Our New Approach to a Challenging Skin Cancer Statistic

As of 2021

For decades, The Skin Cancer Foundation has been one of the most trusted sources for curated and medically reviewed U.S. statistics on skin cancer. The media rely on us, and so do physicians and millions of patients. We take this responsibility very seriously.

Updating our incidence statistics on melanoma is relatively simple. Cases are tracked through the CDC’s National Cancer Registries, and each year, the American Cancer Society releases its “Cancer Facts and Figures” report with those figures, including melanoma.

However, the nonmelanoma types of skin cancer, including basal cell carcinoma (BCC), the most common, and squamous cell carcinoma of the skin (SCC), the second most common, are not tracked in the U.S. Many experts say it would be cost-prohibitive to do that. So we use different types of studies to estimate the numbers for BCC and SCC. This spring, after much thought and research, we are announcing a change.

Currently, the best estimate for the total number of nonmelanoma skin cancers (NMSCs) diagnosed annually in the U.S. is 5.4 million. The study that figure was based on is from 2015, but it is still the best number we have. The statistic that we are changing is the ratio of BCCs to SCCs within that total.

For several years we adhered to the long-held belief that about 80 percent of all NMSCs are BCCs and 20 percent are SCCs (a 4:1 ratio). Meanwhile, we heard anecdotally from physicians and researchers who looked at billing data that the ratio was much closer than that. A 2020 study in JAMA Dermatology helped prove it.

The study found that this ratio varied dramatically based on gender, age, race and geography — and that it approaches 1:1 in older patients. While it is impossible to pinpoint an exact, accurate national ratio from this one study, we believe it is evidence enough to justify a change to our estimated statistics.

With help from our medical advisers, especially New York City dermatologist Désirée Ratner, MD, we have decided to apply a simple 2:1 ratio to the 5.4 million NMSC total, rather than the 4:1 ratio we had been using. Applying this ratio, we get 3.6 million BCCs and 1.8 million SCCs annually. We feel that this change more accurately reflects the reality of skin cancer incidence in the U.S. today.