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Skin Cancer Prevention: Strategies, Challenges and Future Directions

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A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Epidemiology and Prevention".

Deadline for manuscript submissions: 30 May 2026 | Viewed by 12502

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Special Issue Editors

Prof. Dr. Véronique del Marmol

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Guest Editor

Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium
Interests: skin cancer prevention; early diagnosis; treatment; epidemiology

Prof. Dr. Mariano Suppa

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Guest Editor

Department of Dermatology, Hôpital Erasme—Hôpitaux Universitaires de Bruxelles (HUB), 1070 Brussels, Belgium
Interests: skin cancer prevention; early diagnosis; treatment; epidemiology

Prof. Dr. Ana-Maria Forsea

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Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Interests: skin cancer prevention; early diagnosis; treatment; epidemiology

Prof. Dr. Alexander Stratigos

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1st Department of Dermatology and Venereology, Athens Medical School, National and Kapodistrian University of Athens, “Andreas Syggros” Hospital for Skin and Venereal Diseases, 106 79 Athens, Greece
Interests: skin cancer prevention; early diagnosis; treatment; epidemiology
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Special Issue Information

Dear Colleagues,

Skin cancer remains the most common malignancy worldwide, with incidence rates continuing to rise despite decades of prevention campaigns. Both primary prevention, aimed at reducing ultraviolet exposure and other risk factors, and secondary prevention, focused on early detection and screening, are critical to mitigating this burden. However, important challenges persist, such as disparities in awareness and access to prevention, evolving risk factors, the need for culturally adapted messages, and gaps in the implementation of evidence-based strategies.

This Special Issue of Cancers welcomes the submission of original research articles, comprehensive reviews as well as communications, addressing any aspect of skin cancer prevention. Topics of interest include, but are not limited to, epidemiology and burden of disease, behavioral and structural interventions, photoprotection, screening and early detection strategies, prevention in special populations, and innovative tools such as artificial intelligence and digital health. We aim to collate high-quality contributions that advance our understanding of skin cancer prevention and help translate knowledge into effective public health action.

We look forward to receiving your submissions and to collectively shaping a future where skin cancer prevention is more effective, equitable, and evidence-driven.

Prof. Dr. Véronique del Marmol
Prof. Dr. Mariano Suppa
Prof. Dr. Ana-Maria Forsea
Prof. Dr. Alexander Stratigos
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

skin cancer prevention
photoprotection
early detection
screening
epidemiology
public health
behavioral interventions
sun exposure
artificial intelligence
risk factors

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Published Papers (8 papers)

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Research

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14 pages, 281 KB

Open AccessArticle

Impact of Dermatologic Screening and Methods on Breslow Thickness in Melanoma: A Retrospective Cohort Study

by Katharina Wunderlich, Apolline Potiez, Carmen Orte Cano, Joanna Bouchat, Nancy Van Damme, Mariano Suppa, Jonathan M. White, Hassane Njimi, Elizabeth Van Eycken and Véronique Del Marmol

