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Soo Park, MD
Soo Park, MD
Posted: Monday, October 6, 2025
Chronic ultraviolet (UV) exposure has long been identified as a key driver of cutaneous squamous cell carcinoma (cSCC), but the specific role of acute, high-intensity UV injury in the form of sunburn has been less certain. Lead author Isaac Weber, MD, of The University of Texas MD Anderson Cancer Center, and colleagues conducted a systematic review and meta-analysis to evaluate whether sunburn history increases the risk of developing cSCC. Their findings were published in JAMA Dermatology.
Study Methods
After a comprehensive search of PubMed, Embase, and the Cochrane Library from inception through May 2025, the authors identified 43 eligible studies, of which 17 were pooled for analysis (representing 321,473 participants). Analytical studies of the general population were carried out to assess the association between cSCC and any history of sunburn, regardless of age or sunburn type. Sunburn measures included undefined, painful, blistering, or severe burns, with exposures stratified by childhood, adulthood, or lifetime occurrence. Odds ratios were calculated using a random-effects model, with preference given to the most adjusted measures.
Key Findings
According to the study authors, painful, blistering, and/or severe sunburns were significantly associated with an elevated risk of developing cSCC. Their analyses found increased odds among those with medium (odds ratio [OR] = 1.51, 95% confidence interval [CI] = 1.26–1.81) and high lifetime frequencies (OR = 1.69, 95% CI = 1.39–2.06) of such sunburns. Even a single instance of severe sunburn was associated with higher risk of cSCC (OR = 1.38, 95% CI = 1.06–1.79). The most pronounced association was observed in childhood, where frequent severe sunburns increased the odds of cSCC more than threefold. In contrast, no significant association was found between the frequency of undefined sunburns and cSCC risk.
These results align with evidence from studies of sunburn and risk of other skin cancers. As the authors of the new study noted, “A 2023 meta-analysis on basal cell carcinoma demonstrated an increased risk [of the malignancy] associated with ever experiencing a painful or blistering sunburn across the lifetime, and a dose-response relationship with sunburn frequency per decade. Similarly, multiple meta-analyses on melanoma risk and sunburn history indicate that melanoma risk rises with increasing numbers of severe sunburns across all life periods, and that the risk associated with being sunburned is highest in childhood.”
According to the new report’s authors, the clear association between severe sunburns—especially in childhood—and later cSCC risk suggests that acute UV damage may play a more important role in the development of this skin cancer than previously recognized.
“[O]ur 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. These findings align with existing literature and suggest a connection between severe sunburns and cSCC,” they concluded.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
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