The altitude can influence the pathological classification of skin cancer and further affect the five-year survival rate of patients: an unexpected discovery

In our retrospective study of skin cancer cases in Kashgar, Xinjiang, China, which covered a period of 17 years, we found that altitude is also an important factor affecting the pathological differentiation types of skin cancer. We sorted and classified the pathological types and differentiation types of skin cancer patients from 2008 to 2024, as well as the recorded five-year survival rates of different patients. At the same time, we extracted the geographical altitude information of the patients’ usual residence places and carried out classified discussions on this information. With the increase in altitude, the probability of the occurrence of moderately and poorly differentiated types of skin squamous cell carcinoma increases (P < 0.05). At the same time, the five-year survival rate of moderately and poorly differentiated skin squamous cell carcinoma is significantly lower than that of well-differentiated skin squamous cell carcinoma (P < 0.05). Compared with patients with well-differentiated cutaneous SCC, patients with moderately-low differentiated tumors had a 2.75-fold higher risk of tumor-associated mortality (HR = 2.75, 95% CI: 1.74–4.35, P < 0.0001). Altitude may affect the cell differentiation types of skin squamous cell carcinoma and ultimately influence the five-year survival rate of patients. There is a correlation between different pathological classifications of skin squamous cell carcinoma and altitude, especially between the well - differentiated and moderately - low differentiated types. The five - year survival curves of moderately - low differentiated skin squamous cell carcinoma show significant differences from those of the well - differentiated type.