What are the Risk Factors for Developing Basal Cell Carcinoma?

Excessive and unprotected exposure to ultraviolet (UV) radiation from outdoor sunshine or indoor tanning lamps is the leading risk factor for developing basal cell carcinoma (BCC). UV radiation damages correct DNA sequences in basal cells, and once the DNA is damaged, there is a risk that it will be improperly repaired, particularly with repeat damage and cumulative exposure. Since DNA damage accumulates over time, aging also increases the risk of BCC, along with UV-induced damage during childhood and adolescence.

Individuals who work outdoors or spend much of their leisure time outside are at increased risk, especially if they are unprotected from UV radiation, along with anyone who uses indoor tanning devices. People with lighter-colored skin—especially those with sun-sensitive skin that freckles and burns quickly—are at the highest risk because they are more susceptible to UV damage. However, BCC occurs among people of all skin complexions.

Although exposure to UV radiation is BCC’s most notable risk factor, other less-known contributing factors exist. People who have a weakened immune system, for example from disease, age, or medication, are at an increased risk. Individuals who have undergone organ transplantation are at increased risk due to the immunosuppressive medications required to maintain the health of their transplant. Exposure to specific chemicals, like arsenic (from well water for example), coal tar, or agents that enhance sensitivity to the sun, can increase the risk for BCC. Sufferers of severe burns or radiation treatments also have an increased risk at the scarred areas impacted by the trauma.

Additionally, rare genetic mutations, such as albinism or xeroderma pigmentosum, can also increase the risk for BCC. These inherited genetic conditions reduce the cell’s ability to repair DNA damaged by UV radiation.