Disparities in nonmelanoma skin cancer in Hispanic/Latino patients based on Mohs micrographic surgery defect size: A multicenter retrospective study

J Am Acad Dermatol. 2022 Feb;86(2):353-358. doi: 10.1016/j.jaad.2021.08.052. Epub 2021 Oct 5.

Abstract

Background: There is limited literature regarding potential disparities in nonmelanoma skin cancer for patients with skin of color.

Objective: Use the sizes of Mohs micrographic surgery defects to examine disparities in nonmelanoma skin cancer among Hispanic/Latino patients with a secondary aim to examine the effect of insurance type.

Methods: We conducted a multicenter retrospective study using data from 3 major institutions in Los Angeles County. A total of 3486 Mohs micrographic surgeries of basal cell, squamous cell, and basosquamous cell carcinomas were analyzed.

Results: Mohs micrographic surgery defect sizes were 17% larger among Hispanic/Latino patients compared with non-Hispanic White patients. More notably, when comparing defect sizes of squamous cell carcinomas to those of basal cell carcinomas, defects were 80% larger among Hispanic/Latino patients compared to non-Hispanic White patients who had 25% larger defect sizes. Compared to patients with Medicare, patients with health maintenance organization and Medicaid/health maintenance organization had 22% and 52% larger defect sizes, respectively, whereas patients with preferred provider organization, had 10% smaller defect sizes.

Limitations: The data included were from a single county population.

Conclusion: Disparities regarding nonmelanoma skin cancer exist between patients with skin of color and White patients. Patients and the medical community need to be cognizant that skin cancer can develop in patients regardless of their race and ethnicity.

Keywords: Hispanic; Latino; Mohs micrographic surgery; ethnic disparities; nonmelanoma skin cancer; racial disparities; skin cancer; skin of color.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Carcinoma, Basal Cell* / pathology
  • Carcinoma, Basal Cell* / surgery
  • Hispanic or Latino
  • Humans
  • Medicare
  • Mohs Surgery
  • Retrospective Studies
  • Skin Neoplasms* / pathology
  • Skin Neoplasms* / surgery
  • United States / epidemiology