Nationwide Trends in Skin Cancer Incidence, Reconstructive Surgery Utilization, and Economic Burden in the Republic...

To quantify national trends in the incidence, treatment patterns, and direct medical costs of malignant melanoma (MM) and non-melanoma skin cancer (NMSC) in South Korea between 2011 and 2019. We analyzed data from the National Health Insurance Service and Korea Central Cancer Registry and also identified incident cases of basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and MM. Age-standardized incidence rates (ASIRs; Segi World Standards) were calculated. Surgical procedures (wide excision, flap, skin graft, Mohs micrographic surgery), recurrence (repeat surgery ≥6 mo), and medical costs were evaluated. Overall, 43,521 incident skin cancer cases were recorded (BCC 58.9%; SCC 29.7%, MM 11.3%). ASIR doubled from 6.9/100,000 person years between 2011 and 12.0/100,000 in 2019 (average annual percentage change +7.9%). Rural regions had higher incidence rates than metropolitan areas (14.9 vs. 9.8/100,000). Complex reconstructions escalated; flap procedures increased threefold (1341-4038) and Mohs surgery (387-1236). Annual direct medical costs increased from US $66 million to US $177 million (+168%). Recurrence rates were 1.15% for BCC, 1.88% for SCC, and 2.13% for MM. The absolute skin cancer burden in Korea remains modest; however, its incidence, operative complexity, and costs are increasing than what demographic aging alone would predict. Targeted ultraviolet (UV) protection policies, early detection strategies, and resource planning for the reconstruction capacity are required.