We reviewed all reports of skin biopsies that had been performed at the Miami Veterans Administration Hospital within a three-year period. A total of 1,115 biopsy specimens of basal cell and squamous cell carcinomas were identified for 558 patients. Patient names, diagnoses, and dates of biopsies were tabulated for computer analysis. We determined that 121 patients (22%) developed at least one new or recurrent skin cancer during the average follow-up period of 1½ years. From a computer review of clinic appointments, we determined that half of the 558 patients were unavailable for follow-up during that three-year period. Thus, the true rate of new and recurrent skin cancer in patients who had at least one skin cancer is no less than 22% and may approach 50% in the first 18 months. This high rate of new occurrences and recurrences of basal cell and squamous cell carcinomas emphasizes the need for repeated examinations of all patients with a history of skin cancer.