A scoping review of the incidences of basal cell and squamous cell carcinomas in burns survivors, and the efficacy of sun protection

Miss Andrea Mc Kittrick1, Ms Annie  Reeves1, Ms Alexandra  Lee2, Ms  Laurette Cloete2

1Department of Occuaptional Therapy, Royal Brisbane and Women’s Hospital, Herston, Australia, 2School of Allied Health, Australian Catholic University, , Banyo, Australia

Abstract:

Background:

Published incidences of cancer in burn scars is recorded back as far as 1930 and remains a concern today.  Incidences of Marjolin’s ulcers in the burn population result from a scar malignancy with an estimate that 1 in 300 is a carcinoma. The published evidence reports that the latency period for Marjolin’s ulcers is 20-40 years with the original burn injury occurring in childhood.  The aim of this scoping review was to determine incidence of SCC and BCC post burn injury and to determine the efficacy of utilising sunscreen with a sun protection factor (SPF) of 30+ or higher.

Methodology

This scoping review was comprised of three stages. Stage one investigated articles reporting on incidences of persons presenting with an SCC, BCC or Marjolin’s ulcer following a burn injury. Stage two involved a search to retrieve articles pertaining to sun care recommendations following burn injury. The search of stage three sought to find relevant literature exploring the efficacy of sunscreen with a sun SPF of 30+ or higher.

 

Results:

n = 10 for inclusion: 2 case series, 2 prospective cohort studies, 1 cross sectional study, 4 retrospective cohort studies and 1 systematic review. Sample size range from 10- 140 with the exception of the systematic review of published epidemiologic studies which had 16, 903 (Danish hospital) and 37, 095 (Swedish hospital). The extremities and the scalp were the most common sites of SCC or BCC.

Discussion:

To date the aetiology of cancer occurring in burn scars is not fully understood however a number of hypothesis exist including protracted wound proliferation, chronic irritation, reduced revascularisation and a compromised immune system.

Conclusion:

The authors would recommend future prospective longitudinal cohort studies in the burns population in countries with high skin cancer incidence specifically Australia.


Biography:

Andrea is the Advanced Specialist Occupational Therapist in Severe Burn Injuries at the Royal Brisbane and Women’s Hospital in Brisbane, Queensland. She graduated from Trinity College Dublin, Ireland in 2004.  She a Masters in Hand Therapy via University of Derby, United Kingdom in 2015. Andrea is currently enrolled in a PhD through The University of Queensland. She is the current chair of the ANZBA Allied Health committee, and is a casual academic at The University of Queensland and a session lecturer at Australian Catholic University.  Her special interests include hand burn injuries, critical care polyneuropathy and long term outcomes post burn injury.

About ANZBA

ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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