Scar Concern Exceeds Operative Anxiety in Oncologic Dermatologic Surgery: A Prospective Cohort Study

BACKGROUND Preoperative anxiety is common in surgery. In oncologic dermatology, the favorable prognosis of many skin cancers may create a paradoxical context in which appearance-focused concern outweighs procedure-related anxiety. Prospective data directly comparing these 2 dimensions remain scarce. OBJECTIVE To determine whether preoperative scar concern (Q1b) differs from operative anxiety (Q1a) and identify its determinants. MATERIALS AND METHODS Prospective single-center observational cohort (pseudonymized database, Health Data Hub no. 30762729). One hundred consecutive patients undergoing skin tumor excision self-completed the questionnaire. Operative anxiety and scar concern (0–10 numeric rating scales) were compared using the Wilcoxon signed-rank test; determinants were assessed with Mann–Whitney and Kruskal–Wallis tests. RESULTS Scar concern (median 3.0; IQR 0–5) was significantly higher than operative anxiety (median 2.0; IQR 0–4; W = 519.5; p = .006). Scar concern was associated with female sex ( p = .014), younger age (decreasing gradient, p = .008), and anatomical location ( p = .010) but was not significantly associated with histological subtype ( p = .639). CONCLUSION Scar concern exceeded operative anxiety and was associated with identifiable psychosocial and anatomical factors, supporting targeted appearance-focused preoperative counseling for patients with higher scar concern.