Skin deep: detecting basal cell carcinoma

1 November 2023
Autumn 2023

Often presenting as eyelid-based lesions, basal cell carcinoma has a good prognosis – but can pose a high risk to the eyes and surrounding tissues if left untreated. Optometrists are well placed to help with early detection and referral, Helen Bird learns.

Domains covered

Communication Clinical practice

We may have seen a particularly wet British summer, but research suggests skin cancer in the UK is on the up. In fact, it was the most common cancer diagnosed in England, according to data released in 2022, with a record total of 224,000 skin cancers in 2019 – a 26.1% increase since 2013 (British Association of Dermatologists (BAD), 2022). “While it is not possible to give a definitive explanation for this increase, it is likely the ageing population, changing sun exposure behaviours and improvements to cancer registration may be responsible,” BAD says. 

And cases of basal cell carcinoma (BCC), the most common form of skin cancer, also appear to be rising: there were 158,934 BCCs in England in 2019, up from 128,406 in 2013 (BAD, 2022).

Most BCCs are thought to be caused by long-term exposure to ultraviolet (UV) radiation from sunlight and tanning beds, so often develop on areas of skin that are exposed to the sun, such as the head and neck (Mayo Clinic, 2021). With this in mind, there’s a marked geographic variation in the incidence of BCC, with a reported 233 per 100,000 population each year in Wales, versus 884 in the same proportion in Australia (COptom, 2022). Australian actor Hugh Jackman recently received the all-clear for suspected BCCs, having had his first skin cancer removed a decade ago and at least six procedures since. “Please wear sunscreen; it is just not worth it, no matter how much you want a tan,” he warned followers on Instagram.

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