Can a course of fluorouracil cream reduce a person’s risk of BCC and SCC?

This month’s paper from JAMA Dermatology, by Weinstock et al, is instructive. The authors did a randomised trial of five per cent fluorouracil cream applied to the face, to see if a two to four week application would reduce the number of basal cell carcinomas (BCC) and squamous cell carcinomas (SCC) in the following year.

Interestingly, there was a significant and important reduction  of 75 per cent in the number of SCC that developed. There was no corresponding reduction in BCC. The benefit did not persist over the four year study.

There are some interesting implications and considerations we can take from this. The study was done in a high risk group, and presumably by treating SCC precursors (such as actinic keratosis) the five per cent fluorouracil has a beneficial effect – but only for a year.

So, as the authors note, maybe an annual course of fluorouracil is justified in high risk patients.

Read the full paper here.

Professor David Wilkinson.

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