Surgery Rates Rising for Non-Melanoma Skin Cancer: Study

MONDAY, April 16 (HealthDay News) — Surgery for non-melanoma
skin cancer in the United States increased substantially from 2001 to
2006, mainly due to the increased use of a specific surgical procedure, a
new study suggests.

Non-melanoma skin cancer forms in the outer layer of the skin or in
skin squamous cells, but not in the cells that make pigment, according to
the U.S. National Cancer Institute.

More than 3 million non-melanoma skin cancers are diagnosed in the
United States each year. Treatment options include surgical excision
(removal) and Mohs micrographic surgery, which examines the entire
surgical margin during the procedure.

According to the American College of Mohs Surgery, the procedure
“treats skin cancer through a highly specialized and precise technique
that removes the cancer in stages, one tissue layer at a time.”

The new study, by Dr. Kate Viola of the Albert Einstein College of
Medicine in New York City and colleagues, analyzed the medical records of
nearly 27,000 Medicare patients who had either surgical excision or Mohs
micrographic surgery. The findings are published in the April issue of the
journal Archives of Dermatology.

There is debate about whether surgical excision or Mohs micrographic
surgery is more effective for primary non-melanoma skin cancer and about
the cost-effectiveness of the Mohs procedure, Viola pointed out in a
journal news release.

Among the study patients, about 64 percent had surgical excision and 36
percent had Mohs micrographic surgery to treat these skin cancers between
2001 and 2006. During that time, the rate of surgical excision increased
from 1.8 to 2.1 per 100 patients while the rate of the Mohs surgery
doubled from 0.75 to 1.5 per 100 patients.

Mohs micrographic surgery was more likely than surgical excision to be
used for skin cancers on the lip (60 percent versus 40 percent) and eyelid
(57 percent versus 43 percent). Atlanta had the largest proportion of
non-melanoma skin cancer patients treated with the Mohs procedure — about
45 percent — and a larger proportion were performed in younger patients,
the study found.

“Patient age and lesion location were significantly associated with the
type of surgery (Mohs micrographic surgery versus surgical excision), yet
there were wide variations in regional [Mohs procedure] use and
geographical disparity that warrant further investigation. Additional
large, prospective studies are needed to further identify surgical
treatment outcomes for non-melanoma skin cancer,” the authors concluded.

More information

The U.S. National Cancer Institute has more about skin cancer.

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