Basal cell carcinoma
The commonest cancer in Australia. Subtypes and how they look, high-risk features, excision margins, when topical therapy or curettage is enough, Mohs referral, Gorlin syndrome, and hedgehog inhibitors for advanced disease.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Commonest cancer in Australia, which has the highest incidence in the world. About 2 in 3 Australians will be diagnosed with a skin cancer by age 70, and BCC outnumbers squamous cell carcinoma (SCC) by about 2 to 1 in immunocompetent people.
- Locally invasive, almost never metastatic. Morbidity comes from destruction of the face, eyelids, nose and ears.
- Surgical excision with histological clearance is the standard. Superficial BCC on the trunk and limbs can be treated topically.
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Sources
- Clinical practice guidelines for keratinocyte cancer: basal cell carcinoma, squamous cell carcinoma and related lesionsAU/NZCancer Council Australia (approved by NHMRC November 2019), 2019 (current; no newer version found on search, November 2026)
- Quick reference guide: general practice management of keratinocyte cancerAU/NZCancer Council Australia, 2019
- Therapeutic Guidelines: DermatologyAU/NZTherapeutic Guidelines Limited, Version 5, 2022
- Vismodegib (Erivedge) PBS listing, item 11070PAU/NZPharmaceutical Benefits Scheme, Authority Required, metastatic or locally advanced BCC (checked November 2026)
- NCCN Clinical Practice Guidelines in Oncology. Basal Cell Skin CancerNational Comprehensive Cancer Network, Version 1.2027 (August 2026)
- Peris K et al. European consensus-based interdisciplinary guideline for diagnosis and treatment of basal cell carcinoma: update 2023. Eur J Cancer 2023;192:113254EADO, EDF and EORTC, 2023
- Bath-Hextall F et al. Surgical excision versus imiquimod 5% cream for nodular and superficial basal-cell carcinoma (SINS): a multicentre, non-inferiority, randomised controlled trial. Lancet Oncol 2014;15:96-105The Lancet Oncology, 2014; 5-year results Williams HC et al. J Invest Dermatol 2017
- Arits AH et al. Photodynamic therapy versus topical imiquimod versus topical fluorouracil for treatment of superficial basal-cell carcinoma. Lancet Oncol 2013;14:647-654The Lancet Oncology, 2013
- AusPAR: Libtayo (cemiplimab), extension of indications to basal cell carcinomaAU/NZTherapeutic Goods Administration, 2022 (ARTG 9 December 2021; metastatic BCC provisional)
- Imiquimod cream (Aldara) for superficial basal cell carcinoma (PBS restriction from July 2013)AU/NZAustralian Prescriber / NPS RADAR, 2013
- Imiquimod (Aldara) PBS listing, item 2637TAU/NZPharmaceutical Benefits Scheme, Authority Required, superficial BCC (checked November 2026)
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback