Association Between Area Deprivation Index and Periocular Basal Cell Carcinoma Treated With Mohs Micrographic Surgery

Purpose: This study aimed to evaluate the association of neighborhood-level disadvantage with periocular basal cell carcinoma (BCC) sizes and time to surgery for patients treated with Mohs micrographic surgery (MMS). Methods: Periocular BCC treated with MMS were identified from a prospectively maintained database from a single institution over 17 years. The Area Deprivation Index (ADI) was used to rank neighborhoods by socioeconomic disadvantage with higher national ADI scores indicative of greater neighborhood-level deprivation. Primary outcomes included pre- and postoperative defect size and time to surgery from diagnosis date. Results: Our study included a total of 1,592 patients. There were greater percentages of non-White ( p < 0.001) and Hispanic or Latino ( p < 0.001) patients in the higher ADI quartiles. Higher ADI was associated with larger preoperative BCC size ( p < 0.001), larger postoperative BCC size ( p < 0.001), and longer time between diagnosis to surgery ( p < 0.001). Conclusions: To the best of our knowledge, this is the first study to analyze associations between periocular BCC treated with MMS and neighborhood-level deprivation in the United States. Disparities in tumor sizes at presentation and delays in surgery for patients with periocular BCC, provide opportunities for further study to promote timely diagnosis and treatment of periocular cutaneous malignancies.