An ecological study of skin biopsies and skin cancer treatment procedures in the United States Medicare population, 2000 to 2015 - 13/12/17
See related letter on page 171
Abstract |
Background |
Analyses of skin cancer procedures adjusted for population changes are needed.
Objective |
To describe trends in skin cancer–related biopsies and procedures in Medicare beneficiaries.
Methods |
An ecological study of Medicare claims for skin biopsies and skin cancer procedures in 2000 to 2015.
Results |
Biopsies increased 142%, and skin cancer procedures increased 56%. Mohs micrographic surgery (MMS) utilization increased on the head/neck, hands/feet, and genitalia (increasing from 11% to 27% of all treatment procedures) but was low on the trunk/extremities (increasing from 1% to 4%). Adjusted for increased Medicare enrollment (+36%) between 2000 and 2015, the number of biopsies and MMS procedures performed per 1000 beneficiaries increased (from 56 to 99 and from 5 to 15, respectively), whereas the number of excisions and destructions changed minimally (from 18 to 16 and from 19 to 18, respectively). Growth in biopsies and MMS procedures slowed between each time period studied: 4.3 additional biopsies per year and 0.9 additional MMS procedures per year per 1000 beneficiaries between 2000 and 2007, 2.2 and 0.5 more between 2008 and 2011, and 0.5 and 0.3 more between 2012 and 2015, respectively.
Limitations |
Medicare claims–level data do not provide patient-level or nonsurgical treatment information.
Conclusions |
The increased number of skin cancer procedures performed was largely the result of Medicare population growth over time. MMS utilization increased primarily on high- and medium-risk and functionally and cosmetically significant locations where tissue sparing and maximizing cure are critical.
Le texte complet de cet article est disponible en PDF.Key words : Appropriate Use Criteria, basal cell carcinoma, biopsy, destruction, excision, Medicare reimbursement, Mohs micrographic surgery, nonmelanoma skin cancer, skin cancer, squamous cell carcinoma
Abbreviations used : AUC, BCC, CMS, CPT, MMS, NMSC, SCC
Plan
| Supported by Harvard Catalyst/The Harvard Clinical and Translational Science Center (National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health Award UL1 TR001102) and financial contributions from Harvard University and its affiliated academic health care centers. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, Harvard University and its affiliated academic health care centers, or the National Institutes of Health. |
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| Conflict of interest: None declared. |
Vol 78 - N° 1
P. 47-53 - janvier 2018 Retour au numéro
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