Risk Factors for Advanced Basal Cell Carcinoma

Medically Reviewed by Brunilda Nazario, MD on January 22, 2021

Advanced basal cell carcinoma is a type of skin cancer. It’s not as common as milder forms of basal cell carcinoma (BCC). But certain things raise the chances you’ll get it. They include your genes, lifestyle, environment, and some prescription drugs.

Because advanced BCC can be hard to treat, it’s important to know what puts you at risk. Ask a doctor how often you should get your skin checked if you have any of the following risk factors.

Lots of Sun Exposure

The sun is the largest source of ultraviolet (UV) light. Too much can hurt the DNA in your skin cells. That’s what tells them how to fix sun damage. Your chances of skin cancer go up the more time you spend in the sun unprotected. But it can take a long time for cancer to form. It can show up 20-50 years later.

Use of Tanning Equipment

People used to think artificial UV light was safer than the sun. But studies show that’s not true. Because of this, the FDA makes companies put warnings on all tanning beds and indoor sun lamps.

Genetic Conditions

Certain disorders can make you more sensitive to the effects of UV radiation. They include: 

Nevoid basal cell carcinoma syndrome. This is also called Gorlin syndrome or basal cell carcinoma nevus syndrome. It’s a rare condition usually inherited from one of your parents. But you could be the first in your family to have it. It’s caused by mutations, or changes, in a gene that’s supposed to kill tumors. Because the gene doesn’t work right, you might get lots of BCC lesions. Your tumors are more likely to grow fast and show up before age 40. But your chances of advanced BCC go way down if you have dark skin and don’t go in the sun very much.

Others are:

  • Rombo syndrome
  • Xeroderma pigmentosum
  • Bazex-Dupre-Christol syndrome

Delay in Treatment

BCC is usually easy to get rid of when you catch it early. That’s because it tends to grow slower than other kinds of skin cancer. But it’s more likely to spread to other tissue the longer you wait to get treatment. 

Fair Skin

Cancer affects every shade of skin. It mostly found in areas exposed to the sun, like your head and neck. You’re more at risk if your skin is really light or pale. That’s because you have less melanin, or pigment. These cells make your skin light or dark, but they also protect against UV radiation.  

People with fair skin often have:

  • Red or blond hair
  • Light eyes, such as blue or green
  • Skin that sunburns easily

Albinism is when you’re born without any melanin in your skin. You’ll need to be extra careful in the sun. Cover exposed skin with clothing or wear sunscreen with SPF 30 or higher.

Immunosuppressive Drugs

Your chances of skin cancer go up if you have to take drugs to slow down your immune system. That makes it harder for your body to stop tumors from growing. You might have to take this kind of medicine for a long time if you get an organ transplant or have a lifelong medical condition like lupus.

Radiation Therapy

This kind of treatment is used to shrink tumors. But it’s possible to get skin cancer years after radiation therapy. That’s why it’s not often used to treat skin cancer in people who are young.

Other Risk Factors

History of skin cancer. If you’ve had BCC in the past, you’re more likely to get it in the future.

Certain chemicals. There’s evidence that arsenic in what you eat or drink can raise the chances you’ll get BCC.

Older age. The effects of sun exposure build up and damage your skin over time.

Show Sources


Clinical & Translational Oncology: Management of high-risk and advanced basal cell carcinoma.

Skin Cancer Foundation: “UV Radiation & Your Skin,” “Skin Cancer and Skin of Color.” 

Collegium Antropologicum: “The role of UV radiation in the development of basal cell carcinoma.”

FDA: “Indoor Tanning: The Risks of Ultraviolet Rays.”

American Academy of Dermatology: “10 Surprising Facts About Indoor Tanning,” “Skin Cancer Types: Basal Cell Carcinoma Causes.” 

Gorlin Syndrome Alliance: “What is Gorlin syndrome?”

Cancer Support Community: “Advanced Basal Cell Carcinoma — What You Need to Know.”

National Organization for Rare Disorders (NORD): “Nevoid Basal Cell Carcinoma Syndrome.”

Current Dermatology Reports: “Advanced Basal Cell Carcinoma: Epidemiology and Therapeutic Innovations.”

American Osteopathic College of Dermatology: “Albinism.”

American Journal of Transplantation: “Skin Cancers in Organ Transplant Recipients.”

Oxford University Hospitals (NHS UK): “Looking after your skin when you are taking immunosuppressants.”

American Cancer Society: “Radiation Therapy for Basal and Squamous Cell Skin Cancers,” “Basal and Squamous Cell Skin Cancer Risk Factors.”

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