Pain significant predictor of SCC

Winston-Salem, N.C. - Pain is a significant predictor of squamous cell carcinoma compared to basal cell carcinoma, according to results of a recent study.

Investigators with Wake Forest University Baptist Medical Center conducted an institutional review board-approved study, analyzing data on 576 nonmelanoma skin cancers (NMSC) from 478 patients with a mean age of 68.8, Healio.com reports. Of those patients, 353 had basal cell carcinoma (BCC) and 223 had squamous cell carcinoma (SCC). The patients used a visual analogue scale to rate the pain and itch they experienced.

For both types of NMSC, itch was the most reported symptom, at 43.5 percent in SCC and 33.4 percent in BCC. The pain prevalence was 39.8 percent for patients with SCC, compared to 17.7 percent of patients with BCC.

With each one-point increment in visual analogue scale for pain, the odds of having SCC rather than BCC increased by 30 percent, according to the study. There was nearly a fourfold increase in the likelihood of a patient having SCC versus BCC when the score for pain was greater than two (odds ratio=3.94; 95 percent confidence interval, 2.49-6.23).

“With an increasingly aging population, patients often present with numerous BCCs and SCCs, and it is often difficult for the clinician to prioritize lesion biopsy and removal,” the study authors wrote. “Thus, there is a need for better clinical toosl to aid the physician in selecting lesions most likely to be SCCs.”

The study was published in the December issue of JAMA Dermatology, formerly Archives of Dermatology.