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October 20, 1989

The Epidemic of Squamous Cell Carcinoma

JAMA. 1989;262(15):2138-2140. doi:10.1001/jama.1989.03430150106035

Human skin takes a lot of abuse. It is our largest organ and the major barrier between our other organs and the natural and man-made hazards that surround us. These hazards may lead to cancer. Among cancers of the keratinocyte (the predominant cell of skin) in whites, basal cell carcinoma is the more common, yet squamous cell carcinoma (SCC) metastasizes more frequently and causes more deaths.1-3

Although UV radiation is the most important etiologic factor, other factors are known to cause some cases of cutaneous SCC. The first documentation of chemical carcinogenesis was Percivall Pott's description, in 1775, of SCC of the scrotum induced by chimney soot.4 Certain other hydrocarbons derived from coal and oils cause SCC.5 Arsenic in well water was shown to cause SCC in the classic studies from Taiwan,6 and exposure to arsenic in medicinals (such as Fowler's solution, Donovan's solution, and "Asiatic