Purpose <p>Cutaneous squamous cell carcinoma (cSCC) occurs predominantly in older adults. Disease-specific mortality is low, but conventional survival estimates do not capture the reduction in remaining life expectancy attributable to the disease. We therefore quantified years of life lost (YLL) in patients with cSCC overall and according to sex, age at diagnosis, progression, and risk profile.</p> Methods <p>We analysed 1400 prospectively evaluated patients with primary cSCC (median age 78 years) treated at the University Hospital Tübingen. Thirty-three patients died from cSCC, 493 died from other causes, and 874 were censored. Vital status was ascertained by annual queries to the public death registry, and death-certificate information was used to support cause-of-death classification. Patients were classified as at risk if desmoplasia, bone invasion, or immunosuppression was present. Expected remaining life expectancy was derived from German cohort life tables. YLL was estimated as the difference between expected life expectancy and observed survival using empirical and Weibull distributions adjusted for age and censoring.</p> Results <p>For the entire cohort, estimated YLL was 5.67 years; estimates were 5.30 years in men and 6.28 years in women. YLL was strongly influenced by age, sex, progression, and risk factors. In 70-year-old men, the estimated YLL was 7.7 years in patients with progression or risk factors and 2.5 years in those without. The corresponding estimates in women were 11.8 and 6.2 years. Although cSCC-specific mortality in the cohort was only 2.4%, the reduction in life expectancy was clinically relevant, particularly among women and high-risk patients.</p> Conclusion <p>Years of life lost in cSCC increase in the presence of desmoplasia, bone invasion, immunosuppression, and tumor progression. YLL complements conventional survival measures and highlights a clinically meaningful disease burden despite low disease-specific mortality.</p>