Basal cell carcinoma (BCC) continues to be the most common cancer in people of European ancestry. Although treatment is relatively straightforward and mortality rates are low, the high incidence and risk of developing multiple BCCs put a major burden on health care resources. Individual risk factors for BCC include age, male sex, race, phenotypic characteristics, and genetic predisposition. In this prospective, population-based cohort study, Kiiski et al demonstrate that individuals who developed a first BCC after age 75 years were less likely to develop multiple BCCs. Younger patients, and those with red hair, high educational level, and a first BCC on the upper extremity had an elevated risk of multiple BCCs and required closer follow-up over time.