To prevent squamous cell carcinoma of the skin (PEK), attention must be paid to reducing individual risk factors. Behavioral risk factors
- Stimulants
- Alcohol – dose-dependent association: with each glass of alcohol drunk daily, risk increased by an additional 22%;
- Men: > 20 g alcohol per day significant risk increase (+ 33%).
- Women: 5.0-9.9 g alcohol per day significant risk increase (+ 35%).
bes. carcinogenic seems to be white wine
- Tobacco (smoking) – smokers: especially on the trunk and extremities (+20%).
- Alcohol – dose-dependent association: with each glass of alcohol drunk daily, risk increased by an additional 22%;
- UV light exposure (sun; solarium) [lifetime cumulative UV dose].
- Intensive use of tanning salons increases the risk of squamous cell carcinoma of the skin by approximately 80%.
- In women, the rate of squamous cell carcinoma with tanning salon users was 43% higher when all known associated factors and sun-related UV exposure were considered.
Environmental exposure – intoxications (poisonings).
- Chronic exposure to heat
- Occupational contact with carcinogens such as polycyclic aromatic hydrocarbons (PAHs), arsenic, tar, or mineral oils (agricultural or road workers)
- Exposure to ionizing radiation
- UV radiation (chronic UV exposure) – actinic keratosis (precancerous condition; risk factor for squamous cell carcinoma) [lifetime cumulative UV dose].
- X-ray irradiation
Other risk factors
- Long-term therapy with UV or PUVA (= psoralen plus UV-A; synonym: photochemotherapy).
- Patients receiving immunosuppressants [frequently. aggressive subclinical expansion (ASE)]
- State after organ transplantation (due toimmunosuppression) [frequently. aggressive subclinical expansion (ASE)]
Every patient with statutory health insurance is entitled to skin cancer screening every 2 years from the age of 35. Routine skin self-examination (“skin self-examination”, SSE) is also desirable.
Prevention factors (protective factors)
- Diet: diet high in vitamin A: best protective effect could be retinols of animal foods (HR 0.88; 0.79 to 0.97), followed by beta-cryptoxanthins (HR 0.86; 0.76 to 0.96), lycopene (HR 0.87; 0.78 to 0.96), and lutein and zeaxanthin (HR 0.89; 0.81 to 0.99).
- Sun protection [S3 guideline: see below].
- Avoidance of strong sunlight (see also UV index: the UV index (UVI) is a standardized measure of sunburn-effective solar irradiance (ultraviolet radiation). ); Staying inside is better than putting on sunscreen!
- In general, the UV index is considered a measure of the strongest solar radiation around midday (daily maximum).
- Wearing appropriate clothing is preferable to the use of sunscreen as individual sun protection.
- Headgear/sun hat, T-shirt (and one shirt over the other), sunglasses.
- Application of sunscreen
- Long-term use of nonsteroidal anti-inflammatory drugs (NSAID): risk reduction of 15%.
Secondary prevention
- Early skin cancer detection (skin cancer screening) using dermoscopy (reflected light microscopy; increases diagnostic certainty).
Tertiary prevention
- “Keratinocyte Carcinoma Chemoprevention Trial” (VAKCCT): study participants were 932 patients who had previously had keratinocyte carcinoma (spinalioma or basal cell carcinoma (BCC; basal cell carcinoma)) removed twice in 5 years. These treated as instructed for 2-4 weeks 2 times daily with an ointment on the face and ears containing 5% 5-fluorouracil. After one year of treatment, spinalioma had to be removed in 5 of 468 users (placebo group: 20 of 464 patients): The 5-fluorouracil treatment resulted in a significant risk ratio of 0.25 (95 percent confidence interval: 0.09-0.65), i.e., the risk of spinalioma was reduced by 75 percent in the first year.
