Discrepancies in Non-Mohs Micrographic Surgery for Non-melanoma Skin Cancer Between Lighter-Skinned and Darker-Skinned Patients
Non-melanoma skin cancer (NMSC) is highly prevalent in the United States, with darker-skinned patients (DSP) exhibiting lower incidence but increased morbidity and mortality. The purpose of this study is to elucidate NMSC disparities between DSP (Fitzpatrick skin phototype IV or more) and lighter-sk...
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| Veröffentlicht in: | Curēus (Palo Alto, CA) CA), 2024-02, Vol.16 (2), p.e54027-e54027 |
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| creator | Borda, Luis J Encarnacion, Iain Noel M Saal, Ryan C Higgins Ii, H William Pariser, Robert J |
| description | Non-melanoma skin cancer (NMSC) is highly prevalent in the United States, with darker-skinned patients (DSP) exhibiting lower incidence but increased morbidity and mortality. The purpose of this study is to elucidate NMSC disparities between DSP (Fitzpatrick skin phototype IV or more) and lighter-skinned patients (LSP, Fitzpatrick skin phototype III or less), focusing on surgical features of non-Mohs micrographic surgery-treated NMSC.
This retrospective cohort study included LSP and DSP diagnosed with either basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) in an academic dermatology setting. Variables collected included age, gender, type of NMSC, location, staging, time-to-diagnosis (TTD), pre-operative lesion size, and post-operative defect size. Categorical variables were reported as counts and percentages, while the association between categorical variables was assessed using a two-tailed Fisher's test. A paired t-test was used to determine the association between continuous variables. P-values |
| doi_str_mv | 10.7759/cureus.54027 |
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This retrospective cohort study included LSP and DSP diagnosed with either basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) in an academic dermatology setting. Variables collected included age, gender, type of NMSC, location, staging, time-to-diagnosis (TTD), pre-operative lesion size, and post-operative defect size. Categorical variables were reported as counts and percentages, while the association between categorical variables was assessed using a two-tailed Fisher's test. A paired t-test was used to determine the association between continuous variables. P-values <0.05 were considered statistically significant.
A total of 27 patients with NMSC were identified, of which 9 (33.3%) were DSP. Patients of darker skin were predominantly female (n=7; 77.8%), while no gender predilection was found in LSP (n=9; 50.0% female; p=0.23). Time-to-diagnosis was significantly longer in DSP than in LSP (61.3 weeks vs 25.1 weeks, respectively; p = 0.02). Despite this, there was no statistical difference in terms of staging, pre-operative lesion size (11.89 mm in DSP vs 10.76 mm in LSP, p=0.75), and post-operative defect size (45.56 ± 29.21 mm in DSP vs 31.22 ± 19.60 mm in LSP; p=0.33).
Darker-skinned patients had a longer TTD without staging differences. Our study confirms the need for reducing TTDs for NMSC in DSP. Action initiatives include continued educational efforts to increase awareness of NMSC risk in DSP and more rigorous routine skin cancer screening.</description><identifier>ISSN: 2168-8184</identifier><identifier>EISSN: 2168-8184</identifier><identifier>DOI: 10.7759/cureus.54027</identifier><identifier>PMID: 38481907</identifier><language>eng</language><publisher>United States: Cureus Inc</publisher><subject>Biopsy ; Defects ; Dermatology ; Ethnicity ; Females ; Hispanic Americans ; Medical diagnosis ; Medical research ; Melanoma ; Morbidity ; Mortality ; Oncology ; Public Health ; Skin cancer ; Software ; Squamous cell carcinoma ; Surgery ; Surgical outcomes</subject><ispartof>Curēus (Palo Alto, CA), 2024-02, Vol.16 (2), p.e54027-e54027</ispartof><rights>Copyright © 2024, Borda et al.</rights><rights>Copyright © 2024, Borda et al. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2024, Borda et al. 2024 Borda et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c300t-2fa3ad86d3684ee6c0ad05a880a291faf916947a93daca968afebf7dcb7c0de43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10932725/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10932725/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53770,53772</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38481907$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Borda, Luis J</creatorcontrib><creatorcontrib>Encarnacion, Iain Noel M</creatorcontrib><creatorcontrib>Saal, Ryan C</creatorcontrib><creatorcontrib>Higgins Ii, H William</creatorcontrib><creatorcontrib>Pariser, Robert J</creatorcontrib><title>Discrepancies in Non-Mohs Micrographic Surgery for Non-melanoma Skin Cancer Between Lighter-Skinned and Darker-Skinned Patients</title><title>Curēus (Palo Alto, CA)</title><addtitle>Cureus</addtitle><description>Non-melanoma skin cancer (NMSC) is highly prevalent in the United States, with darker-skinned patients (DSP) exhibiting lower incidence but increased morbidity and mortality. The purpose of this study is to elucidate NMSC disparities between DSP (Fitzpatrick skin phototype IV or more) and lighter-skinned patients (LSP, Fitzpatrick skin phototype III or less), focusing on surgical features of non-Mohs micrographic surgery-treated NMSC.
