Copyright 2011 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2011
Nonmelanoma skin cancers (NMSCs), principally basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are the most common human cancers. Accordingly, they are treated in a number of different ways. Unfortunately, there is a lack of high-quality randomized clinical trials comparing different techniques of treatment for NMSC. Recent Cochrane database reviews have focused on interventions for BCC,1 interventions for nonmetastatic cutaneous SCC,2 and a comparison between standard excision and Mohs micrographic surgery (MMS) for eyelid BCC.3 In all of these reviews, a few conclusions become clear. First, there are no high-quality randomized controlled studies comparing frequently used interventions for BCC and SCC. Most studies are case series or case-control studies, and many do not have very extensive follow-up. Second, interventions are hard to compare because they are typically used in very different clinical scenarios. It may be difficult to justify MMS for low-risk tumors and sites or standard excision for high-risk ones. Finally, in an age where cost control is a serious concern, it is difficult to compare the cost-effectiveness of these interventions given the lack of long-term follow-up, complication rates, patient satisfaction, and treatment-associated morbidity.
Tsai KY. Assessing the Treatment of Nonmelanoma Skin Cancers. Arch Dermatol. 2011;147(5):605-606. doi:10.1001/archdermatol.2011.91