ANAIS DO FÓRUM DE INICIAÇÃO CIENTÍFICA DO UNIFUNEC · Jun 2026
Actinic keratosis and the risk of progression to cutaneous squamous cell carcinoma: an integrative literature review
By FERREIRA BDLCCV, MARREGA IG, VILELA LST et al.
INTRODUCTION: Actinic keratosis (CA) is a premalignant skin lesion resulting from the dysplastic proliferation of keratinocytes, strongly associated with chronic exposure to ultraviolet radiation. Clinically relevant because of its potential for transformation into cutaneous squamous cell carcinoma (CEC), CA primarily affects fair-skinned individuals, older adults, and immunosuppressed individuals. OBJECTIVE: To review the literature on the rate of progression from CA to CEC, discussing risk factors, mechanisms of transformation, therapeutic strategies, and preventive measures. METHODS: An integrative review conducted in the PubMed, SciELO, and Google Scholar databases using the descriptors “actinic keratosis,” “squamous cell carcinoma,” and “progression.” Articles in Portuguese and English between 2006 and 2025 addressing prevalence, clinical course, risk factors, diagnosis, therapies, and prevention were included. Duplicates, conference abstracts, in vitro or animal studies, and publications without full-text access were excluded. RESULTS: CA has an estimated risk of progression of 0.6% in one year and up to 2.57% in four years, potentially reaching 20% in ten years in immunosuppressed individuals. More than 70% of CEC cases arise in areas previously affected by CA. Molecular alterations, such as mutations in the p53 protein and loss of cell polarity, underpin this process. Early treatment reduces progression, with cryosurgery, curettage, field therapies with 5-fluorouracil, imiquimod, diclofenac, tirbanibulin, and photodynamic therapy being effective. Continuous photoprotection is essential as a preventive measure. CONCLUSIONS: Actinic keratosis constitutes a marker of cutaneous cancer risk. Early diagnosis, individualized management, and systematic photoprotection are fundamental to reducing the burden of cutaneous squamous cell carcinoma, reinforcing the relevance of preventive strategies in public health.