Risk of SCC Determined With New Tool



A recent study found that squamous cell carcinoma (SCC) was associated with higher scores on the Actinic Keratosis Area and Severity Index (AKASI). This new tool for assessing the severity actinic keratoses (AK) on the head could be used to stratify patients at risk for developing squamous cell carcinoma.

In the retrospective study, the researchers examined the associations between AKASI scores and basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). A total of 210 patients who underwent oncological surgery for UV-induced tumors and were assessed prior to surgery with the AKASI and Physician Global Assessment (PGA) were included in the analysis.

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Twenty-six patients had histologically defined SCCs and a median AKASI score of 6.9 (0-13) and PGA score of 2 (0-4). Conversely, the 82 patients diagnosed with BCCs had a median AKASI score of 3.3 (0-15.2) and PGA score of 1 (0-4).

Additional analyses showed differences between AKASI scores among patients with SCC and BCC. Compared with non-invasive lesions, such as actinic keratosis and Bowen disease, SCC was associated with higher AKASI scores. “Spearman's coefficient of rank correlation between AKASI and PGA indicates that these measures of AK severity were strongly correlated,” the researchers wrote.

“Patients with SCC show significantly higher AKASI than patients with BCC or patients without invasive tumors,” the researchers concluded. “Hence, AKASI may be used to stratify risk for developing invasive SCC.”


Schmitz L, Gambichler T, Gupta G, Stücker M, Dirschka T. Actinic keratosis area and severity index (AKASI) is associated with the incidence of squamous cell carcinoma. J Eur Acad Dermatol Venereol. 2018;32(5):752-756.