Patients With Skin Cancer Prefer to Participate in Procedure Cost Discussions: A Cross-Sectional Survey

We report the prevalence and economic cost of skin cancer treatment compared to other cancers overall in the USA from 2012 to 2018. Using the Medical Expenditure Panel Survey full-year consolidated data files and associated medical conditions and medical events files, we estimate the prevalence, total costs, and per-person costs of treatment for melanoma and non-melanoma skin cancer among adults aged ≥ 18years in the USA. To understand the changes in treatment prevalence and treatment costs of skin cancer in the context of overall cancer treatment, we also estimate the prevalence, total costs, and per-person costs of treatment for non-skin cancer among US adults. During 2012-15 and 2016-18, the average annual number of adults treated for any skin cancer was 5.8 (95% CI: 5.2, 6.4) and 6.1 (95% CI: 5.6, 6.6) million, respectively, while the average annual number of adults treated for non-skin cancers rose from 10.8 (95% CI: 10.0, 11.5) to 11.9 (95% CI: 11.2, 12.6) million, respectively. The overall estimated annual costs rose from $8.0 (in 2012-2015) to $8.9 billion (in 2016-18) for skin cancer treatment and $70.2 to $79.4 billion respectively for non-skin cancer treatment. The prevalence and economic cost of skin cancer treatment modestly increased in recent years. Given the substantial cost of skin cancer treatment, continued public health attention to implementing evidence-based sun-safety interventions to reduce skin cancer risk may help prevent skin cancer and the associated treatment costs.

There are poorly documented variations in the journey a skin cancer patient will follow from diagnosis to treatment in the European Union. To investigate the possible difficulties or obstacles that a person with a skin malignancy in the European Union may have to overcome in order to receive adequate medical screening and care for his/her condition. In addition, we wished to explore differences in European health systems, which may lead to health inequalities and health inequities within Europe. Ten European countries took part in this investigation (in alphabetical order): Finland, Germany, Greece, Italy, Malta, Poland, Romania, Spain, the Netherlands and the U.K. The individual participants undertook local and national enquiries within their own country and completed a questionnaire. This exercise has identified important differences in the management of a skin cancer patient, reflecting major disparities in health care between European countries. Further investigation of health disparities and efforts to address health inequalities should lead to improvements in European health care quality and reduction in morbidity from skin cancer.

Skin biopsy and skin cancer treatment use in the Medicare population, 1993 to 2016

Nonmelanoma skin cancer (NMSC) prevalence and treatment costs are rapidly increasing at an unknown rate. To determine actual prevalence and treatment costs for NMSC in patients over 65 years of age covered by Medicare. We used a 5% random sample of Medicare claims available for 1994 and 1995. Demographic characteristics, period prevalence, treatment types and frequencies, treating physician specialty, and allowable treatment charges associated with the diagnosis of NMSC were analyzed and described. More than 789,000 patients over age 65 covered by Medicare had a diagnosis and treatment for NMSC in 1995. Fifty-eight percent were men and 98% were Caucasian. The majority were from the South and West regions of the United States. Dermatologists treated more than 60% of these NMSCs. Treatment costs were approximately $285 million. The largest percentage of treatment expenditures (34%) was for excisions. The number of patients with NMSC is far greater than previous estimates. Dermatologists treat the majority of NMSCs. The mean treatment cost per patient is $329. Total expenditures for NMSC eradication represent 0.7% of the Medicare budget. NMSC is a major public health concern because of its increasing prevalence, costs, and the aging U.S. population.

