The Period Prevalence and Costs of Treating Nonmelanoma Skin Cancers in Patients Over 65 Years of Age Covered by Medicare

BACKGROUND Nonmelanoma skin cancer (NMSC) prevalence and treatment costs are rapidly increasing at an unknown rate. OBJECTIVE To determine actual prevalence and treatment costs for NMSC in patients over 65 years of age covered by Medicare. METHODS We used a 5% random sample of Medicare claims available for 1994 and 1995. Demographic characteristics, period prevalence, treatment types and frequencies, treating physician specialty, and allowable treatment charges associated with the diagnosis of NMSC were analyzed and described. RESULTS More than 789,000 patients over age 65 covered by Medicare had a diagnosis and treatment for NMSC in 1995. Fifty-eight percent were men and 98% were Caucasian. The majority were from the South and West regions of the United States. Dermatologists treated more than 60% of these NMSCs. Treatment costs were approximately $285 million. The largest percentage of treatment expenditures (34%) was for excisions. CONCLUSION The number of patients with NMSC is far greater than previous estimates. Dermatologists treat the majority of NMSCs. The mean treatment cost per patient is $329. Total expenditures for NMSC eradication represent 0.7% of the Medicare budget. NMSC is a major public health concern because of its increasing prevalence, costs, and the aging U.S. population.