Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Estimating the Cost of Skin Cancer Detection

J Am Acad Dermatol; 2018 Apr; Matsumoto, et al

Melanoma detection through total body skin examination is most efficient in patients aged ≥50 years and those with a personal history of melanoma, a recent study found. Researchers conducted a retrospective observational study in order to determine the number needed to screen (NNS) and biopsy (NNB) and cost per skin cancer diagnosed in a large dermatology practice in patients undergoing total body skin examination. They found:

  • During 2011-2015, a total of 20,270 patients underwent 33,647 visits for total body skin examination; 9,956 lesion biopsies were performed yielding 2,763 skin cancers, including 155 melanomas.
  • The NNS to detect 1 skin cancer was 12.2 and 1 melanoma was 215.
  • The NNB to detect 1 skin cancer was 3.0 and 1 melanoma was 27.8.
  • In a multivariable model for NNS, age and personal history of melanoma were significant factors.
  • Age switched from a protective factor to a risk factor at age 51 years.
  • The estimated cost per melanoma detected was $32,594.

Citation:

Matsumoto M, Secrest A, Anderson A, et al. Estimating the cost of skin cancer detection by dermatology providers in a large health care system. J Am Acad Dermatol. 2018;78(4):701-709.e1. doi:10.1016/j.jaad.2017.11.033.

This Week's Must Reads

Racial Differences in Psoriasis Therapy Perceptions, J Invest Dermatol; ePub 2019 Feb 6; Takeshita, et al

Detecting Atherosclerotic Plaques in Psoriasis, PLoS One; ePub 2019 Feb 8; Gonzalez-Cantero, et al

Smoking, Not Alcohol, Linked with Psoriasis Risk, J Am Acad Dermatol; 2019 Mar; Dai, et al

Maternal Socioeconomic Position, Psoriasis Linked, Br J Dermatol; 2019 Feb; Groot, Nybo Andersen, et al

Psoriasis: A “Protective Effect” Against Allergens?, Br J Dermatol; 2019 Feb; Claßen, et al

Must Reads in Business of Medicine

TNF inhibitor prices rose despite increased drug class competition, San-Juan-Rodriguez A et al. JAMA Intern Med. 2019 Feb 18. doi: 10.1001/jamainternmed.2018.7656

Trends in Medicare Usage by Dermatologists, JAMA Dermatology; ePub 2018 Dec 19; Ya, et al

Outpatient Dermatology Services Disparities Found, JAMA Dermatology; ePub 2018 Sep 26; Tripathi, et al

Actinic Keratosis Treatment Burden in Medicare , JAMA Dermatology; ePub 2018 Sep 19; Yeung, et al

Economic Analysis of Noninvasive Pathologic Assay, JAMA Dermatology; ePub 2018 Jul 11; Hornberger, et al