Design: National registry analysis with joinpoint regression
Population: All keratinocyte cancers diagnosed in England, 2013 to 2022
Primary outcome: Age-standardised incidence and mortality trends
Effect: 2022 cSCC 102 per 100,000; NMSC mortality APC 4.0% (2.5 to 5.7)

This registry study analysed every keratinocyte cancer diagnosed in England from 2013 to 2022, counting up to one basal cell and one squamous cell carcinoma per person per year. That method found 67% more basal cell and 42% more squamous cell carcinomas than counting only each person's first tumour.

In 2022 the age-standardised rates were 295 per 100,000 person-years for basal cell carcinoma and 102 for cutaneous squamous cell carcinoma. Basal cell carcinoma rates have been flat since 2015 (annual change −0.2%, 95% CI −0.8 to 0.3). Squamous cell carcinoma rose 6.1% a year to 2015 and 2.3% a year to 2019, and kept rising in people under 60 and over 80. Non-melanoma skin cancer mortality rose 4.0% a year (2.5 to 5.7), faster in men than in women.

The numbers are English and from a mostly White population, so they do not transfer directly to Indian practice, where keratinocyte cancer is far less common. The message that travels is about the oldest patients: squamous cell carcinoma in people over 80 is increasing, and these are the patients least able to reach a clinic quickly.

Examine the skin of patients over 80 at routine visits, since squamous cell carcinoma is still rising in that group.
Do not assume squamous cell carcinoma is confined to the elderly; rates are also rising under 60.
Prioritise fast assessment for a rapidly growing or tender keratotic lesion.
Count every tumour, not just the first, if your service audits its skin cancer workload.

Why it matters

Rising mortality from a mostly curable cancer points to late presentation, especially in the very old.

The statistics, in plain English

An annual percentage change of 4.0% in mortality compounds to roughly a 40% rise over the decade. The interval for basal cell carcinoma spans zero, meaning its rate has effectively stopped changing.