Cancer Control Group, Population Health Department, QIMR Berghofer Medical Research Institute, Queensland, Australia.
Virginia Commonwealth University Dermatology Residency Program, Richmond, Virginia.
J Am Acad Dermatol. 2014 Jul;71(1):21-6.e1. doi: 10.1016/j.jaad.2014.02.011. Epub 2014 Mar 28.
Keratinocyte cancers (basal cell carcinoma, squamous cell carcinoma) are the commonest cancers in human beings. Population data on incidence trends are scant because few jurisdictions reliably record diagnoses or treatments.
We sought to examine temporal trends of treating keratinocyte cancers in Australia.
We analyzed Medicare Australia data relating to the diagnosis and treatment of keratinocyte skin cancer between 2000 and 2011. We examined counts and rates for each procedure, and the average annual percentage rate of change.
There were significant increases in excision rates for keratinocyte cancers (3.3% per annum for men and 2.2% per annum for women), however temporal trends differed significantly by age group. Although annual increases in excision rates were highest for men aged 75 to 84 years (8.6% per annum), they declined significantly for men and women younger than 45 years. Skin biopsy rates increased substantially in all age groups over the study period, suggesting no lessening in skin cancer surveillance in any age group.
The Medicare data do not include services provided in public hospitals, however fewer than 2% of skin cancers are treated in these settings.
Although overall treatment rates for keratinocyte cancers have increased substantially during the past decade, excision rates are declining in younger Australians.
角化细胞癌（基底细胞癌、鳞状细胞癌）是人类最常见的癌症。由于很少有司法管辖区可靠地记录诊断或治疗情况，因此关于发病率趋势的人口数据很少。
我们试图检查澳大利亚治疗角化细胞癌的时间趋势。
我们分析了澳大利亚医疗保险局（Medicare Australia）在 2000 年至 2011 年间与角化细胞皮肤癌的诊断和治疗相关的数据。我们检查了每种程序的计数和比率，以及平均年变化率。
角化细胞癌的切除率显著增加（男性每年增加 3.3%，女性每年增加 2.2%），但不同年龄组的时间趋势差异显著。尽管 75 至 84 岁的男性每年的切除率增加最高（8.6%），但 45 岁以下的男性和女性的切除率显著下降。在整个研究期间，所有年龄组的皮肤活检率都大幅上升，这表明任何年龄组的皮肤癌监测都没有减少。
医疗保险数据不包括公立医院提供的服务，但这些服务不到 2%的皮肤癌患者接受治疗。
尽管在过去十年中，角化细胞癌的整体治疗率大幅上升，但在年轻的澳大利亚人中，切除率正在下降。
