Delay in diagnosis and treatment of squamous cell carcinoma of the skin.

Istituto Dermopatico dell'Immacolata, Rome, Italy.
Acta Dermato-Venereologica 11/2010; 90(6):595-601. DOI: 10.2340/00015555-0966
Source: PubMed

ABSTRACT Advanced squamous cell carcinomas (SCC) of the skin can cause significant tissue destruction and may metastasize. Understanding the determinants of patient delay could help prevent advanced presentation. The purpose of the present study was to examine patient- and healthcare-related factors associated with delay before the detection and treatment of SCC. A sample of 308 patients with SCC treated at a dermatological referral centre in Italy were interviewed. Clinical data were obtained from the medical records. The highest quartile patients reported > 9 months delay between noticing the lesion and the first medical visit (defined as long patient delay). Multivariate analysis showed that SCC arising on pre-existing chronic lesions were associated with long patient delay (odds ratio = 3.17; 95% confidence interval 1.1-9.3). Controlling for confounders, the first physician's advice to remove the lesion immediately was associated with a shorter treatment delay (p < 0.001). In conclusion, our work emphasizes the importance of seeing a doctor about any change in a pre-existing lesion, particularly in light of the fact that SCC on chronic lesions are at greater risk of metastasis and recurrence.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Skin cancer is the most common type of cancer in humans and the incidence is increasing worldwide. Our objective was to understanding the needs, experiences and knowledge of individuals with Non Melanoma Skin Cancer (NMSC) from diagnosis up until one year. Patients with NMSC completed questionnaires at diagnosis, treatment, 8 weeks post treatment and 12 months post diagnosis. Body image, psychological morbidity and Quality of Life (QOL) were assessed at each time point, with the exception of QOL that was not assessed at diagnosis. Knowledge of NMSC was assessed at baseline and 8 weeks. A sub-sample of participants was also interviewed to allow a more in-depth exploration of patients' experiences. 76 participants completed the initial questionnaire, of which 15 were interviewed. Patients were anxious about a diagnosis of skin cancer, however they were no more depressed or anxious than the general population. QOL significantly improved from diagnosis to 8 weeks and from diagnosis to one year. Knowledge of NMSC was poor and did not improve after treatment. Hairdressers were highlighted as playing an important role in raising awareness and encouraging individuals to seek medical help. Most participants were aware of the need to check their skin for suspicious lesions but were not sure what to look for. At one year participants had forgotten their experience and were not overly concerned about skin cancer. There is a need to raise awareness of the signs and symptoms of NMSC. Information on skin cancer needs to be tailored to the individual both at the start of treatment and during the follow up months, ensuring that participants' needs and expectations are met. Targeting education at individuals in the community who regularly come into contact with skin should help in early identification of NMSC. This is important since skin cancer caught early is easily treatable and delay in presentation leads to larger and more complex lesions which impacts in terms of increased morbidity and increased health care costs.
    BMC Dermatology 10/2013; 13(1):13.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Basal cell carcinomas and squamous cell carcinomas are non-melanoma skin cancers reported to be among the most common malignancies, being responsible for high human morbidity. Conventional chemotherapy applied to these conditions shows non-specific targeting, thus severe adverse side effects are also commonly reported. New therapeutic strategies based on nanoparticulates technology have emerged as alternatives for site specific chemotherapy. Among the different types of nanoparticulates, lipid nanoemulsions and nanoparticles have several advantages for topical delivery of poorly soluble chemotherapeutics. These particles show sustained drug release and protection of loaded drugs from chemical degradation. This technology is promising to enhance the intracellular concentration of drugs and consequently reduce the cytotoxicity of skin chemotherapy.
    Clinical and Translational Oncology 01/2013; · 1.28 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Cutaneous squamous cell carcinoma (cSCC) constitutes the most common cancer capable of metastasis. While the latest version of the American Joint Committee on Cancer guidelines represents a significant step forward in accurate staging of cSCC, several proven independent risk factors remain excluded. We review the current literature on the incidence and proven independent risk factors of metastasis for cSCC and proposes their full inclusion in the staging system for primary lesions. J. Surg. Oncol. © 2014 Wiley Periodicals, Inc.
    Journal of Surgical Oncology 08/2014; · 2.84 Impact Factor

Full-text (2 Sources)

Available from
May 16, 2014

Similar Publications