High Frequency Basal Cell Carcinoma—Who is at Risk?

skin cancer dermoscopy
Female dermatologist (30s, mixed race, Asian / Caucasian) examining male patient (30s) with dermascope, looking for signs of skin cancer. Focus on woman.
A study sought to establish prevalence of HF-BCC in the US and the characterization of patients with HF-BCC in the US.

Men in the United States with a history of melanoma or squamous cell carcinoma are more likely to have high frequency basal cell carcinoma (BCC), according to the results of a national retrospective cohort study published in the Journal of the American Academy of Dermatology.

To characterize those with nonsyndromic HF-BCC in the US and to determine its prevalence in the US, insurance claims data from 15,283,373 patients) ≥18 years of age were analyzed. HF-BCC was defined as ≥9 BCC during a 3-year period.

Patients with HF-BCC were more likely to be men (odds ratio [OR], 2.02; 95% CI, 1.90-2.14; P <.001), have a history of squamous cell carcinoma (OR, 4.66; 95% CI 4.41-4.92; P <.001), and to have a history of melanoma (OR, 2.47; 95% CI 2.29-2.66; P<.001) compared with patients who only had 1 BCC. HF-BCC has an estimated prevalence of 51 per 100,000 persons ≥18 years of age in the US in 2012 through 2014, whereas the highest documented prevalence of the most common genetic syndrome associated with HF-BCC is 32.4 per 100,000 persons.

The results of this study imply that patients with HF-BCC are more likely to be men and have a history of melanoma or squamous cell carcinoma. The disparity in the prevalence of HF-BCC and that of the genetic syndrome most commonly associated with HF-BCC suggests that there are nongenetic contributors to HF-BCC, the investigators concluded.


Chiang A, Solis DC, Rogers H, et al. Prevalence and risk factors for high frequency basal cell carcinoma in the United States. [published online July 24, 2020]. JAAD. doi:10.1016/j.jaad.2020.07.088