Cancers 2026, 18(3), 461; https://doi.org/10.3390/cancers18030461 - 30 Jan 2026

Viewed by 729

Abstract

Background/Objectives: Melanoma is the most lethal cutaneous neoplasm, with Breslow thickness being a key prognostic factor. This retrospective cohort study aimed to assess the impact of screening frequency and diagnostic methods on tumour stage at diagnosis and to explore implications for risk-adapted strategies. Methods: Between 2017 and 2024, 475 cases of melanoma were diagnosed in 397 patients. Screening frequency, diagnostic method, and patient risk were analyzed in relation to tumour stage. Results: Compared with first-visit cases, patients who underwent screening within two years prior to diagnosis were more often diagnosed with melanoma in situ (32.6% vs. 44–51%; p < 0.05) and had thinner invasive tumours (0.68–0.73 mm vs. 1.8 mm; p ≤ 0.001), though no differences were seen between screening frequencies. Full-body examination was associated with more in situ melanomas (46% vs. 34%; p = 0.016) and thinner invasive tumours (0.92 vs. 2.05 mm; p = 0.2) compared with lesion-directed screening, but this effect disappeared after excluding first-visit cases. Invasive melanomas diagnosed by mole mapping were significantly thinner than by dermoscopy (0.55 vs. 1.07; p = 0.035). In high-risk patients, tumour thickness decreased with more frequent visits (0.905 mm without screening vs. 0.40–0.55 mm with ≥1 visit; p = 0.001). Moreover, mole mapping identified thinner melanomas in the high-risk group compared with dermoscopy (0.47 vs. 0.60 mm; p = 0.02). Conclusions: Screening is associated with thinner melanomas and more in situ diagnoses. Digital mole mapping offers additional benefits, with high-risk patients profiting most, while low-risk individuals could be managed with less resource-intensive approaches. These findings support risk-adapted screening strategies focusing on intensive, digitally supported modalities for high-risk groups. Full article

(This article belongs to the Special Issue Skin Cancer Prevention: Strategies, Challenges and Future Directions)

15 pages, 3966 KB

Open AccessArticle

Diagnostic Performance of Line-Field Confocal Optical Coherence Tomography for Basal Cell Carcinoma: A Prospective Study

by Carmen Orte Cano, Dilara Sanak, Clément Lenoir, Gwendoline Diet, Margot Fontaine, Lucas Boussingault, Lyna Mtimet, Dina Aktas, Stefan Rusu, Anne-Laure Trepant, Gerardo Palmisano, Alessandro Di Stefani, Elisa Cinotti, Linda Tognetti, Javiera Pérez-Anker, Ketty Peris, Pietro Rubegni, Susana Puig, Josep Malvehy, Jean-Luc Perrot, Véronique Del Marmol and Mariano Suppa Show full author list Hide full author list

Cancers 2026, 18(1), 153; https://doi.org/10.3390/cancers18010153 - 1 Jan 2026

Cited by 1 | Viewed by 845

Abstract

Background: Line-field confocal optical coherence tomography (LC-OCT) is an innovative non-invasive imaging technique recently introduced in dermatology. Its use has been established particularly in the diagnosis of skin cancer. The LC-OCT description of basal cell carcinoma (BCC) criteria has served for the conduction of retrospective evaluations on its diagnostic performance, which demonstrated its utility in diagnosis and subtyping BCC. However, prospective studies performed at patients’ bedside are currently lacking in this field. Objective: The objective of the study was to provide parameters of LC-OCT diagnostic performance for BCC derived from a prospective study performed at patients’ bedside. Methods: Lesions clinically equivocal for BCC were prospectively included. Dermoscopic and LC-OCT diagnoses were obtained at the patients’ bedside by an expert observer prior to surgical excision or biopsy. Results: A total of 214 lesions (163 BCCs and 51 BCC imitators) belonging to 119 patients were included. For the differentiation of BCC from BCC-imitators, LC-OCT had the same sensitivity as dermoscopy (98%) but a better specificity (90% vs. 37%). For the discrimination of superficial BCC from other BCC subtypes, LC-OCT had an increased sensitivity and specificity compared to dermoscopy (72% vs. 62%, and 97% vs. 84%, respectively). Conclusions: This prospective study showed that the diagnostic performance for BCC diagnosis and subtyping can be remarkedly increased by LC-OCT compared to dermoscopic examination alone. Our data encourages the inclusion of LC-OCT in the diagnostic process and management of equivocal lesions for BCC. Full article

(This article belongs to the Special Issue Skin Cancer Prevention: Strategies, Challenges and Future Directions)

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13 pages, 1229 KB

Open AccessArticle

Ten Years of Euromelanoma in Hungary: Nationwide Trends and Risk Factors for Skin Cancer in Central–Eastern Europe

by Benjamin Tamás Papp, Krisztina Toplenszky, Henriette Ócsai, Ildikó Csányi, Lajos Kemény, Rolland Gyulai, Judit Oláh and Eszter Baltas