BACKGROUND Nonmelanoma skin cancer (NMSC) prevalence and treatment costs are rapidly increasing at an unknown rate. OBJECTIVE To determine actual prevalence and treatment costs for NMSC in patients over 65 years of age covered by Medicare. METHODS We used a 5% random sample of Medicare claims available for 1994 and 1995. Demographic characteristics, period prevalence, treatment types and frequencies, treating physician specialty, and allowable treatment charges associated with the diagnosis of NMSC were analyzed and described. RESULTS More than 789,000 patients over age 65 covered by Medicare had a diagnosis and treatment for NMSC in 1995. Fifty-eight percent were men and 98% were Caucasian. The majority were from the South and West regions of the United States. Dermatologists treated more than 60% of these NMSCs. Treatment costs were approximately $285 million. The largest percentage of treatment expenditures (34%) was for excisions. CONCLUSION The number of patients with NMSC is far greater than previous estimates. Dermatologists treat the majority of NMSCs. The mean treatment cost per patient is $329. Total expenditures for NMSC eradication represent 0.7% of the Medicare budget. NMSC is a major public health concern because of its increasing prevalence, costs, and the aging U.S. population.

A comparison of skin cancer screening and treatment costs at a Massachusetts cancer center, 2008 versus 2013

The most common form of cancer in Brazil is non-melanoma skin cancer, which affects approximately 0.06% of the population. There are no public policies for its prevention and the economic impact of its diagnosis has yet to be established. To estimate the costs of the diagnosis and treatment of non-melanoma skin cancer in the state of São Paulo between 2000 and 2007 and to compare them with the costs associated with skin melanoma in the same period. The Clinical Practice Guidelines in Oncology (National Comprehensive Cancer Network) was used as a procedure model, adapted to the procedures at the SOBECCan Foundation at the Ribeirão Preto Cancer Hospital in São Paulo. The estimated costs were based on the costs of medical treatment in the public and private sectors in 2007. The mean annual costs of each individual treatment of non-melanoma skin cancer were much lower than those estimated for the treatment of skin melanoma. Nevertheless, when the total costs of the treatment of non-melanoma skin cancer were taken into consideration, it was found that the total cost of the 42,184 cases of this type of cancer in São Paulo within the study period was 14% higher than the costs of the 2,740 cases of skin melanoma registered in the same period within the Brazilian National Health Service (SUS). However, in the private sector, the total cost was approximately 34% less for the treatment of non-melanoma skin cancer compared to melanoma. The high number of cases of non-melanoma skin cancer in Brazil, with 114,000 new cases predicted for 2010, 95% of which are diagnosed at early stages, represents a financial burden to the public and private healthcare systems of around R$37 million and R$26 million annually, respectively.

The cumulative personal, functional, and cosmetic burdens of skin cancer are compounded by massive health care expenditures (,). Nonmelanoma skin cancer (NMSC) treatment in the Medicare population alone amounts to $426 million annually (), and malignant melanoma, or melanoma skin cancer (MSC) has been estimated to cost approx $1 billion annually (). Although these estimates are based on different populations and disease categories, they provide a measure of the vast direct and indirect costs of skin cancer screening, biopsy, and treatment. Despite this heavy toll, skin cancer remains a relatively underexplored area of chemoprevention research, perhaps illustrating the medical paradox that “rare conditions are intensively studied, while common conditions are often overlooked” ().

There is a skin cancer epidemic in the United States. To examine skin cancer treatment modality, location, and cost and physician specialty in the Medicare population from 1996 to 2008. Centers for Medicare and Medicaid Services databases were used to examine skin cancer treatment procedures performed for Medicare beneficiaries. From 1996 to 2008, the total number of skin cancer treatment procedures [malignant excision, destruction, and Mohs micrographic surgery (MMS)] increased from 1,480,645 to 2,152,615 (53% increase). The numbers of skin cancers treated by excision and destruction increased modestly (20% and 39%, respectively), but the number of MMS procedures increased more rapidly (248% increase). Dermatologists treated an increasing percentage (75-82%) of skin cancers during these years, followed by plastic and general surgery. In 2008, more than 90% of all skin cancers were treated in the office, with the remainder being treated in facility-based settings. Allowable charges paid to physicians by Medicare Part B for skin cancer treatments increased 137% from 1996 to 2008, from $266,960,673 to $633,448,103. The number of skin cancer treatment procedures increased substantially from 1996 to 2008, as did overall costs to Medicare. Dermatologists treated the vast majority of skin cancers in the Medicare population, using a mix of treatment modalities, almost exclusively in the office setting.

