Medical Oncologist
CION Cancer Clinics
XP and cancer: which cancers, and how high the risk is | CION Cancer Clinics
Xeroderma pigmentosum, or XP, mainly raises the risk of skin cancers, and of cancers on the eye and the tip of the tongue, because damaged DNA from sunlight is not repaired. Without protection, skin cancers often begin in childhood. This page explains which cancers, why they start so young, why carriers are not at the same risk, and how protection changes the picture. At CION Cancer Clinics, our oncologists explain what a gene result means for you and your family, and plan the checks that follow.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
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On this page
- Which cancers does xeroderma pigmentosum raise the risk of?
- Which parts of the body are affected, and how?
- How does sunlight turn into cancer in a child with XP?
- The words you will meet, in plain language
- A child with XP compared with a carrier parent
- What this page cannot tell you
- Four things families tell us, and what is actually true
- Common questions about XP and cancer risk
The short answer
Which cancers does xeroderma pigmentosum raise the risk of?
Xeroderma pigmentosum, or XP, mainly raises the risk of skin cancers, and of cancers on the surface of the eye and the tip of the tongue. These are the parts of the body the sun reaches. Without protection, skin cancers often begin in childhood, decades earlier than in other people.
Why the risk is so high
Sunlight damages the DNA in skin cells every day. Most people repair that damage quietly. A child with XP has two faulty copies of one of the repair genes, so the damage stays and builds up. Over time, some of those damaged cells become cancers. The risk of skin cancer in young people with XP is many thousands of times higher than in other children.
Why protection changes the picture
The same numbers carry a hopeful message. Because sunlight drives most of the risk, strict protection from ultraviolet light lowers it. Children who are diagnosed early and protected carefully develop fewer skin cancers, and later, than children whose XP was found late.
XP is recessive. Parents and brothers or sisters with one faulty copy are carriers and are not thought to share this risk.Where the risk lies
Which parts of the body are affected, and how?
Most of the risk sits where light falls. A smaller part sits inside the body.
Skin cancers other than melanoma
Basal cell and squamous cell cancers are the most common. They usually appear on the face, lips, neck, hands and arms. Found early, most can be removed with a small procedure.
Often begins as
- A rough, scaly patch that keeps coming back
- A small pearly lump or a sore that will not heal
Melanoma
Melanoma is less common than the other skin cancers but more serious. In XP it tends to appear in young adulthood. A new dark spot, or one that changes shape or colour, needs checking soon.
Eye and eyelid cancers
The front of the eye and the eyelids take sun too. Cancers can form on the clear surface of the eye or the lid edge. Redness, a growth or a change in the eye should be shown to an eye doctor.
Tongue and inside the body
The tip of the tongue can develop cancer because it is exposed when the mouth is open. There is also a smaller rise in some internal cancers, such as brain tumours, blood cancers and lung cancer in people who smoke.
Not sure whether this applies to you?
Ask an oncologistHow the damage builds
How does sunlight turn into cancer in a child with XP?
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Ultraviolet light reaches the skin
Every exposure to sunlight, and to some indoor lights, damages a little DNA in the skin and eye cells it reaches.
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The damage is not repaired
In most people, repair genes fix this within hours. In XP, one of those genes does not work, so the damage stays in the cell.
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Freckles and dry skin appear early
Heavy freckling on sun-exposed skin in early childhood is often the first sign. Some children also burn badly after very little sun, while others do not burn at all.
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Precancerous patches form
Rough, scaly spots appear. They are not cancer yet, and a skin doctor can treat them early before they change.
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Some patches become cancer
Without protection, some of those patches turn into skin cancers. Every exposure avoided removes one more chance for this to happen.
On your report
The words you will meet, in plain language
- Xeroderma pigmentosum
- An inherited condition where skin and eye cells cannot repair sunlight damage. It is usually shortened to XP.
- Complementation group
- The XP type, named by a letter such as XP-A or XP-C. Each letter matches a different faulty gene.
- XP variant
- A milder-looking form caused by a different gene. It still carries a high skin cancer risk.
- Actinic keratosis
- A rough, scaly precancerous patch caused by sun damage. It is treated early to stop it turning into cancer.
- Recessive
- Both copies of the gene must be faulty for XP to appear. Parents are usually healthy carriers of one copy each.