Cancers 2025, 17(23), 3749; https://doi.org/10.3390/cancers17233749 - 24 Nov 2025

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Abstract

Background/Objectives: Large-scale, country-specific data on skin cancer predictors are scarce in Hungary. The Euromelanoma campaign offers a decade-long opportunity to investigate constitutional, behavioral, and motivational risk factors in a Central European setting through a national cross-sectional analysis. Methods: Between 2009 and 2018, Hungarian participants underwent dermatological screening. Diagnoses of clinically suspicious skin cancers were based on dermoscopic assessment, as histopathological confirmation was not systematically available. Among 18,598 standardized surveys, logistic regression identified independent predictors of clinically suspicious skin cancers overall and separately for melanoma and non-melanoma skin cancers (NMSCs). Results: Clinically suspicious skin cancers were detected in 3.9% of participants (1.7% melanoma, 2.3% NMSC). Strong predictors across all cancer types were atypical nevi (OR 4.75), personal history of NMSC (OR 3.42), and melanoma (OR 1.99). For melanoma, atypical nevi (OR 13.12), prior melanoma (OR 5.95), heavy sunbed use (OR 2.15), and trunk lentigines (OR 1.47) were significant. For NMSC, age (OR 1.08 per year), personal history of NMSC (OR 4.75), family history of melanoma (OR 2.41), and atypical nevi (OR 1.76) were dominant. Screening motivation influenced detection: participants attending for a changing lesion had higher odds of suspicious findings, whereas those attending for routine checks, family/friend history, or “many moles” had lower odds. Conclusions: Over a decade of Euromelanoma screening, atypical nevi, prior skin cancer history, and heavy sunbed use emerged as the strongest predictors of suspicious skin cancers. Participant motivation shaped detection patterns, supporting risk-stratified screening, targeted public education, and stricter regulation of artificial ultraviolet exposure. Full article

(This article belongs to the Special Issue Skin Cancer Prevention: Strategies, Challenges and Future Directions)

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12 pages, 772 KB

Open AccessArticle

Cigarette Smoking and Survival of Patients with Non-Melanoma Skin Cancer: A Systematic Literature Review and Meta-Analysis

by Chiara Andreon, Aurora Gaeta, Maddalena Carretti, Alice Graziani, Giulio Tosti, Chiara Doccioli, Maristella Saponara, Giuseppe Gorini, Mariano Suppa, Elisa Di Maggio, Sara Gandini and Saverio Caini

Cancers 2025, 17(22), 3670; https://doi.org/10.3390/cancers17223670 - 15 Nov 2025

Cited by 1 | Viewed by 1043

Abstract

Background: Non-melanoma skin cancer (NMSC) is the most frequent cancer in fair-skinned populations and represents a growing public health concern due to its impact in terms of morbidity and treatment costs. While some meta-analyses have investigated cigarette smoking as a risk factor for NMSC, less is known about its prognostic implications in patients with NMSC. This systematic review and meta-analysis aims to fill this gap by assessing the association between smoking habits and survival in patients with NMSC. Methods: A systematic search was conducted in PubMed and EMBASE up to 25 February 2025, to identify prospective studies of patients with histologically confirmed NMSC that evaluated the association between smoking habits and survival. Study-specific hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were pooled using random effects meta-analysis models. Results: A total of five studies published between 2015 and 2022 were included. The meta-analysis revealed that being a current or ever smoker at diagnosis was associated with a worse overall survival (summary HR 2.42, 95% CI 1.91–3.06). A similar result was observed when smoking exposure was assessed in terms of pack-years or number of cigarettes per day (summary HR 2.44, 95% CI 2.02–2.93). Conclusions: Our findings indicate that cigarette smoking is a negative prognostic factor in these patients, despite the generally excellent prognosis of NMSC. It is reasonable to assume that this unfavourable effect is largely due to the increased risk of developing other life-threatening conditions, in which smoking plays a causal role. These results underscore the clinical relevance of systematically integrating smoking cessation counselling into the routine management of patients with NMSC. Full article

(This article belongs to the Special Issue Skin Cancer Prevention: Strategies, Challenges and Future Directions)

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Review

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19 pages, 314 KB

Open AccessReview

Photoprotection for Skin Cancer: What’s New

by Yolanda Gilaberte, Andrés Ederra-Galé, Juan J. García-Alfonso and Tamara Gracia-Cazaña

Cancers 2026, 18(4), 634; https://doi.org/10.3390/cancers18040634 - 15 Feb 2026

Viewed by 3454

Abstract

Background: Skin cancer is the most common malignancy worldwide. Although photoprotection is the cornerstone of skin cancer prevention, evidence regarding the role of other radiations different from the ultraviolet radiation and the efficacy of sunscreens, oral supplements, DNA-repair enzymes, and antioxidants continues to evolve. Objectives: To review the current evidence on photoprotective strategies and assess their role in preventing actinic keratoses (AK), keratinocyte carcinomas and melanoma. Methods: A narrative review of the literature was conducted using PubMed (2010–2025), including studies in English and Spanish. Search terms comprised “photoprotection,” “sunscreen,” “oral photoprotection,” “skin cancer,” “melanoma,” “keratinocyte cancer,” “UV radiation,” “non-melanoma skin cancer” and related concepts. Articles were selected for clinical relevance. Results: Daily sunscreen use significantly reduces AK and cutaneous squamous cell carcinoma in high-risk individuals, although evidence for basal cell carcinoma and melanoma prevention remains heterogeneous. Balanced broad-spectrum protection, including UVA and visible light filtering, seems to be important, whereas high-energy visible light needs further investigation. DNA-repair enzymes have shown reductions in cyclobutane pyrimidine dimers and clinical improvement of AK. Antioxidants such as Polypodium leucotomos extract, topical and oral, exhibit preventive effects on actinic damage and carcinogenesis. Topical and especially oral nicotinamide demonstrate chemopreventive potential in immunocompetent patients. Vulnerable populations—including transplant recipients, XP patients, individuals with albinism, and outdoor workers—require tailored photoprotection strategies with demonstrated benefit. Conclusions: Photoprotection extends far beyond UV filters, encompassing biological ingredients, antioxidants, oral supplements, and broad-spectrum strategies that target the full exposome. Comprehensive, behaviour-based photoprotection programmes are essential for high-risk groups. Full article

(This article belongs to the Special Issue Skin Cancer Prevention: Strategies, Challenges and Future Directions)

13 pages, 1508 KB

Open AccessReview

A Narrative Review of European Registries for Skin Cancer: Where Are We and Where Should We Be?

by Alexander Katalinic, Karima Hammas, Lukasz Taraszkiewicz, Marieke Louwman, Joanna Julia Bartnicka, Giorgia Randi, Manola Bettio, Andreas Stang and Emanuele Crocetti

Cancers 2026, 18(3), 524; https://doi.org/10.3390/cancers18030524 - 5 Feb 2026

Cited by 1 | Viewed by 1120

Abstract

Background: European population-based cancer registries (PBCRs) provide the foundation for monitoring skin cancer, yet registration practices and coverage vary, particularly for non-melanoma skin cancer (NMSC). Methods: We conducted a narrative review combining descriptive analyses of European Cancer Information System (ECIS) outputs with evidence from the European Network of Cancer Registries (ENCR) Working Group on NMSC and from national reports. A targeted PubMed search (2015–2025) assessed scientific usage of European registry data. Results: Nearly 200 PBCRs operate across about 40 European countries, with heterogeneous structures and timeliness. The ECIS estimated 101,500 incident cutaneous melanomas (CM) in the European Union in 2022. Long-term data from Nordic countries show a tenfold increase in CM incidence over the last six decades, with recent plateauing in younger cohorts. NMSC registration remains inconsistent: some countries record both cutaneous squamous cell carcinoma (cSCC) and basal cell carcinoma (BCC), others record cSCC only, and several omit NMSC entirely. Consequently, Europe-wide NMSC figures are not available from the ECIS. Global estimates exclude BCC and understate the true burden, which is likely between 1 and 1.6 million incident cases annually in Europe. The PubMed search identified 538 European registry-based publications on skin cancer (2015–2025). Conclusions: Melanoma registration in Europe is robust, but NMSC remains under-registered. Priorities include harmonized definitions and counting rules, better integration of outpatient and pathology data, streamlined EU-level reporting, digital/AI-enabled case ascertainment, and sentinel regions to generate reliable NMSC estimates. Full article

