Squamous cell carcinoma incidence and skin cancer deaths are still climbing in England

Design

National cancer registry analysis with joinpoint regression

Population

All keratinocyte cancers diagnosed in England, 2013-2022

Primary outcome

Age-standardised incidence and mortality trends

Effect

cSCC 102 per 100,000 in 2022; NMSC mortality APC 4.0% (95% CI 2.5-5.7)

Using the National Disease Registration Service, investigators counted every keratinocyte cancer diagnosed in England from 2013 to 2022, allowing each person one basal cell and one squamous cell carcinoma per year rather than only their first ever (BJD, 19 October 2026). That method found 67% more basal cell and 42% more squamous cell carcinomas than first-registration counting.

In 2022 the age-standardised incidence was 295 per 100,000 person-years for basal cell carcinoma and 102 for cutaneous squamous cell carcinoma. Basal cell rates stabilised after 2015, but squamous cell rates kept rising, by 6.1% a year to 2015 and 2.3% a year to 2019. Non-melanoma skin cancer mortality rose about 4.0% a year (95% CI 2.5-5.7), roughly twice as fast in men as in women. Squamous cell incidence continued to rise in people under 60 and over 80.

These are English data in a largely White population, but the direction matters for any service planning: squamous cell carcinoma is not a disease to deprioritise, and the oldest patients carry a growing share.

• Prioritise prompt excision for suspected squamous cell carcinoma, especially in patients over 80.
• Examine the whole skin of anyone treated for a keratinocyte cancer; many patients have more than one.
• Reinforce sun protection advice in younger adults, where squamous cell rates are still rising.
• In Indian practice, these rates do not transfer directly, but immunosuppressed and fair-skinned patients share the risk pattern.

Why it matters

Counting only the first tumour per patient badly underestimates the workload, and the mortality trend shows these are not trivial cancers.

The statistics, in plain English

Annual percentage change describes the average yearly rise in a rate. A 4% yearly rise in mortality compounds to about 40% over a decade.

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