Systematic Review of Incidence of Cancer in Burns

Abstract

INTRODUCTION: The incidences of malignant transformation of burn scar are well documented. The most common carcinoma in burned areas is squamous cell carcinoma (SCC), followed by basal cell carcinoma (BCC). However, there is a lack of information regarding the rate of SCC and BCC onset after burn injury and if burn injury itself attributes to such malignancies. METHODS: A systematic review was performed according to the Preferred Reporting Section for Systematic Review and Meta-analysis (PRISMA) guidelines to retrospectively determine the incidence of cancer development, mainly squamous cell carcinoma and basal cell carcinoma, reported in burn studies. Two independent reviewers screened eligibility and selected 120 studies (75 SCC, 23 BCC, 32 others) from 330 published studies between 1946 and July 16, 2021. RESULTS: The patients’ age at the onset of burn exhibited a negative correlation with the length of the latency period in both SCC and BCC studies. The mean latency period for BCC was 40.8 + 22 years compared with SCC, 32.2 + 22.3 years. The latency period for SCC development after burn was lower for males (28.8 + 23.48 years) compared with females (38.9 + 20 years; Figure). Around 5% of studies reported scars in the grafted sites. Wide local excision followed by autologous skin grafting was the primary line of treatment in most of the studies; however, there was no consensus regarding the treatment of recurrence of carcinoma.Figure.: BCC, basal cell carcinoma; SCC, squamous cell carcinoma.CONCLUSION: Future retrospective studies with a higher number of patients are warranted to determine whether burn injury accelerates cancer progression.