Nonmelanoma Skin Cancer Visits and Procedure Patterns in a Nationally Representative Sample: National Ambulatory Medical Care Survey 1995-2007
Department of Dermatology, School of Medicine, Stanford University, Redwood City, California.Dermatologic Surgery (Impact Factor: 2.11). 01/2013; 39(4). DOI: 10.1111/dsu.12092
BACKGROUND: The rising incidence of nonmelanoma skin cancer (NMSC) is well documented, but data are limited on the number of visits and treatment patterns of NMSC in the outpatient setting. OBJECTIVES: To evaluate practice and treatment patterns of NMSC in the United States over the last decade and to characterize differences according to sex, age, race, insurance type, and physician specialty. METHODS AND MATERIALS: Adults with an International Classification of Diseases, Ninth Revision, diagnosis of NMSC were included in this cross-sectional survey study of the National Ambulatory Medical Care Survey between 1995 and 2007. Primary outcomes included population-adjusted NMSC visit rates and odds ratios of receiving a procedure for NMSC using logistic regression. RESULTS: Rates of NMSC visits increased between 1995 and 2007. The number of visits was significantly higher in men, particularly those aged 65 and older. Fifty-nine percent of NMSC visits were associated with a procedure, and the individuals associated with that visit were more likely to be male, to be seen by a dermatologist, and to have private-pay insurance. CONCLUSIONS: Nonmelanoma skin cancer visit rates increased from 1995 to 2007 and were higher in men than women. Visits to a dermatologist are more likely to be associated with a procedure for NMSC, and there may be discrepancies in treatment patterns based on insurance type and sex.
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ABSTRACT: Background:In Canada, there is no formal process for registering nonmelanoma skin cancer (NMSC); thus, the epidemiology, treatment practices, and associated health costs are not well known. Objectives:To investigate trends in new cases of skin cancer, treatment practices, and health care costs in New Brunswick, Canada.Methods:Data were extracted from the Provincial Cancer Registry and New Brunswick administrative health databases for 2002-2010.Results:New cases: Basal Cell Carcinoma (BCC) was the most common skin cancer diagnosed, and incidence rates significantly increased between 1992 and 2010.Treatment practice: Dermatologists managed the majority (45%) of the overall skin cancer treatments.Health care costs: NMSC accounted for ∼80% of the health care costs for skin cancer and was dominated by BCC.Conclusions:Development of best practice treatment guidelines for NMSC in New Brunswick would improve future health care efficiencies, and standard protocols for registering new cases of NMSC in Canada would strengthen surveillance and reporting capacity.
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