Advanced Dermatology, Norwich, Connecticut.
Department of Dermatology, Brown University, Providence, Rhode Island3Department of Epidemiology, Brown University, Providence, Rhode Island4Center for Dermatoepidemiology, VA Medical Center, Providence, Rhode Island5Department of Dermatology Rhode Island.
JAMA Dermatol. 2015 Oct;151(10):1081-6. doi: 10.1001/jamadermatol.2015.1187.
Understanding skin cancer incidence is critical for planning prevention and treatment strategies and allocating medical resources. However, owing to lack of national reporting and previously nonspecific diagnosis classification, accurate measurement of the US incidence of nonmelanoma skin cancer (NMSC) has been difficult.
To estimate the incidence of NMSC (keratinocyte carcinomas) in the US population in 2012 and the incidence of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in the 2012 Medicare fee-for-service population.
DESIGN, SETTING, AND PARTICIPANTS: This study analyzes US government administrative data including the Centers for Medicare & Medicaid Services Physicians Claims databases to calculate totals of skin cancer procedures performed for Medicare beneficiaries from 2006 through 2012 and related parameters. The population-based National Ambulatory Medical Care Survey database was used to estimate NMSC-related office visits for 2012. We combined these analyses to estimate totals of new skin cancer diagnoses and affected individuals in the overall US population.
Incidence of NMSC in the US population in 2012 and BCC and SCC in the 2012 Medicare fee-for-service population.
The total number of procedures for skin cancer in the Medicare fee-for-service population increased by 13% from 2,048,517 in 2006 to 2,321,058 in 2012. The age-adjusted skin cancer procedure rate per 100,000 beneficiaries increased from 6075 in 2006 to 7320 in 2012. The number of procedures in Medicare beneficiaries specific for NMSC increased by 14% from 1,918,340 in 2006 to 2,191,100 in 2012. The number of persons with at least 1 procedure for NMSC increased by 14% (from 1,177,618 to 1,336,800) from 2006 through 2012. In the 2012 Medicare fee-for-service population, the age-adjusted procedure rate for BCC and SCC were 3280 and 3278 per 100,000 beneficiaries, respectively. The ratio of BCC to SCC treated in Medicare beneficiaries was 1.0. We estimate the total number of NMSCs in the US population in 2012 at 5,434,193 and the total number of persons in the United States treated for NMSC at 3,315,554.
This study is a thorough nationwide estimate of the incidence of NMSC and provides evidence of continued increases in numbers of skin cancer diagnoses and affected patients in the United States. This study also demonstrates equal incidence rates for BCC and SCC in the Medicare population.
了解皮肤癌的发病率对于规划预防和治疗策略以及分配医疗资源至关重要。然而，由于缺乏全国性报告和以前非特异性的诊断分类，准确衡量美国非黑色素瘤皮肤癌（NMSC）的发病率一直存在困难。
估计 2012 年美国人口中非黑色素瘤皮肤癌（角化细胞癌）的发病率，以及 2012 年医疗保险服务人群中基底细胞癌（BCC）和鳞状细胞癌（SCC）的发病率。
设计、地点和参与者：本研究分析了美国政府的行政数据，包括医疗保险和医疗补助服务中心医生索赔数据库，以计算 2006 年至 2012 年期间医疗保险受益人的皮肤癌手术总数及相关参数。利用基于人群的全国门诊医疗护理调查数据库来估计 2012 年与 NMSC 相关的就诊情况。我们将这些分析结合起来，以估计美国总人口中新诊断出的皮肤癌病例总数和受影响的个体人数。
2012 年美国人口中非黑色素瘤皮肤癌的发病率以及 2012 年医疗保险服务人群中基底细胞癌和鳞状细胞癌的发病率。
在医疗保险服务人群中，皮肤癌手术总数增加了 13%，从 2006 年的 2048517 例增至 2012 年的 2321058 例。每 10 万名受益人的年龄调整后皮肤癌手术率从 2006 年的 6075 例增至 2012 年的 7320 例。2006 年至 2012 年间，医疗保险受益人的 NMSC 特定手术数量增加了 14%，从 1918340 例增至 2191100 例。至少接受过一次 NMSC 手术的人数增加了 14%（从 1177618 例增至 1336800 例），从 2006 年到 2012 年一直在增加。在 2012 年医疗保险服务人群中，BCC 和 SCC 的年龄调整后手术率分别为每 10 万人 3280 例和 3278 例。在医疗保险受益人中，BCC 与 SCC 的治疗比例为 1.0。我们估计，2012 年美国 NMSC 病例总数为 5434193 例，美国接受 NMSC 治疗的人数为 3315554 例。
本研究是对 NMSC 发病率的全面全国性估计，并提供了美国皮肤癌诊断和受影响患者数量持续增加的证据。本研究还表明，在医疗保险人群中，BCC 和 SCC 的发病率相等。
