Skin cancer incidence continuing to rise

There were approximately 3.7 million nonmelanoma skin cancers in the United States in 2009, up almost 2% from the previous year.

This number marks the continuation of an upward trend in the incidence of skin cancer, noted a dermatologic surgeon and member of the dermatology faculty at the University of Cincinnati.

Presented preliminary 2009 data at the meeting and noted that the vast numbers of those affected seem to indicate an epidemic.

“At this rate of increase, the total number of nonmelanoma skin cancer (NMSC) will double every 15-20 years.”

The data update a study published last year estimating that there were 3.5 million NMSCs, affecting 2.1 million people in the United States in 2006. Colleagues estimated that the number of skin cancer procedures increased b 77% from 1992 to 2006.

During that time, there was a 16% increase in procedures for NMSCs in the Medicare population.

NMSC is not a responsible disease, so there have not been good estimates for how many Americans are affected. For his initial paper, “It occurred one day that you can’t treat NMSC without a positive pathologic diagnosis, or they’ll send you off to jail.”

So procedure data from Medicare’s Fee-for-Service Physicians Claims database and the National Ambulatory Medical Care Survey database. Procedures are “a pretty good proxy for the actual number of NMSCs.”

To get a total number of NMSCs, colleagues multiplied the estimated crude number of skin cancers by the proportion of skin cancer procedure code claims associated with the ICD-9-CM for invasive nonmelanoma cutaneous malignancy/and in situ malignancy.

From trends, it appears the number of procedures has been leveling off at about a 2% rate in the last few years.

However, the continued increase should be of concern to physicians, patients, and policy makers.

The cost of treating NMSCs is around $8 billion a year, “so it’s serious money.”

In commenting on findings, a professor of dermatology, and dermatologic surgery at New York University Medical Center, said that the number of NMSCs is “surprisingly high.” Overall, skin cancer is much more common than all other cancers combined. Adding that he had conducted studies showing that the lifetime risk of developing melanoma — invasive and in situ — now stood at 1 in 35 in the United States.

And, more than 10,000 Americans will die from skin cancer this year. “So it is a serious public health problem.”

For his part, “have to convince people there is an epidemic out there.” In addition to increasing Medicare funding to treat NMSCs. “It’s prudent and cost effective to focus on prevention.”