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Pain significantly predicted SCC compared with BCC

Pain and itch were common symptoms of nonmelanoma skin cancer, with pain a significant predictor of squamous cell carcinoma, according to study results.

In an institutional review-board study, researchers at Wake Forest University Baptist Medical Center collected data on 576 biopsy-proven nonmelanoma skin cancers from 478 patients (mean age, 68.8 years; 63.6% men) with basal cell carcinoma (BCC; n=353) or squamous cell carcinoma (SCC; n=223). Patients used a visual analogue scale (VAS, 0-10) to rate pain and itch.

Itch was the most reported symptom (43.5% of SCC; 33.4% of BCC) for both cancers, but there was no statistical significance in this difference. Pain prevalence was 39.8% for patients with SCC (95% CI, 35.4%-44.2%) and 17.7% (95% CI, 13.4%-21.9%) for patients with BCC.

Patient pain scores were highly significant predictors of having SCC instead of BCC (P<.001). With each 1-point increment in VAS for pain, odds of having SCC rather than BCC increased 30%. Researchers also found nearly a fourfold increase in the likelihood of a patient having SCC vs. BCC when VAS score for pain was greater than 2 (OR=3.94; 95% CI, 2.49-6.23). In subanalysis, patients with SCC in situ compared with invasive SCC did not significantly differ in pain.

Gil Yosipovitch

“This helps clinicians prioritize biopsy and removal of malignant lesions,” researcher Gil Yosipovitch, MD, professor in the department of dermatology, neurobiology and anatomy, and regenerative medicine at Wake Forest University Health Sciences, told Healio.com.“Nowadays, many older patients can have several lesions, and those that are painful need to be removed first.

“Pain and itch assessments are such a simple measure to assess that have not been done before, and pain may be a prognostic sign for malignancy. It is a simple assessment with no additional time and equipment, and it yields important information.”