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September 10, 2014

Potential Overdiagnosis of Basal Cell Carcinoma in Older Patients With Limited Life Expectancy

Author Affiliations
  • 1Department of Dermatology, University of California, San Francisco
  • 2Department of Medicine, University of California, San Francisco
  • 3Dermatology Service, San Francisco Veterans Affairs Medical Center, San Francisco, California
JAMA. 2014;312(10):997-998. doi:10.1001/jama.2014.9655

More patients are diagnosed with basal cell carcinoma (BCC) in the United States each year than all other cancers combined—more than 2.5 million BCCs compared with 1.7 million other cancers.13 Most of these BCCs occur in people aged 65 years and older, and each year, more than 100 000 BCCs are treated in persons who ultimately die within 1 year. Procedures to remove skin cancers have doubled in the last 15 years, and the use of Mohs surgery, histologically guided serial excision, increased by 400% between 1995 and 2009.4 Many clinicians have suggested that this is an epidemic of skin cancer1 attributed to excessive sun exposure, a thinning ozone layer, and indoor tanning. These numbers will likely increase further; as the number of older adults doubles between 2010 and 2030, overall cancer incidence is projected to increase 45%.5

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