Delayed Diagnoses of CSCC in People of Color: The Hidden Risk of Detection at Advanced Stages

Sponsored by Regeneron

There is a common misconception that people of color are not susceptible to skin cancer, but this is a myth.^1,2 While skin cancer is more common in white individuals, people of color are also at risk.^1,2 Unfortunately, people of color who present with non-melanoma skin cancers like cutaneous squamous cell carcinoma (CSCC) are often diagnosed at a more advanced stage, leading to worse overall prognoses and outcomes.²

Read on to learn more about CSCC, how it can progress to become advanced, and discover ways to be proactive about your skin health.

What is Advanced CSCC?

CSCC is a type of non-melanoma skin cancer that originates in the squamous cells, which are thin, flat cells forming the top layer of the skin.³ It is the second most common form of non-melanoma skin cancer after basal cell carcinoma.⁴ CSCC is the most common form of skin cancer in Black people and is also very common in Hispanic and Asian people.^5,6

While melanoma often receives more attention, non-melanoma skin cancers like CSCC are far more prevalent, with over 5.4 million cases of CSCC and basal cell carcinoma diagnosed annually in over 3.3 million people in the U.S.⁷ Approximately 90% of non-melanoma skin cancers are associated with exposure to ultraviolet (UV) radiation from the sun.⁸

While early stage CSCC can be easily treated, about 2 to 5% of CSCC cases progress to become advanced and are more challenging to treat.^9,10 CSCC is considered advanced when it has spread or has not responded to treatment like surgery or radiation.¹⁰ There are two forms of advanced CSCC, including metastatic, meaning the tumor has spread beyond its original location to other parts of the body, and locally advanced, meaning the tumor is large or has grown into underlying tissues, muscles or nerves.¹⁰ Advanced cases are diagnosed more often in people of color, which is why timely detection is so important.²

How does CSCC present differently in people of color?

The signs and symptoms of CSCC can vary significantly based on skin tone, and these differences are often missed by both patients and providers, contributing to a more advanced diagnosis.²

What are skin checks, and why are they important?

Regular skin checks, including self-exams and professional examinations with a dermatologist, are essential for timely detection of skin cancer.² Since lesions in people of color may occur on less exposed parts of the body where they are less likely to be noticed, a professional skin exam can be particularly important.²

Thorough skin examinations should include a look at skin on all parts of the body, including in between crevices and in areas that are typically unexposed, such as ^2,12:

CSCC can occur on any of these surfaces, so it is important to check them all.²

What are ways to protect your skin from the sun?

Sun protection is important for everyone, regardless of skin tone, as anyone can be at risk for skin cancer.² Here are some key sun protection tips ¹³:

Where can you learn more?

For more information about CSCC, you can visit letsgetrealaboutskincancer.com, an educational program about advanced non-melanoma skin cancers.

You can also visit the following independent websites – Skin Cancer Foundation (SCF) and AIM at Skin Cancer – for additional information on CSCC.

References:

1. Shao K, Feng H. Racial and Ethnic Healthcare Disparities in Skin Cancer in the United States: A Review of Existing Inequities, Contributing Factors, and Potential Solutions. J Clin Aesthet Dermatol. 2022;15(7):16-22.
2. Gupta AK, Bharadwaj M, Mehrotra R. Skin Cancer Concerns in People of Color: Risk Factors and Prevention. Asian Pac J Cancer Prev. 2016;17(12):5257-5264. doi:10.22034/APJCP.2016.17.12.5257
3. What Are Basal and Squamous Cell Skin Cancers? | Types of Skin Cancer. American Cancer Society. November 15, 2024. Accessed February 24, 2025. https://www.cancer.org/cancer/types/basal-and-squamous-cell-skin-cancer/about/what-is-basal-and-squamous-cell.html
4. Roky AH, Islam MM, Ahasan AMF, et al. Overview of skin cancer types and prevalence rates across continents. Cancer Pathogenesis and Therapy. 2025;3(2):89-100. doi:10.1016/j.cpt.2024.08.002
5. Gloster HM, Neal K. Skin cancer in skin of color. Journal of the American Academy of Dermatology. 2006;55(5):741-760. doi:10.1016/j.jaad.2005.08.063
6. Jackson BA. Nonmelanoma skin cancer in persons of color. Semin Cutan Med Surg. 2009;28(2):93-95. doi:10.1016/j.sder.2009.04.010
7. Basal & Squamous Cell Skin Cancer Statistics. October 31, 2023. Accessed July 23, 2024. https://www.cancer.org/cancer/types/basal-and-squamous-cell-skin-cancer/about/key-statistics.html
8. Skin Cancer Facts & Statistics. The Skin Cancer Foundation. July 2025. Accessed September 11, 2025. https://www.skincancer.org/skin-cancer-information/skin-cancer-facts/
9. Thai Lim Solomon Rischin D. Biology and Treatment Advances in Cutaneous Squamous Cell Carcinoma. 2021;13(22):5645. doi.org/10.3390/cancers13225645
10. Advanced Squamous Cell Carcinoma Treatment. Skin Cancer Foundation. 2025. Accessed September 11, 2025. https://www.skincancer.org/skin-cancer-information/squamous-cell-carcinoma/advanced-scc/
11. Burton KA, Ashack KA, Khachemoune A. Cutaneous Squamous Cell Carcinoma: A Review of High-Risk and Metastatic Disease. Am J Clin Dermatol. 2016;17(5):491-508. doi:10.1007/s40257-016-0207-3
12. Find skin cancer: How to perform a skin self-exam. American Academy of Dermatology Association. 2025. Accessed September 11, 2025. https://www.aad.org/public/diseases/skin-cancer/find/check-skin
13. How to Protect Yourself and Your Family From the Sun. Published online June 2024. Accessed September 11, 2025. https://www.cancer.org/content/dam/cancer-org/cancer-control/en/booklets-flyers/protect-from-the-sun.pdf