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Although UV radiation from the sun is the major risk factor for most skin cancers, genetic risk factors for Basal Cell Carcinoma have been found that appear to act independently of UV exposure.

The deCODEme Genetic Scan analyzes your DNA for these variants and provides you with a personalized interpretation of your genetic risk for Basal Cell Carcinoma.

The path to prevention starts with knowing your risk – deCODEme helps you assess your genetic risk for skin cancer of the basal cell type

Basal cell carcinoma is the most common type of skin cancer

Skin cancer is the most prevalent type of cancer in human beings and occurs in three main forms: melanoma, basal cell carcinoma and squamous cell carcinoma. Each of these takes its name from the type of skin cell in which it originates. The latter two, basal cell carcinoma and squamous cell carcinoma, are often referred to as non-melanoma skin cancers.

Most basal cell cancers are found on sun-exposed skin

Basal cell carcinomas are malignant tumors that originate in the basal cells lining the inner part of the epidermis. They are the most common form of skin cancer, accounting for 75% of all diagnosed cases. It is estimated that about one million new cases are diagnosed in the US each year. This type of skin cancer usually appears on areas of the skin most exposed to the sun (head, face, neck, hands and arms).

Exposure to UV-rays of the sun are the main risk factor

Regular exposure to the ultraviolet (UV) rays of the sun increases the risk of developing all types of skin cancer, including Basal Cell Carcinoma. Exposure to UV rays from the sun is mainly dependent on how far away from the equator one lives. In the far north (e.g. in places such Iceland, Finland and Alaska) there is relatively little UV radiation from the sun and the risk of too much exposure is low, whereas those living in northern Australia, Florida, India and Ethiopia are much more highly exposed.

Exposure to UV radiation on tanning beds also increases the risk of developing Basal Cell Carcinoma.

An interaction of genes and environment result in Basal Cell Carcinoma

Given the same level of exposure to UV radiation as people with a dark complexion, individuals with pale skin, with red or blonde hair, blue or green eyes and who are tan-resistant and burn easily, are particularly at risk of developing Basal Cell Carcinoma. This is thought to be due to the fact that a light complexion provides less protection from UV radiation than a dark complexion. Because skin, hair and eye color are by and large genetically determined, the risk of developing Basal Cell Carcinoma from UV radiation exposure therefore results from a mixture of genetic and environmental factors.

However, there are also genetic risk factors for Basal Cell Carcinoma that appear to act independently of exposure to UV radiation.

Genetics contribute significantly to the risk of skin cancer

Scientists at deCODE genetics have identified genetic variants that confer a significant risk of developing Basal Cell Carcinoma in people of European descent. Two variants are located on chromosome 1 and one variant on each of the following chromosomes; 5, 7, 9, and 12. These variants are not known to affect the hair, eye and skin color traits that are associated with poor UV protection. Therefore they probably represent risk factors that are separate from and therefore additional to UV radiation exposure.

deCODEme calculates your genetic risk of developing Basal Cell Carcinoma

The deCODEme Genetic Scan identifies these six genetic variants and uses them to provide customers of European descent with a personalized interpretation of their genetic risk for developing Basal Cell Carcinoma.

At present, the necessary scientific information to interpret the genetic risk for individuals of other ethnicities is not available. This information will be added as soon as it becomes available and we are assured of its quality.

Risk factors for Basal Cell Carcinoma

• Ultraviolet (UV) radiation: UV exposure is thought to be the major risk factor for basal cell carcinoma and most other skin cancers. This is because UV can damage the DNA carried by skin cells causing them to grow and divide uncontrollably. Sunlight and tanning beds are the main sources of UV radiation. People with excessive and unprotected exposure to light from these sources are at greater risk for all kinds of skin cancers. Studies also suggest that exposure at a young age is an added risk factor.
• Complexion: Hair, eye and skin color are determined by the amount and type of melanin produced by cells called melanocytes. Melanin is a special form of pigment that absorbs light and provides protection from the damaging effects of UV radiation. People with fair skin, freckles and red or blonde hair have less light-absorbing melanin in their skin and hence have a higher risk of developing skin cancer.
• Gender and age: Men are 50% more likely to develop basal cell carcinoma than women. This is thought to be mainly because men are more exposed to the sun (outdoor labor) less aware of the need for UV protection. Basal cell carcinoma is more common in both sexes after the age of 40.
• Family history: Not surprisingly, family history plays a role in the development of skin cancers. This is partly because complexion is largely genetically determined. At the same time, family members also tend to live in the same areas with comparable UV radiation exposure. Genetic variants have been found to increase risk for certain skin cancers, mostly through their effect on lightening skin complexion.

Avoiding sun-burn is an important prevention strategy

The best known way to lower the risk of any skin cancer is to avoid sun-burn and limit exposure to the sun and other sources of UV radiation, including tanning beds and sun lamps.

Early detection is key to successful treatment of BCC

If detected early, basal cell carcinoma is comparatively easy to treat. However, 5-10%of basal cell carcinoma tumors can be resistant to treatment or can damage the skin around them, sometimes invading bone and cartilage. Fortunately, however, basal cell carcinoma has an extremely low rate of spreading to other parts or organs of the body (metastasis), and although it can result in scarring it is usually not life threatening.

Routine skin-examinations important for early diagnosis

As early detection of basal cell carcinoma is the key to successful treatment, it is important to recognize what basal cell cancer looks like and perform regular self-examinations of your skin, especially if you are at increased risk for developing this type of skin cancer. If you observe any unusual change in your skin such as a bump, a sore that doesn’t heal, or an area with different color or texture than the skin around it, consult your physician.

A variety of treatment methods exist for BCC

There is no single best method to treat all skin cancers. The method of choice is determined by many factors, including the location, type, size, whether it is a first-time tumor or a recurrent one, and the health and preference of the patient.

Continue skin-examinations after successful treatment

Patients who have had one occurrence of basal cell skin cancer have a 40% greater risk of developing new tumors in the next five years. The tumors can recur even when they appear to have been adequately treated. Therefore, even after successful treatment of basal cell carcinoma, patients should perform skin self examinations routinely and continue to see their physician for regular follow-up visits for several years to make sure that the growth has not recurred and also to check for new skin cancers.

More information

You can find out more information about atrial fibrillation by talking with your doctor and visiting these Web sites:

• The American Cancer Society on Skin Cancers
• The American Cancer Society on Squamous and Basal Cell Skin Cancer
• Medline Plus – Trusted Health Information for You

This content was last reviewed on February 08, 2010.

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