Racial Differences in Mohs Micrographic Surgery Defect Size: Does Size Matter?
Posted: Friday, November 12, 2021
Non-White patients are at risk of developing non-melanoma skin cancer, yet most relevant studies have focused on White patients. According to a multicenter, retrospective study published in the Journal of the American Academy of Dermatology, disparities may exist between non-Hispanic White patients and Hispanic or Latinx patients with non-melanoma skin cancer. By comparing Mohs micrographic surgery defects between patients, Jenny C. Hu, MD, MPH, of the University of Southern California, Los Angeles, and colleagues found that defect size was significantly larger among Hispanic and Latinx patients than non-Hispanic White patients. Disparities in health insurance also tended to show disproportionately negative outcomes based on socioeconomic status and race.
“During residency training and in continuing medical education, additional focus should be placed on helping dermatologists and primary care physicians recognize skin cancer in [non-White] patients,” the research team concluded.
The investigators analyzed data from 3,486 Mohs micrographic surgeries of basal cell, squamous cell, and basosquamous cell carcinomas. The data were from three major institutions in Los Angeles County, California. Overall, 76% of the study population identified as non-Hispanic White, and 8.8% identified as Hispanic or Latinx. A secondary objective evaluated the effect of insurance type.
On average, Hispanic and Latinx patients exhibited defect sizes that were 17% larger than those exhibited by non-Hispanic White patients (P = .01). When defect sizes were compared between squamous cell carcinomas and basal cell carcinomas, Hispanic and Latinx patients exhibited defects that were 80% larger versus non-Hispanic White patients (P < .001).
Insurance status also appeared to influence defect sizes. Patients with health maintenance organization (HMO) and Medicaid/HMO had 22% and 52% larger defects, respectively, compared with patients with Medicare (P < .01). By contrast, patients with a preferred provider organization had 10% smaller defect sizes (P = .016).
Disclosure: For full disclosures of the study authors, visit sciencedirect.com.
