RESUMEN
OBJECTIVES: To estimate the incidence of nonmelanoma skin cancer (NMSC) in the US population in 2006 and secondarily to indicate trends in numbers of procedures for skin cancer treatment. DESIGN: A descriptive analysis of population-based claims and US Census Bureau data combined with a population-based cross-sectional survey using multiple US government data sets, including the Centers for Medicare and Medicaid Services Fee-for-Service Physicians Claims databases, to calculate totals of skin cancer procedures performed for Medicare beneficiaries in 1992 and from 1996 to 2006 and related parameters. The National Ambulatory Medical Care Service database was used to estimate NMSC-related office visits. We combined these to estimate totals of new skin cancer diagnoses and affected individuals in the overall US population. RESULTS: The total number of procedures for skin cancer in the Medicare fee-for-service population increased by 76.9% from 1 158 298 in 1992 to 2 048 517 in 2006. The age-adjusted procedure rate per year per 100 000 beneficiaries increased from 3514 in 1992 to 6075 in 2006. From 2002 to 2006 (the years for which the databases allow procedure linkage to patient demographics and diagnoses), the number of procedures for NMSC in the Medicare population increased by 16.0%. In this period, the number of procedures per affected patient increased by 1.5%, and the number of persons with at least 1 procedure increased by 14.3%. We estimate the total number of NMSCs in the US population in 2006 at 3 507 693 and the total number of persons in the United States treated for NMSC at 2 152 500. CONCLUSIONS: The number of skin cancers in Medicare beneficiaries increased dramatically over the years 1992 to 2006, due mainly to an increase in the number of affected individuals. Using nationally representative databases, we provide evidence of much higher overall totals of skin cancer diagnoses and patients in the US population than previous estimates. These data give the most complete evaluation to date of the underrecognized epidemic of skin cancer in the United States.
Asunto(s)
Vigilancia de la Población/métodos , Medición de Riesgo/métodos , Neoplasias Cutáneas/epidemiología , Anciano , Estudios Transversales , Humanos , Incidencia , Medicare/estadística & datos numéricos , Estudios Retrospectivos , Factores de Riesgo , Neoplasias Cutáneas/diagnóstico , Estados Unidos/epidemiologíaRESUMEN
Granuloma annulare is a dermatologic condition of unknown etiology that has been associated with systemic diseases and reported to be a paraneoplastic manifestation. Two patients with generalized granuloma annulare as an initial manifestation of chronic myelomonocytic leukemia are herein described. We suggest that chronic myelomonocytic leukemia should be added to the list of systemic diseases associated with generalized granuloma annulare.
Asunto(s)
Granuloma Anular/diagnóstico , Leucemia Mielomonocítica Crónica/diagnóstico , Anciano , Antimetabolitos Antineoplásicos/uso terapéutico , Azacitidina/análogos & derivados , Azacitidina/uso terapéutico , Decitabina , Diagnóstico Diferencial , Resultado Fatal , Granuloma Anular/tratamiento farmacológico , Granuloma Anular/etiología , Humanos , Leucemia Mielomonocítica Crónica/complicaciones , Leucemia Mielomonocítica Crónica/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Terapia PUVARESUMEN
In a linguistically diverse society, healthcare professionals must overcome the daunting task of effectively communicating with patients who speak a different language. In effort to aid healthcare professionals and their patients, an on-line dermatology patient education resource was created with links to various skin related topics in over 30 languages. The development of the on-line resource, key features of the information available on the website, and limitations experienced during its creation are discussed in the article.