- Carrier
- Someone with one faulty copy and one working copy. Carriers do not have XP and are not thought to have a raised skin cancer risk.
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Side by side
A child with XP compared with a carrier parent
Two faulty copies (XP)
One faulty copy (carrier)
Very high skin, eye and tongue cancer risk
No clear rise in cancer risk
Strict daily ultraviolet protection
Ordinary sun sense, like anyone else
Regular skin, eye and sometimes nerve checks
No extra checks because of the gene
Care led by a skin doctor and eye doctor
Counselling mainly for future children
Being straight with you
What this page cannot tell you
It cannot tell you your child's own risk. That depends on the XP type, how early protection began, and how strictly it has been kept. What your child's specific variant means is a question for the counsellor who ordered the test, working with the skin doctor who follows your child.
It cannot give you exact figures
XP is rare, and most of what is known comes from small groups of patients, many outside India. Studies so far are small. Numbers from those studies may not match a child in Telangana, where the sun is strong all year and outdoor life is part of school and family.
Who this does not apply to
Most children with freckles, or with skin that burns easily, do not have XP. Both are common. This page also does not apply to carriers, or to adults whose skin cancer report mentions a gene change in the tumour only. That is tumour testing, covered on our targeted therapy pages.
Commonly believed
Four things families tell us, and what is actually true
"Our skin is dark, so the sun cannot harm our child."
Darker skin gives some natural shade, but not nearly enough for a child with XP. Children with XP of every skin colour develop skin cancers without strict protection.
"My child does not burn, so it must be mild."
Some XP types cause little or no sunburn, yet the cancer risk stays high. Burning is not a safe guide to how much damage is building up.
"Cancer is certain, so protection is pointless."
Protection is the most powerful tool families have. Strictly protected children develop fewer skin cancers, and later, than those who are not protected.
"Every DNA repair condition means skin cancer."
Not so. Some related repair conditions, such as Cockayne syndrome, cause sun sensitivity without a raised skin cancer risk. The exact diagnosis matters.
Questions we are asked
Common questions about XP and cancer risk
At what age do skin cancers usually start in XP?
Without protection, skin cancers often start in childhood, far earlier than in other people. With early diagnosis and strict protection, they tend to appear later and less often. Your skin doctor will explain what to watch for in your child.
How often should my child's skin be checked?
Regularly, by a skin doctor who knows XP, and more often if new spots keep appearing. Parents also learn to check the skin at home. Photos of spots help show whether anything has changed between visits.
Are the eye cancers preventable?
The risk can be lowered. Wraparound ultraviolet-blocking glasses, hats and face shields protect the eyes, and lubricating drops ease dryness. Regular eye checks catch changes early, when they are easier to treat.
Can skin cancers in XP be treated?
Yes. Most are small when found on regular checks and are removed with minor surgery. Early patches can be treated with creams or freezing. The aim is to catch each one early and keep the skin as healthy as possible.
Does XP raise the risk of lung cancer?
Tobacco smoke causes DNA damage that uses the same repair system, so people with XP who smoke may be at higher risk. Keep your child away from tobacco smoke at home, and never let them start smoking.
Do carrier parents need skin checks?
Not because of the gene. Carriers have one working copy, which is enough for repair. They should follow ordinary sun sense and see a doctor about any changing spot, like anyone else.
Does marriage within the family raise the chance of XP?
It can. When parents are related by blood, they are more likely to carry the same faulty gene. This is common in parts of India and is nothing to be ashamed of. Tell the counsellor, because it helps plan testing for the wider family.
Where can we get XP care near Hyderabad?
Care is shared between a skin doctor, an eye doctor and a genetics team. Call the CION helpline, and someone will help you find the right specialists and plan visits around your child's protection needs.
Your Specialists
Meet CION's oncologists. Bring your family history or genetic report to them.
Our medical oncologists see people with a strong family history of cancer, arrange genetic counselling and testing where it fits, and plan the checks that follow.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
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Sources
- GeneReviews (NCBI) — Xeroderma Pigmentosum
- MedlinePlus Genetics — Xeroderma pigmentosum
- National Cancer Institute — Genetics of Skin Cancer (PDQ) – Health Professional Version
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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Worried about a new spot on your child's skin?
Tell us what the report says and what you have noticed. We will help you reach a skin doctor and genetics team who see children with XP. One helpline serves every CION centre.