Basal cell carcinoma (BCC) is the most common cancer in humans. In the United States alone, roughly 6.1 million adults are treated for basal cell and squamous cell skin cancers combined each year, and BCC accounts for the majority of those cases. About 1 in 3 white Americans will develop basal cell carcinoma at some point in their lifetime, making it far more prevalent than any other type of cancer.
How BCC Compares to Other Skin Cancers
Basal cell carcinoma outnumbers every other skin cancer by a wide margin. Non-melanoma skin cancers, which include both BCC and squamous cell carcinoma, occur at rates 18 to 20 times higher than melanoma. Among non-melanoma skin cancers, BCC has traditionally been taught as occurring at a 4:1 ratio compared to squamous cell carcinoma, though more recent data suggests the true ratio is closer to 1.4:1 overall. The gap depends heavily on age: in younger adults, BCC cases far exceed squamous cell cases, but the ratio nearly equalizes in people over 60.
For white adults over 60, the lifetime prevalence of BCC is about 11%, compared to roughly 6% for squamous cell carcinoma. That 2:1 lifetime prevalence ratio holds up across multiple studies, even as the year-to-year incidence ratio narrows with age.
Who Gets It Most Often
BCC is overwhelmingly a cancer of lighter-skinned populations, and geography reflects this. Australia and New Zealand have the highest incidence rates in the world, followed by North America. Fair skin, a history of sunburns, and cumulative UV exposure over decades are the primary drivers.
Age is the single biggest demographic factor. Most cases are diagnosed in people over 50, and rates climb steeply after 60. But BCC is not exclusively a disease of older adults. Among people aged 18 to 39, BCC is by far the dominant skin cancer, outnumbering squamous cell carcinoma by nearly 10 to 1. In that younger age group, women are especially affected: young women are about 12.6 times more likely to be diagnosed with BCC than with squamous cell carcinoma, compared to 7.2 times for young men. This pattern likely reflects tanning behavior and UV exposure habits in younger women.
People with darker skin tones develop BCC far less often, but it does happen. Among populations with medium skin tones (common in East Asian populations), rates are rising, particularly among the elderly. Darker-skinned populations have the lowest risk overall, though BCC in these groups is sometimes diagnosed later because it isn’t expected.
The Trend Is Still Going Up
Global BCC cases have been rising for decades. From 1990 to 2005, incidence climbed steadily worldwide before stabilizing somewhat through 2021. But the total number of new cases continues to grow, driven by aging populations, greater cumulative UV exposure, and improved detection. The steepest increases have occurred in high-income North America, where both awareness and diagnostic rates are high.
This upward trend means BCC is becoming more common in absolute terms even in regions where the rate per person has leveled off. More people are living long enough to develop it, and the sun damage accumulated decades ago is now showing up as skin cancers in today’s older adults.
Why the Numbers Are Hard to Pin Down
Unlike melanoma and most internal cancers, basal cell and squamous cell carcinomas are not normally tracked by central cancer registries. The CDC notes that standard cancer surveillance systems simply don’t collect this data. Estimates come instead from insurance claims, medical expenditure surveys, and individual studies, which is why you’ll see a range of numbers rather than one definitive count. The 6.1 million annual treatment figure comes from the Medical Expenditure Panel Survey, which captures how many adults seek care for these cancers each year, at a cost of roughly $8.9 billion.
Serious Complications Are Rare
Despite being incredibly common, BCC is rarely life-threatening. The risk of metastasis (the cancer spreading to distant parts of the body) is extremely low, estimated between 0.003% and 0.55% of cases. BCC grows slowly and tends to stay localized, which is why early treatment is so effective. Most cases are handled with outpatient procedures and don’t require further treatment.
That said, BCC can become locally aggressive if left untreated for years, growing into surrounding tissue and causing significant damage, particularly on the face, ears, and nose. In a study of locally advanced cases, 18% of those patients eventually developed metastases, and 12% died from their disease. These are the exceptions, not the rule, but they underscore why ignoring a suspicious spot for years carries real risk.
Recurrence After Treatment
Even after successful removal, BCC can come back. Five-year recurrence rates vary depending on the treatment method and the type of tumor. European treatment guidelines report recurrence rates ranging from 3% to 20% for common outpatient removal techniques. One single-center study found an overall recurrence rate of 11% over five years, consistent with prior research.
People who have had one BCC are also at elevated risk for developing new, separate BCCs in the future. A first diagnosis is often a signal that your skin has accumulated enough UV damage to produce additional tumors over time, which is why regular skin checks become important after a first case. Research from Stanford has also found that a BCC diagnosis can signal a modestly increased risk of developing other types of cancer, likely reflecting shared risk factors like immune function and cumulative cellular damage.