Documenting Dermatology Practice: Ratio of Cutaneous Tumors Biopsied That Are Malignant

BACKGROUND: Skin biopsy is an important part of dermatology practice. Little is known regarding dermatologist biopsying practices. OBJECTIVE: The objective was to assess the ratio of malignant lesions biopsied in practice and factors that influence this ratio. METHODS: Using a dermatopathology database, we analyzed tumors biopsied by dermatologists to determine the ratio of malignant to all tumors (malignancy ratio). Additional analyses were performed for factors influencing this ratio. RESULTS: Over 6 months, 11,072 tumors were submitted. Overall, the malignancy ratio was 41.7%, 3.8% for pigmented lesions. Practice type, location, or use of dermatoscopy did not influence this ratio; provider age was positively correlated with a higher malignancy ratio (r=0.51; p=0.02) and was a predictor of malignancy ratio (b=0.02; p=0.04). CONCLUSION: Approximately 40% of biopsied tumors were malignant. Dermatologists exhibit a wide range in their individual practice patterns. Increasing provider age predicted higher malignancy ratios with a 2% increase for each incremental year.