P209 The survival divide in skin cancer: national evidence across common and rare tumour types

Abstract

Understanding survival patterns across all skin cancers is essential for informing service planning, early diagnosis strategies, patient communication and research priorities. Skin cancer net survival (NS) patterns, including high and low surviving, were evaluated using the National Disease Registration Service’s ‘Get Data Out’ skin tumour data for 2014–2016 diagnoses for England. NS is used to estimate the probability of surviving cancer itself by adjusting for deaths expected in the general population, allowing fair comparison between tumour groups. Tumour-specific 5-year NS was compared across anatomical sites, subtypes and stage at diagnosis. Where 2014–2016 NS was unavailable, single-year estimates from adjacent Get Data Out releases are reported with an asterisk. Basal cell carcinoma and melanoma in situ had the highest NS (> 100%*), and stage I melanoma had a survival of around 100%*. The NS with nongenital cutaneous squamous cell carcinoma (cSCC) was 90.1% [95% confidence interval (CI) 89.5–90.6], similar to that for melanoma overall (90%, 95% CI 89.5–90.6). Rare skin cancers and rare subtypes had worse outcomes: the NS for genital cSCC was 73.1% (95% CI 69.8–76.3), acral lentiginous melanoma (ALM) 77.6% (95% CI 72.0–83.2), cutaneous sarcoma 87.9% (95% CI 84.0–91.9), Kaposi sarcoma 88.6% (95% CI 81.3–91.9) and cutaneous T-cell lymphoma 77.2% (95% CI 73.6–80.7). Merkel cell carcinoma showed the poorest prognosis with 51.7% (95% CI 46.5–56.9). Across all skin tumours with stage data, 5-year NS declined as stage advanced. The 5-year NS was high for most common skin cancers, but some rare skin cancers and rare subtypes of common cancers, including Merkel cell carcinoma, ALM and anogenital cSCC, had lower NS. Notably, the 5-year NS for cSCC was comparable with that for melanoma. These survival patterns reflect tumour biology, immune status and associated comorbidities, anatomical visibility, delays in diagnosis and therapeutic advancements. Reporting of national survival remains crucial for targeting early detection strategies and prioritizing research into rare and aggressive skin cancers.