Incidence of nonmelanoma skin cancer

The registration of incidence rates of NMSC is likely not correct because NMSC is considered a negligible health problem with low risks of mortality and morbidity. NMSC is curable when it is detected early and appropriately treated; it can also be prevented through protective measures. Therefore, it is important to determine the number of cases in the population. We do know that NMSC is the most common cancer affecting Caucasians, with the incidence increasing worldwide. Australia has the highest incidence of skin cancer in the world; the population-based cancer registry shows that, in Australia, the incidence of this cancer type has increased 1.5-fold over the past 17 years. The incidence of BCC is higher than SCC and the rates in men are higher than women for both cancer types. In 2002, the age-standardized rate per 100,000 population for NMSC was 1170, the rates of BCC were 884, and for SCC were 387. The approximate number of NMSC patients in Australia was 374,000 and an estimated 2% of the Australian population is treated for these cancers each year. The rates increase with age. Four percent of the affected population is older than 40 years and 8% are older than 70. Multiple primary NMSCs are seen frequently. Approximately 40% of cases can develop a second NMSC within 2 years.

NMSC is also the most common malignancy in the United States; however, the exact incidence of NMSC is unknown because NMSC is not reported in most registries. A mathematical model was used to estimate the prevalence of NMSC in the United States. The number of procedures for NMSC among Medicare patients increased 76.9% between 1992 and 2006, from 1,158,298 to 2,048,517. From 2002 to 2006 the number of NMSCs increased 16%; the estimated total number of NMSCs in the United States in 2006 was 3,507,693 and the total number of people treated for NMSC was 2,152,500. Using mathematical research from the National Health Interview Survey, 2007, and the National Cancer Institute Skin Cancer Incidence Data (1977–1978), it is estimated that 13 million white non-Hispanic individuals in the United States in 2007 had a history of at least 1 NMSC and 1 in 5 people aged 70 years or older was diagnosed with NMSC.

No reliable epidemiologic data exist for NMSC in most European Union countries because these low-grade carcinomas are not recorded. Studies show that in Europe, there was an increase of the incidence of NMSC during the 25-year period between 1978 and 2002. Women were more affected with NMSC, and the highest rate was obtained in Switzerland (Geneva) between 1998 and 2002. The incidence rate was found to be 113 per 100,000. In men, the highest incidence was observed in Ireland, with an incidence rate of 146 per 100,000 persons. In Europe, the highest incidence was observed in Switzerland and Ireland. The average incidence rates in England were 76 of 100,000 persons for BBC and 22 of 100,000 persons for SCC.

Health care costs of nonmelanoma skin cancer

The increasing incidence of NMSC has an important impact on health care costs. Skin cancer has the potential to lead to years of potential life lost and lost productivity. Findings from a study estimated the average number of years of potential life lost per death for NMSC of 10. The prevalence of skin cancer cases is approximately 5 times higher than the prevalence of breast or prostate cancer and higher than the prevalence of all other cancers. Compared with other cancer types, NMSC treatment costs are currently low because NMSC can be primarily treated efficiently in office-based settings. NMSC care cost stands in fifth place after prostate, lung, colon, and breast carcinomas. Cost of NMSC care depends on 2 factors: care settings and treatment modalities. Treatment modalities include surgical excision, microscopically controlled surgical excision (Mohs surgery), radiation therapy electrodessication, curettage, cryosurgery, laser ablation photodynamic therapy, and topical chemotherapeutic agents.