Cutaneous squamous cell carcinoma
High-risk features and staging, excision margins, nodal assessment, PD-1 inhibitors for advanced disease (cemiplimab, PBS-listed) and the 2025 adjuvant data, and skin cancer surveillance and chemoprevention in transplant recipients and other immunosuppressed patients.
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
- Second commonest skin cancer in Australia. Most arise from sun-damaged skin of the head, neck, forearms and hands, often in a field of actinic keratoses.
- Most are cured by excision. About 2 to 5% metastasise, usually to regional lymph nodes (parotid and neck for head and neck tumours), and the risk sits in identifiable high-risk tumours and patients.
- Immunosuppression transforms the disease: transplant recipients get many, aggressive SCCs.
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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)
- Cemiplimab for cutaneous squamous cell carcinoma: DUSC analysis (PBS listing from 1 November 2022)AU/NZPharmaceutical Benefits Scheme, Drug Utilisation Sub-Committee, June 2025
- Prescription medicines: applications under evaluation (Libtayo, adjuvant cSCC)AU/NZTherapeutic Goods Administration, Application accepted April 2026; not registered for this indication at November 2026 on available information
- National targeted skin cancer screening to be accelerated with $10.3 million investmentAU/NZAustralian Government Department of Health, Disability and Ageing, Announced 25 October 2024 ($10.3 million; Melanoma Institute Australia leads the Roadmap, started March 2025, with AIHW improving skin cancer data); report due 2028
- NCCN Clinical Practice Guidelines in Oncology. Squamous Cell Skin CancerNational Comprehensive Cancer Network, Version 1.2027 (October 2026)
- Rischin D et al. Adjuvant cemiplimab or placebo in high-risk cutaneous squamous-cell carcinoma (C-POST). N Engl J Med 2025;393:774-785New England Journal of Medicine, 2025
- Chen AC et al. A phase 3 randomized trial of nicotinamide for skin-cancer chemoprevention (ONTRAC). N Engl J Med 2015;373:1618-1626New England Journal of Medicine, 2015
- Allen NC et al. Nicotinamide for skin-cancer chemoprevention in transplant recipients (ONTRANS). N Engl J Med 2023;388:804-812New England Journal of Medicine, 2023
- Euvrard S et al. Sirolimus and secondary skin-cancer prevention in kidney transplantation (TUMORAPA). N Engl J Med 2012;367:329-339New England Journal of Medicine, 2012
- Last updated
- 14 November 2026
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