Prevention and adjuvant therapy

UV radiation is the main environmental risk factor for the induction of non-melanoma skin cancer (NMSC). The mechanisms underlying the development of NMSC are sufficiently clear to allow preventive treatment. Primary prevention is related to reduction of UV exposure. Basal cell carcinoma is related to sunburns during childhood. Prevention of this type of skin cancer is thus related to avoidance of aggressive sun exposure at this age. Squamous cell carcinoma is related to chronic sun exposure. Prevention of squamous cell carcinoma is related to avoidance of sun exposure associated with outdoor activities such as outdoor work and sports. Immunosuppressed patients are particularly at risk of NMSC if they are exposed to UV. A specific primary and secondary prevention should be focused for them. There is a high risk of de novo NMSC following treatment of NMSC. NMSC is most often the result of field cance-risation, indicating that metachronous lesions are present. The same mechanisms may prove useful as adjuvant therapy. Treatment schedules should include not only evidence-based targeted treatments of tumours, but also preventive and adjuvant measures.