This retrospective cohort study included LSP and DSP diagnosed with either basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) in an academic dermatology setting. Variables collected included age, gender, type of NMSC, location, staging, time-to-diagnosis (TTD), pre-operative lesion size, and post-operative defect size. Categorical variables were reported as counts and percentages, while the association between categorical variables was assessed using a two-tailed Fisher's test. A paired t-test was used to determine the association between continuous variables. P-values <0.05 were considered statistically significant.
A total of 27 patients with NMSC were identified, of which 9 (33.3%) were DSP. Patients of darker skin were predominantly female (n=7; 77.8%), while no gender predilection was found in LSP (n=9; 50.0% female; p=0.23). Time-to-diagnosis was significantly longer in DSP than in LSP (61.3 weeks vs 25.1 weeks, respectively; p = 0.02). Despite this, there was no statistical difference in terms of staging, pre-operative lesion size (11.89 mm in DSP vs 10.76 mm in LSP, p=0.75), and post-operative defect size (45.56 ± 29.21 mm in DSP vs 31.22 ± 19.60 mm in LSP; p=0.33).
Darker-skinned patients had a longer TTD without staging differences. Our study confirms the need for reducing TTDs for NMSC in DSP. Action initiatives include continued educational efforts to increase awareness of NMSC risk in DSP and more rigorous routine skin cancer screening.</description><subject>Biopsy</subject><subject>Defects</subject><subject>Dermatology</subject><subject>Ethnicity</subject><subject>Females</subject><subject>Hispanic Americans</subject><subject>Medical diagnosis</subject><subject>Medical research</subject><subject>Melanoma</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Oncology</subject><subject>Public Health</subject><subject>Skin cancer</subject><subject>Software</subject><subject>Squamous cell carcinoma</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><issn>2168-8184</issn><issn>2168-8184</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkcFvFCEUxomxsU3tzbMh8eLBqTDMDHAyurVqslWT6pm8hTe7tDuwwoymp_7r0m7bbHuC8H7ve7zvI-QVZ8dStvq9nRJO-bhtWC2fkYOad6pSXDXPd-775CjnC8YYZ7Jmkr0g-0I1imsmD8j1ic824QaC9ZipD_R7DNVZXGV65m2KywSblbf0fEpLTFe0j-mWGHANIQ5Azy9Lz6y0Y6KfcPyHGOjcL1cjpuqmFtBRCI6eQLrcefoJo8cw5pdkr4d1xqO785D8Pv38a_a1mv_48m32cV5ZwdhY1T0IcKpzolMNYmcZONaCUgxqzXvoNe90I0ELBxZ0p6DHRS-dXUjLHDbikHzY6m6mxYDOltkJ1maT_ADpykTw5nEl-JVZxr-GMy1qWbdF4e2dQop_JsyjGYp1uC4-YJyyqXUredd2rSjomyfoRZxSKPsZwUoETVOgQr3bUsXmnBP2D7_hzNyka7bpmtt0C_56d4MH-D5L8R8AbqQ7</recordid><startdate>20240211</startdate><enddate>20240211</enddate><creator>Borda, Luis J</creator><creator>Encarnacion, Iain Noel M</creator><creator>Saal, Ryan C</creator><creator>Higgins Ii, H William</creator><creator>Pariser, Robert J</creator><general>Cureus Inc</general><general>Cureus</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20240211</creationdate><title>Discrepancies in Non-Mohs Micrographic Surgery for Non-melanoma Skin Cancer Between Lighter-Skinned and Darker-Skinned Patients</title><author>Borda, Luis J ; Encarnacion, Iain Noel M ; Saal, Ryan C ; Higgins Ii, H William ; Pariser, Robert J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c300t-2fa3ad86d3684ee6c0ad05a880a291faf916947a93daca968afebf7dcb7c0de43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Biopsy</topic><topic>Defects</topic><topic>Dermatology</topic><topic>Ethnicity</topic><topic>Females</topic><topic>Hispanic Americans</topic><topic>Medical diagnosis</topic><topic>Medical