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Review
. 2018 Apr;78(4):663-672.e3.
doi: 10.1016/j.jaad.2017.11.026. Epub 2017 Nov 13.

All-cause mortality in patients with basal and squamous cell carcinoma: A systematic review and meta-analysis

Mackenzie R Wehner  1 , Wilmarie Cidre Serrano  2 , Adi Nosrati  3 , Patrick Michael Schoen  4 , Mary-Margaret Chren  3 , John Boscardin  5 , Eleni Linos  6
Affiliations
Review

All-cause mortality in patients with basal and squamous cell carcinoma: A systematic review and meta-analysis

Mackenzie R Wehner et al. J Am Acad Dermatol. 2018 Apr.

Abstract

Background: There are varying reports of the association of basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (SCC) with mortality.

Objective: To synthesize the available information on all-cause mortality after a diagnosis of BCC or SCC in the general population.

Methods: We searched PubMed (1966-present), Web of Science (1898-present), and Embase (1947-present) and hand-searched to identify additional records. All English articles that reported all-cause mortality in patients with BCC or SCC were eligible. We excluded case reports, case series, and studies in subpopulations of patients. Random effects model meta-analyses were performed separately for BCC and SCC.

Results: The searches yielded 6538 articles, and 156 were assessed in a full-text review. Twelve studies met the inclusion criteria, and 4 were included in the meta-analysis (encompassing 464,230 patients with BCC and with 175,849 SCC), yielding summary relative mortalities of 0.92 (95% confidence interval, 0.83-1.02) in BCC and 1.25 (95% confidence interval, 1.17-1.32) in SCC.

Limitations: Only a minority of studies controlled for comorbidities. There was significant heterogeneity in meta-analysis (χ2P < .001, I2 > 98%), but studies of SCC were qualitatively concordant: all showed statistically significant increased relative mortality.

Conclusions: We found that patients with SCC are at higher risk for death from any cause compared with the general population.

Keywords: all-cause mortality; basal cell carcinoma; cutaneous squamous cell carcinoma; keratinocyte carcinoma; meta-analysis; systematic review.

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Conflict of interest statement

Conflicts of Interest Disclosure: The authors have no conflict of interest to declare

Figures

Figure 1
Figure 1. PRISMA flow diagram of literature search and study selection for systematic review and meta-analysis of all-cause mortality in patients with a history of basal cell carcinoma (BCC) or squamous cell carcinoma (SCC)
* Subpopulations: articles that presented data on a subpopulation of patients (e.g. xeroderma pigmentosum patients, organ transplant patients, patients with SCC of the lip)
Figure 2
Figure 2. Relative all-cause mortality among patients with history of basal cell carcinoma (BCC)
Figure 3
Figure 3. Relative all-cause mortality among patients with history of squamous cell carcinoma (SCC)
See this image and copyright information in PMC

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