same disease spectrum. However, while AK often regress spontaneously, and IEC often regress in response to immune-activating treatments, SCC typically do not regress. Therefore, it is vital to define whether fundamental immunological changes occur during progression to SCC. Here we show that proinflammatory cytokine expression, chemokine expression, and immune cell infiltration density change during progression to SCC. Our findings suggest a switch from predominantly proinflammatory cytokine production to chemokine production is a key feature of progression from precancer to cancer. Together, these observations propose a model that can underpin current research and open new avenues of exploration into the clinical significance of these profiles with respect to immunotherapeutic or other treatment outcomes.