Basal cell carcinoma risk factors include which combination of factors?

• A. Smoking and alcohol use
• B. Immunosuppression
• C. Fair skin with chronic sun exposure
• D. HPV infection

Answer: (C)

Basal cell carcinoma is most strongly linked to ultraviolet (UV) light exposure. UV radiation causes DNA damage in skin cells, especially keratinocytes in the basal layer. People with fair skin have less melanin, which provides less natural protection against UV rays, so they accumulate more UV-induced DNA damage over time. When sun exposure is chronic, this damage builds up, increasing the likelihood of basal cell carcinoma developing. This is why the combination of fair skin with chronic sun exposure best explains the risk.

Other factors like smoking and alcohol are not primary drivers of BCC, and while immunosuppression can raise skin cancer risk in general, it isn’t the classic factor pair highlighted for BCC. HPV infection is not a characteristic risk factor for basal cell carcinoma.