Increasing Mohs Micrographic Surgery Utilization in Darker Skin Phenotypes From 2011 to 2022

Skin cancer incidence continues to rise, yet national treatment trends among lighter- and darker-skinned patient populations have not been compared.

To evaluate procedural skin cancer treatments trends.

The authors used Optum's deidentified Clinformatics Data Mart Database (2011-2022) to identify patients with light skin (race value: White; Skin Color Ethnicity [SCE] I‒III) and those with darker skin (race values: African, Asian, Hispanic; SCE IVa-VI). The authors identified skin cancer treatments using Current Procedural Treatment codes for Mohs Micrographic Surgery (MMS), wide local excision (WLE), and destructive skin cancer treatments with same-day International Classification of Disease 9/10 codes for basal cell carcinoma, squamous cell carcinoma, melanoma, and Merkel cell carcinoma. Mann-Kendall tests and Joinpoint analysis assessed trends over time and evaluated average annual percent changes (AAPCs).

The authors included 1,625,367 adult patients with 4,184,496 skin cancer treatments. Annual MMS frequency increased from 2011 to 2022 for both groups {SCE IVa‒VI 53.9% increase, AAPC 3.89% (95% confidence interval [CI] 2.84-4.96, p < .001); SCE I‒III 46.7% increase, AAPC 3.86% (95% CI 3.61-4.12, p < .001)}. The rates for WLE and destructive methods decreased for both populations ( p < .001).

Mohs micrographic surgery utilization is increasing over time for both lighter- and darker-skinned patients.