34714 Contextualization of skin cancer incidence rates in Costa Rica

Abstract

Costa Rica is the only Central American country with a higher life expectancy than the United States. However, there are limited studies that characterize the country’s skin cancer burden. We contextualize regional trends on the incidence of skin cancer in Costa Rica through the lens of poverty rates and the estimated proportional density of dermatologists per province. The last report from the Ministerio de Salud de Costa Rica on the incidence of malignancies includes data from 2014. When combining incidence data on the female and male populations through an average weighing the country’s sex ratio, the highest rate was seen in San José (72.99 per 100,000 individuals) and the lowest rates in Limón and Guanacaste (31.78 and 38.56 per 100,000 individuals, respectively). A weak negative correlation was identified between skin cancer incidence and poverty rates across provinces (r = -0.195, r2 = 0.038). We identified a strong positive correlation between the incidence rate of skin cancer and the proportional density of dermatologists across provinces (r = 0.6464, r2 = 0.4178), and a strong negative correlation between the latter and poverty rates (r = -0.739, r2 = 0.546 ) These relationships suggest several possibilities, including: (1) more dermatologists translates to better access to skin examinations and biopsies, (2) a lower number of dermatologists in poorer provinces contributes to underdetection of skin cancer, and/or (3) overdiagnosis of skin cancer may be occurring and is more pronounced in provinces with more dermatologists. Further investigations are needed to elucidate the implications of these findings.