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March 2016

Redefinition of Skin Cancer as a Chronic Disease

Author Affiliations
  • 1Department of Dermatology, Keck School of Medicine of USC (University of Southern California), Los Angeles
JAMA Dermatol. 2016;152(3):255-256. doi:10.1001/jamadermatol.2015.4215

Chronic diseases have profound associated morbidity and mortality. In addition to having a significant effect on a patient’s quality of life (QOL), they have substantial direct costs to our health care system and indirect costs to society. At present, all types of cancer except nonmelanoma skin cancer (NMSC) are considered chronic diseases. The exclusion of NMSC as a chronic disease limits our ability to characterize NMSC and to optimize its management for patients.

Nonmelanoma skin cancer has become an epidemic in the United States. The incidence and total cost of treating basal cell and squamous cell carcinoma are increasing annually. In the 18-year period from 1994 to 2012, the estimated incidence of NMSC increased from 1 200 000 to 5 434 193.1 This figure makes the annual incidence of NMSC more than 3 times as common as all other forms of cancer combined.2 The rapid rise in incidence has been closely mirrored by an increase in treatments as dermatologists have devoted more resources and training to the treatment of basal cell and squamous cell carcinoma. From 2007 to 2011, approximately 5 million individuals were treated for skin cancer annually with an estimated annual cost of $8.1 billion. The cost of treating skin cancer just 5 years earlier was $3.6 billion, representing a 126.2% increase.3

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