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Objective: Determine the proportion of patients with more than 1 cSCC and identify factors associated with multiple tumors. Methods: Histopathological cSCC diagnoses from Pirkanmaa, Finland (2006–2020) were retrieved, and clinical records were reviewed. Results: 1421 patients/1988 tumors; 20% had multiple cSCCs. Men and patients with actinic keratosis, Bowen’s disease, and basal cell carcinomas were more likely affected. Median interval to second tumor was 13 months, often at the same site; invasion depth >2 mm associated with multiple tumors. Conclusions: Multiple tumors occurred in 20% and were more common with premalignant lesions and BCCs.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/clinical-and-histopathological-risk-factors-for-multiple-cutaneous-squamous-cell-carcinomas/353386/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/clinical-and-histopathological-risk-factors-for-multiple-cutaneous-squamous-cell-carcinomas/353386.png","ImageObject",300,407,{"name":92,"@type":93},"mieayamfan","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What proportion of patients with cutaneous squamous cell carcinoma had multiple tumors in the study period?","Question",{"text":113,"@type":114},"One-fifth of the patients (n=285) had multiple cSCC tumors during 2006–2020.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Which patient or tumor factors were associated with multiple cSCCs?",{"text":118,"@type":114},"Patients with multiple cSCCs were more often men and had actinic keratosis, Bowen’s disease, and basal cell carcinomas more frequently than patients with a single cSCC.",{"name":120,"@type":111,"acceptedAnswer":121},"Where and when did the second cSCC typically appear, and what invasion feature increased risk?",{"text":122,"@type":114},"The median time between the index and second cSCC was 13 months, and the second tumor appeared at the same location in 71% of cases. Invasion depth greater than 2 mm was associated with multiple tumors.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},353386,1790190748,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},962090893677,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Original Article  \nClinical and Histopathological Risk Factors for Multiple Cutaneous Squamous Cell Carcinomas  \nMarika Lounas, MD 1,2, Tiina Luukkaala, MSc3,4, Teea Salmi, MD, PhD 1,2, Leea Ylitalo, MD, PhD 1,2, JuhaJernman, MD, PhD5, Johanna Palve, MD, PhD2,6, and Niina Korhonen, MD, PhD 1,2  \nJournal of Cutaneous Medicine and Surgery 2026, Vol. 30(4) 363–368 © The Author(s) 2026  \nArticle reuse guidelines:  \n[sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI: 10.1177/12034754261427420](DOI: 10.1177/12034754261427420)[ ](DOI: 10.1177/12034754261427420)[jcms.sagepub.com](jcms.sagepub.com)  \nAbstract  \nBackground: Some patients with cutaneous squamous cell carcinoma (cSCC) may suffer from multiple tumors but little is known of the patient-or tumor-related factors associated with multiple cSCCs.  \nObjective: To investigate the proportion of patients having more than 1 cSCC tumor and to explore whether there are factors that associate with multiple cSCC tumors.  \nMethods: Histopathological diagnoses of “cSCC” from patients treated in Pirkanmaa, Finland, between 2006 and 2020, were obtained from the pathology database to identify patients with cSCC and to obtain the number of all diagnosed cSCC tumors. Clinical records were reviewed to collect information on the patients and their tumors.  \nResults: A total of 1421 patients with 1988 cSCC tumors were identified. One-fifth of the patients (n = 285) had multiple cSCC tumors during the study period. A multivariable-adjusted model showed the patients with multiple cSCCs to be more often men and to have actinic keratosis, Bowen’s disease, and basal cell carcinomas (BCCs) more frequently than the patients with a single cSCC. The median time between the index and the second cSCC was 13 (interquartile range 2-34) months and the second tumor appeared at the same location as the index tumor in 71% of the cases. An invasion depth of more than 2 mm was associated with multiple tumors.  \nConclusions: Multiple tumors appeared in 20% of the patients with cSCC, and were more common among those with previous or simultaneous premalignant skin lesions and BCCs.  \nKeywords  \ncutaneous squamous cell carcinoma, keratinocyte carcinoma, nonmelanoma skin cancer, actinic keratosis, Bowen’s disease  \nIntroduction  \nThe incidence of cutaneous squamous cell carcinoma (cSCC) has been increasing worldwide placing a marked burden on health care systems.1-3 Even so, the true impact of these malignant tumors is often an underestimation, since some of the epidemiological studies have not to assessed cSCCs separately from other keratinocyte carcinomas, while others have counted only 1 tumor/person or 1 tumor/person/year.4 It has been suggested previously that the real number of cSCCs requiring treatment may increase by more than 30% if each tumor is considered individually rather than counting only 1 cSCC tumor/patient.5  \nCumulative exposure to ultraviolet (UV) radiation is the most important causal factor for cSCC, although immunosuppression, smoking, certain β-human papilloma virus subtypes and treatment with BRAF inhibitor, thiazide diuretics, and high doses of psoralen and UVA therapy, for example, have also been associated with cSCC.6,7 Moreover, hematological  \nmalignancies8 and solid organ transplantations have been shown to increase the risk of cSCC tumors,8,9 and in some  \n1 Department of Dermatology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland  \n2Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland  \n3Research, Development and Innovation Centre, Tampere University Hospital, Tampere, Finland  \n4Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland  \n5Department of Pathology, Tampere University and Fimlab Laboratories, Wellbeing Services County of Pirkanmaa, Tampere, Finland 6Department of Plastic Surgery, Tampere University Hospital, Wellbeing Services","cbCaibmzqudTZpxL","https://ap.wps.com/l/cbCaibmzqudTZpxL","pdf",3380305,"English","# Abstract\n## Background\n## Objective\n## Methods\n## Results\n## Conclusions\n# Introduction\n## Epidemiology and burden of cSCC\n## Known causal and associated risk factors\n## Rationale for studying multiple cSCCs\n## Follow-up considerations","[{\"question\":\"What proportion of patients with cutaneous squamous cell carcinoma had multiple tumors in the study period?\",\"answer\":\"One-fifth of the patients (n=285) had multiple cSCC tumors during 2006–2020.\"},{\"question\":\"Which patient or tumor factors were associated with multiple cSCCs?\",\"answer\":\"Patients with multiple cSCCs were more often men and had actinic keratosis, Bowen’s disease, and basal cell carcinomas more frequently than patients with a single cSCC.\"},{\"question\":\"Where and when did the second cSCC typically appear, and what invasion feature increased risk?\",\"answer\":\"The median time between the index and second cSCC was 13 months, and the second tumor appeared at the same location in 71% of cases. Invasion depth greater than 2 mm was associated with multiple tumors.\"}]","Clinical and Histopathological Risk Factors for Multiple Cutaneous Squamous Cell Carcinomas | PDF",1790105043,15]