research</topic><topic>Melanoma</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Oncology</topic><topic>Public Health</topic><topic>Skin cancer</topic><topic>Software</topic><topic>Squamous cell carcinoma</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Borda, Luis J</creatorcontrib><creatorcontrib>Encarnacion, Iain Noel M</creatorcontrib><creatorcontrib>Saal, Ryan C</creatorcontrib><creatorcontrib>Higgins Ii, H William</creatorcontrib><creatorcontrib>Pariser, Robert J</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Curēus (Palo Alto, CA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Borda, Luis J</au><au>Encarnacion, Iain Noel M</au><au>Saal, Ryan C</au><au>Higgins Ii, H William</au><au>Pariser, Robert J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Discrepancies in Non-Mohs Micrographic Surgery for Non-melanoma Skin Cancer Between Lighter-Skinned and Darker-Skinned Patients</atitle><jtitle>Curēus (Palo Alto, CA)</jtitle><addtitle>Cureus</addtitle><date>2024-02-11</date><risdate>2024</risdate><volume>16</volume><issue>2</issue><spage>e54027</spage><epage>e54027</epage><pages>e54027-e54027</pages><issn>2168-8184</issn><eissn>2168-8184</eissn><abstract>Non-melanoma skin cancer (NMSC) is highly prevalent in the United States, with darker-skinned patients (DSP) exhibiting lower incidence but increased morbidity and mortality. The purpose of this study is to elucidate NMSC disparities between DSP (Fitzpatrick skin phototype IV or more) and lighter-skinned patients (LSP, Fitzpatrick skin phototype III or less), focusing on surgical features of non-Mohs micrographic surgery-treated NMSC.
This retrospective cohort study included LSP and DSP diagnosed with either basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) in an academic dermatology setting. Variables collected included age, gender, type of NMSC, location, staging, time-to-diagnosis (TTD), pre-operative lesion size, and post-operative defect size. Categorical variables were reported as counts and percentages, while the association between categorical variables was assessed using a two-tailed Fisher's test. A paired t-test was used to determine the association between continuous variables. P-values <0.05 were considered statistically significant.
A total of 27 patients with NMSC were identified, of which 9 (33.3%) were DSP. Patients of darker skin were predominantly female (n=7; 77.8%), while no gender predilection was found in LSP (n=9; 50.0% female; p=0.23). Time-to-diagnosis was significantly longer in DSP than in LSP (61.3 weeks vs 25.1 weeks, respectively; p = 0.02). Despite this, there was no statistical difference in terms of staging, pre-operative lesion size (11.89 mm in DSP vs 10.76 mm in LSP, p=0.75), and post-operative defect size (45.56 ± 29.21 mm in DSP vs 31.22 ± 19.60 mm in LSP; p=0.33).
Darker-skinned patients had a longer TTD without staging differences. Our study confirms the need for reducing TTDs for NMSC in DSP. Action initiatives include continued educational efforts to increase awareness of NMSC risk in DSP and more rigorous routine skin cancer screening.</abstract><cop>United States</cop><pub>Cureus Inc</pub><pmid>38481907</pmid><doi>10.7759/cureus.54027</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Biopsy Defects Dermatology Ethnicity Females Hispanic Americans Medical diagnosis Medical research Melanoma Morbidity Mortality Oncology Public Health Skin cancer Software Squamous cell carcinoma Surgery Surgical outcomes |
| title | Discrepancies in Non-Mohs Micrographic Surgery for Non-melanoma Skin Cancer Between Lighter-Skinned and Darker-Skinned Patients |
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