5-fluorouracil (5-Fu) is an antineoplastic drug, topically used for the treatment of actinic keratosis and nonmelanoma skin cancer. It shows poor percutaneous permeation through the conventionally applicable creams and thus inefficient for the treatment of deep-seated skin cancer. In the present article, transfersomal gel containing 5-Fu was investigated for the treatment of skin cancer. Different formulation of tranfersomes was prepared using Tween-80 and Span-80 as edge activators. The vesicles were characterized for particle size, shape, entrapment efficiency, deformability and in vitro skin permeation. Optimized formulation was incorporated into 1% carbopol 940 gel and evaluated for efficacy in the treatment of skin cancer. 5-Fu-loaded transfersomes (TT-2) has the size of 266.9 ± 2.04 nm with 69.2 ± 0.98% entrapment efficiency and highest deformability index of 27.8 ± 1.08. Formulation TT-2 showed maximum skin deposition (81.3%) and comparable transdermal flux of 21.46 µg/cm2 h. The TT-2-loaded gel showed better skin penetration and skin deposition of the drug than the marketed formulation. Composition of the transfersomal gel has been proved nonirritant to the skin. We concluded that the developed 5-Fu-loaded transfersomal gel improves the skin absorption of 5-Fu and provide a better treatment for skin cancer.

Background: The aim of this presentation is to provide an update on the economic evaluation of the Australian SunSmart program as well as outline the cost of skin cancer treatment to the Victorian public hospital system. This follows the publication of two recently released published economic evaluations that discusses the potential effects of skin cancer prevention inventions. Aim: 1. To highlight the cost effectiveness of skin cancer prevention in Australia 2. To highlight the costs of skin cancer treatment in the Victorian public hospital system 3. To provide strong evidence to inform governments of the value of skin cancer prevention to reduce the costs of treatment in future years. Methods: Program cost was compared with cost savings to determine the investment return of the program. In a separate study, a prevalence-based cost approach was undertaken in public hospitals in Victoria. Costs were estimated for inpatient admissions, using state service statistics, and outpatient services based on attendance at three hospitals in 2012-13. Cost-effectiveness for prevention was estimated from 'observed vs expected' analysis, together with program expenditure data. Results: With additional $AUD 0.16 ($USD 0.12) per capita investment into skin cancer prevention across Australia from 2011 to 2030, an upgraded SunSmart Program would prevent 45,000 melanoma and 95,000 NMSC cases. Potential savings in future healthcare costs were estimated at $200 million, while productivity gains were significant. A future upgraded SunSmart Program was predicted to be cost-saving from the funder perspective, with an investment return of $3.20 for every additional dollar the Australian governments/funding bodies invested into the program. In relation to the costs to the Victorian public hospital system, total annual costs were $48 million to $56 million. Skin cancer treatment in public hospitals ($9.20∼$10.39 per head/year) was 30-times current public funding in skin cancer prevention ($0.37 per head/year). Conclusion: The study demonstrates the strong economic credentials of the SunSmart Program, with a strong economic rationale for increased investment. Increased funding for skin cancer prevention must be kept high on the public health agenda. This would also have the dual benefit of enabling hospitals to redirect resources to nonpreventable conditions.

Assessment of society for assisted reproductive technology (SART) fertility clinic websites for male infertility information and resources

