Increased incidence and recurrence rates of nonmelanoma skin cancer in patients with non-Hodgkin lymphoma: a Rochester Epidemiology Project population-based study in Minnesota

J Am Acad Dermatol. 2015 Feb;72(2):302-9. doi: 10.1016/j.jaad.2014.10.028. Epub 2014 Dec 2.


Background: Cutaneous malignancy is associated with worse outcomes in patients with chronic lymphocytic leukemia (CLL).

Objective: We sought to identify the incidence and recurrence rate of nonmelanoma skin cancer (NMSC) in patients with non-Hodgkin lymphoma (NHL).

Methods: NMSC incidence was calculated and Cox proportional hazards models were used to evaluate associations with risk of recurrence for patients with NHL between 1976 and 2005 who were in the Rochester Epidemiology Project research infrastructure.

Results: We identified 282 patients with CLL or small lymphocytic lymphoma and 435 with non-CLL NHL. The incidence of basal cell carcinoma and squamous cell carcinoma was 1829.3 (95% confidence interval [CI] 1306.7-2491.1) and 2224.9 (95% CI 1645.9-2941.6), respectively, in patients with CLL. The cumulative recurrence rate at 8 years after treatment with Mohs micrographic surgery was 8.3% (95% CI 0.0%-22.7%) for basal cell carcinoma and 13.4% (95% CI 0.0%-25.5%) for squamous cell carcinoma in patients with CLL.

Limitations: This was a retrospective cohort study.

Conclusions: After Mohs micrographic surgery and standard excision of NMSC, patients with NHL had a skin cancer recurrence rate that was higher than expected. Careful treatment and monitoring of patients with NHL and NMSC are warranted.

Keywords: Mohs micrographic surgery; chronic lymphocytic leukemia; immunosuppression; malignant melanoma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Carcinoma, Basal Cell / epidemiology*
  • Carcinoma, Basal Cell / secondary
  • Carcinoma, Squamous Cell / epidemiology*
  • Carcinoma, Squamous Cell / secondary
  • Cohort Studies
  • Comorbidity
  • Esophageal Neoplasms / secondary
  • Female
  • Humans
  • Incidence
  • Leukemia, Lymphocytic, Chronic, B-Cell / epidemiology*
  • Lymphatic Metastasis
  • Lymphoma, Non-Hodgkin / epidemiology*
  • Male
  • Middle Aged
  • Minnesota / epidemiology
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasms, Second Primary / epidemiology*
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Skin Neoplasms / epidemiology*