Mohs micrographic surgery as treatment option for non-basal cell or squamous cell carcinomas in the United States

Background: Skin cancer has the highest incidence of all cancers in the United States. Conventional surgical excision (CSE) and Mohs micrographic surgery (MMS) are among the most common surgical treatment options for skin cancer.Objective: The purpose of this study was to examine utilization patterns of MMS compared to CSE in the United States for non-basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) skin cancers.Methods: Data from the NCI SEER program, collected from 1973 to 2015, were retrospectively analyzed. Cases were separated into MMS and CSE. Patient characteristics were analyzed. Multivariate models were fitted to evaluate significant predictors for MMS.Results: Of the total procedures performed during the years 1988-2015, a total of 12,654 MMS cases and 267,291 CSE were considered for analysis. Females, white, and non-Hispanic patients of increasing age were more likely to undergo MMS compared to CSE. Cases diagnosed in the pacific coast, east, and southwest regions were more likely to be treated with MMS compared to those in the northern plains Additionally, in situ cases and of the face had the highest likelihood of being treated with MMS.Conclusions: Studying demographics and tumor characteristics aid in understanding the utilization patterns of MMS.