Skin cancer is one of the most common cancers in the world. Non-melanoma skin cancer refers to a group of cancers that slowly develop in the upper layers of the skin. The term non-melanoma distinguishes these more common types of skin cancer from the less common skin cancer known as melanoma, which can be more serious.

In the UK, around 147,000 new cases of non-melanoma skin cancer are diagnosed each year. It affects more men than women and is more common in the elderly.

Symptoms of non-melanoma cancer

The first sign of non-melanoma skin cancer is usually the appearance of a lump or discoloured patch on the skin that persists after a few weeks and slowly progresses over months or sometimes years. This is the cancer, or tumour.

In most cases, cancerous lumps are red and firm and sometimes turn into ulcers, while cancerous patches are usually flat and scaly. Non-melanoma skin cancer most often develops on areas of skin regularly exposed to the sun, such as the face, ears, hands, shoulders, upper chest and back.

When to get medical advice

See a GP if you have any skin abnormality, such as a lump, ulcer, lesion or skin discolouration that has not healed after 4 weeks. While it's unlikely to be skin cancer, it's best to get it checked.

Types of non-melanoma skin cancer

Non-melanoma skin cancers usually develop in the outermost layer of skin (epidermis) and are often named after the type of skin cell from which they develop. The 2 most common types of non-melanoma skin cancer are:

• basal cell carcinoma (BCC), also known as a rodent ulcer, starts in the cells lining the bottom of the epidermis and accounts for about 75 in every 100 skin cancers
• squamous cell carcinoma (SCC) starts in the cells lining the top of the epidermis and accounts for about 20 in every 100 skin cancers

What causes non-melanoma skin cancer?

Overexposure to ultraviolet (UV) light is the main cause of non-melanoma skin cancer. UV light comes from the sun, as well as from artificial tanning sunbeds and sunlamps.

Other risk factors that can increase your chances of developing non-melanoma skin cancer include:

• a previous non-melanoma skin cancer
• a family history of skin cancer
• pale skin that burns easily
• a large number of moles or freckles
• taking medicine that suppresses your immune system
• a co-existing medical condition that suppresses your immune system

Diagnosing non-melanoma skin cancer

A GP can examine your skin for signs of skin cancer. They may refer you to a skin specialist (dermatologist) or a specialist plastic surgeon if they're unsure or suspect skin cancer.

You'll have an urgent referral (within 2 weeks) if you have squamous cell skin cancer. Basal cell skin cancers usually do not need an urgent referral, but you should still see a specialist within 18 weeks.

The specialist will examine your skin and may do a biopsy to confirm a diagnosis of skin cancer. A biopsy is a procedure where some of the affected skin is removed so it can be examined.

Treating non-melanoma skin cancer

Surgery is the main treatment for non-melanoma skin cancer. It involves removing the cancerous tumour and some of the surrounding skin.

Other treatments for non-melanoma skin cancer include freezing (cryotherapy), anti-cancer creams, radiotherapy and a form of light treatment called photodynamic therapy (PDT).

The treatment used will depend on the type, size and location of the non-melanoma skin cancer you have.

Treatment for non-melanoma skin cancer is usually successful as, unlike most other types of cancer, there's a considerably lower risk that the cancer will spread to other parts of the body.

Basal cell carcinoma (BCC) does not usually spread to other parts of the body. There's a small risk (up to 5%) of squamous cell carcinoma (SCC) spreading to other parts of the body, usually the lymph nodes (small glands found throughout your body).

However, for both BCC and SCC there can sometimes be considerable skin damage if the tumour is not treated. At least 9 out of 10 non-melanoma skin cancer cases are successfully cured.

Preventing non-melanoma skin cancer

Non-melanoma skin cancer is not always preventable, but you can reduce your chance of developing it by avoiding overexposure to UV light.

You can protect yourself from sunburn by using high-factor sunscreen, dressing sensibly in the sun, and limiting the amount of time you spend in the sun during the hottest part of the day. Sunbeds and sunlamps should also be avoided.

Regularly checking your skin for signs of skin cancer can help lead to an early diagnosis and increase your chance of successful treatment.