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

Publication date: April 2018
Source:Journal of the American Academy of Dermatology, Volume 78, Issue 4
Author(s): Mackenzie R. Wehner, Wilmarie Cidre Serrano, Adi Nosrati, Patrick Michael Schoen, Mary-Margaret Chren, John Boscardin, Eleni Linos
BackgroundThere are varying reports of the association of basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (SCC) with mortality.ObjectiveTo synthesize the available information on all-cause mortality after a diagnosis of BCC or SCC in the general population.MethodsWe 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.ResultsThe 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.LimitationsOnly 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.ConclusionsWe found that patients with SCC are at higher risk for death from any cause compared with the general population.