Despite reports of increases in the cost of cancer treatment, little is known about how costs of cancer treatment have changed over time and what services have contributed to the increases. We used data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database for 306,709 persons aged 65 and older and diagnosed with breast, lung, colorectal, or prostate cancer between 1991 and 2002 to assess the number of patients assigned to initial cancer care, from 2 months before diagnosis to 12 months after diagnosis, and mean annual Medicare payments for this care according to cancer type and type of treatment. Mutually exclusive treatment categories were cancer-related surgery, chemotherapy, radiation therapy, and other hospitalizations during the period of initial cancer care. Linear regression models were used to assess temporal trends in the percentage of patients receiving treatment and costs for those treated. We extrapolated our results based on the SEER data to the US Medicare population to estimate national Medicare payments by cancer site and treatment category. All statistical tests were two-sided. For patients diagnosed in 2002, Medicare paid an average of $39,891 for initial care for each lung cancer patient, $41 134 for each colorectal cancer patient, and $20,964 for each breast cancer patient, corresponding to inflation-adjusted increases from 1991 of $7139, $5345, and $4189, respectively. During the same interval, the mean Medicare payment for initial care for prostate cancer declined by $196 to $18261 in 2002. Costs for any hospitalization accounted for the largest portion of payments for all cancers. Chemotherapy use increased markedly for all cancers between 1991 and 2002, as did radiation therapy use (except for colorectal cancers). Total 2002 Medicare payments for initial care for these four cancers exceeded $6.7 billion, with colorectal and lung cancers being the most costly overall. The statistically significant increase in costs of initial cancer treatment reflects more patients receiving surgery and adjuvant therapy and rising prices for these treatments. These trends are likely to continue in the near future, although more efficient targeting of costly therapies could mitigate the overall economic impact of this trend.

Cancer is a group of diseases occurring in all regions of the world and is the cause of millions of deaths each year. It is believed that approximately 132 000 melanoma skin cancer cases arise each year [1]. This high incidence of skin cancer cases in mostly associated with increased levels of ultraviolet radiation [2]. Plants provide an immeasurable source of bioactive compounds for drug discovery. Some of these plant-derived compounds are currently being used in chemotherapy for the treatment of a variety of cancers [3]. The vast amount of unexplored plants therefore represents the potential of finding new drugs for the treatment of cancer. The current study focuses on the ethanolic leaf and fruit extracts of Combretum molle R. Br. ex G. Don [Combretaceae] and the potential of these extracts for anti-cancer activity against skin cancer and their possible mechanisms of action. The C. molle extracts were investigated for their cytotoxicity and synergistic activity on two human skin cancer cell lines (MEL-1; A431) and a non-cancerous skin cell line (HaCat) using the XTT Cell Proliferation Kit II. Cell death studies of the lead extracts were determined using light microscopy and an Annexin V kit. Other mechanistic studies included inflammation and immunity studies and the anti-metastatic potential of the lead extracts. The leaf extract of C. molle showed the highest cytotoxic activity on the MEL-1 cells with an IC50 of 17.56 µg/ml. The leaf and fruit extracts of Combretum molle showed good activity on the A431 cell line with IC50 values of 27.03 µg/ml and 29.99 µg/ml, respectively. From the light microscopy images morphological characteristics of apoptosis were observed. Both the fruit and leaf extracts also showed significant anti-inflammatory potential. The results obtained for the C. molle extracts indicate that these extracts can be potentially useful as a topical application for the treatment of squamous cell carcinoma and melanoma skin cancer.

in 2020, the incidence of breast cancer was 2261419 cases worldwide, 1186598 cases in Africa and 817 cases in Senegal. However, direct medical costs of cancer treatment are not known in Senegal. For a better resource allocation, it is important to estimate costs. The purpose of this study is to analyze direct medical costs of breast cancer treatment at the Joliot Curie Institute in Dakar. we conducted a retrospective study of patients diagnosed with breast cancer between January and December 2017 at the Joliot Curie Institute. A questionnaire survey and semi-structured interviews were conducted among patients and their relatives to reconstruct direct medical costs. average direct medical costs of breast cancer treatment at the Joliot Curie Institute were $33 713.45 with a minimum of $1 495.15 and a maximum of $10 662.97 over an average period of 31 months. These costs include chemotherapy (29%); diagnosis (15%) and surgery (15%). Costs of radiotherapy and prescription medicines accounted for 13% for each procedure. Medical costs were related to educational level (p=0.05) and stage of disease (p=0.03). direct medical costs of breast cancer treatment are very high in Senegal. Direct medical costs of maximum treatment is $10 662.97 and of minimum treatment is $495.15, reflecting an average cost of $3 713.45.