Updated European Guideline on Cutaneous SCC Diagnostics and Prevention Introduces New Difficult-to-Treat Classification

Updated 2026 European guideline on invasive cutaneous SCC introduces new 5-group classification for difficult-to-treat disease, refines risk stratification, and emphasizes stepwise diagnostics including imaging when indicated. Prevention: oral nicotinamide, sun protection.

• Consensus update by EADO/EDF/ESTRO/UEMS/EORTC refines CSCC diagnostics: clinical/dermatoscopy → histopathology → staging (physical exam + imaging if indicated) using AJCC8 and BWH systems.
• New difficult-to-treat (DTT) classification: 5 groups encompassing common CSCC complex due to tumor/patient factors, locally advanced, and metastatic disease.
• Recommendations are consensus-based; some may reflect expert opinion where high-quality evidence is limited.

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