TOPLINE:

A meta-analysis of 17 studies showed that painful, blistering, and/or severe sunburns of medium and high frequencies significantly increase the risk for cutaneous squamous cell carcinoma (cSCC).

METHODOLOGY:

• To examine the association between cSCC and any type of sunburn history at any age, researchers conducted a meta-analysis of 17 studies published through May 2025, which included 321,473 participants.
• Overall, most were case-control studies, five were cohort studies, and one was a cross-sectional study.
• The main outcome was the risk of developing cSCC, and the exposure was any sunburn history (undefined, painful/blistering, frequency, or age at first sunburn).

TAKEAWAY:

• Medium and high frequencies of painful, blistering, and/or severe sunburns throughout lifetime were associated with increased odds of cSCC (moderate frequency: odds ratio [OR], 1.51; 95% CI, 1.26-1.81; high frequency: OR, 1.69; 95% CI, 1.39-2.06).
• High frequencies of painful, blistering, and/or severe sunburns during childhood showed significantly elevated odds of cSCC (OR, 3.11; 95% CI, 1.26-7.66).
• A history of any painful, blistering, and/or severe sunburn across the lifetime was linked to increased odds of cSCC (OR, 1.38; 95% CI, 1.06-1.79).
• No significant association was found between the frequency of undefined sunburns throughout the lifetime and the risk for cSCC.

IN PRACTICE:

“Our results show that painful, blistering, and/or severe sunburns are associated with cSCC, whereas undefined sunburn frequency throughout an individual’s lifetime did not show an association,” the study authors concluded. “This study further emphasizes the importance of effective sunburn prevention strategies, especially against painful, blistering, and/or severe burns.” In an accompanying editorial, dermatologists Adewole S. Adamson, MD, MPP, The University of Texas at Austin; and Howa Yeung, MD, MSc, Emory University, Atlanta, noted that while measuring the impact of previous sunburns on the development of cSCC is “challenging,” public health interventions “on counseling children, adolescents, young adults, and their parents with fair skin types on minimizing UV [ultraviolet] radiation remain an important cornerstone of prevention, as sun protection behaviors can have long-term implications for skin cancer.”

SOURCE:

This study was led by Isaac Weber, MD, The University of Texas MD Anderson Cancer Center in Houston, and was published online on September 24 in JAMA Dermatology.

LIMITATIONS:

This study was limited by inconsistent adjustment for phenotypic and geographic factors, with many studies reporting only unadjusted data. The inclusion of varied study designs introduced potential bias and uncertainty, while many studies had high risk for bias, likely overstating the association between sunburn and cSCC. Sunburn measurement varied widely, contributing to statistical heterogeneity. The lack of standardized definitions for sunburn severity required broad groupings. Finally, retrospective studies were included in the meta-analysis.

DISCLOSURES:

The research was supported by the Cancer Prevention and Research Institute of Texas, Cancer Center Support; one author is supported by a National Cancer Institute grant. Study authors reported no conflicts of interest. Yeung reported receiving grants and personal fees from Eli Lilly, L’Oreal, and Sanofi Genzyme outside the submitted work.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.