(This article belongs to the Special Issue Skin Cancer Prevention: Strategies, Challenges and Future Directions)

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33 pages, 3892 KB

Open AccessReview

Chemoprevention in Skin Cancer: What Advice?

by Ariadna Ortiz-Brugués, Carmen Orte Cano, Lluis Corbella, Francesc Alamon-Reig, Ignasi Martí-Martí, Maria Ayguasanosa-Avila, Marc Hernández-Santacana, Priscila Giavedoni, Paula Aguilera and Cristina Carrera

Cancers 2026, 18(3), 436; https://doi.org/10.3390/cancers18030436 - 29 Jan 2026

Viewed by 1154

Abstract

The incidence of melanoma and non-melanoma skin cancers (NMSCs) is increasing worldwide. While NMSCs are more common, melanoma remains the most challenging because of its higher aggressiveness. Although the use of sunscreens is key in high-risk populations, it provides limited protection, which highlights the need for alternative solutions. In this review, we discuss current evidence on chemopreventive therapies, as well as their efficacy and adverse events, including immunocompetent and immunosuppressed patients. Acitretin, nicotinamide, 5-fluorouracil, and photodynamic therapy have shown overall promising results in actinic keratosis and squamous cell carcinoma. Nevertheless, more research is needed to establish their efficacy, particularly in melanoma, Merkel cell carcinoma, and cutaneous lymphoma, due to their higher mortality rates. Full article

(This article belongs to the Special Issue Skin Cancer Prevention: Strategies, Challenges and Future Directions)

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21 pages, 591 KB

Open AccessReview

The Impact of Multidisciplinary Research on Progress in Skin Cancer Prevention

by Alyssa Susanto, Clare Primiero, Simone M. Goldinger, H. Peter Soyer and Monika Janda

Cancers 2025, 17(21), 3473; https://doi.org/10.3390/cancers17213473 - 29 Oct 2025

Cited by 1 | Viewed by 2033

Abstract

Background/objectives: The global incidence of skin cancer is rising, creating a need to strengthen prevention strategies. In this review, we examine the contributions of public health, dermatology, behavioural science, and emerging technologies such as artificial intelligence and bioinformatics, which have collectively shaped prevention in recent decades. Methods: Using a narrative scoping review approach guided by the PRISMA-ScR framework, we synthesised research across these disciplines to highlight their roles in enhancing skin cancer prevention. Results: Initial efforts focused on increasing public knowledge through sun protection campaigns and symptom recognition. Dermatologists enhanced early detection through refined techniques and clinical guidelines. Initiatives such as Euromelanoma enabled broader collaboration and population-level screening. As more disciplines joined, advances in risk stratification, digital imaging, artificial intelligence, molecular and genetic diagnostics and bioinformatics became possible. Beyond skin cancer prevention, these tools may have additional applications for systemic health issues. However, a number of challenges remain, particularly regarding data privacy concerns, cost-effectiveness, equitable access, and the validation of artificial intelligence tools in diverse populations. Conclusions: The prevention of skin cancer brings together knowledge spanning the fields of public health and dermatology to behavioural research and digital innovation. Working together, these disciplines have improved early detection and awareness. However, fragmented collaboration across regions throughout the world continue to limit their impact. Improved equity alongside stronger, more coordinated partnerships will be essential for the next phase of progress. Full article

(This article belongs to the Special Issue Skin Cancer Prevention: Strategies, Challenges and Future Directions)

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