Dermatologic surgeons likely to propose pharmacologic nonmelanoma skin cancer prevention

Most dermatologic surgeons recommended pharmacologic interventions to prevent nonmelanoma skin cancer, according to a presentation at the American Society for Dermatologic Surgery annual meeting.

An eight-question survey was sent to dermatologic surgeons of the American College of Mohs Surgery to assess prescribing practices for nonmelanoma skin cancer (NMSC) prevention.

Of 85 respondents, 95.3% recommended intervention for NMSC prevention, with 84.2% recommending nicotinamide, 59.8% recommending acitretin and 39% recommending topical retinoids. Further analysis found 45% of respondents recommended preventive therapies after five or more NMSCs and more than 10% recommended preventive therapies among patients with actinic keratoses but no history of NMSC.

Physicians in practice for less than 5 years were 7.41 times more likely to recommend nicotinamide compared with those in practice for more than 15 years (P = .017). Physicians in academic settings were more likely to recommend twice-daily nicotinamide 500 mg compared with once-daily nicotinamide 500 mg for physicians in private practice (P = .01).

“Prescribing practices varied by years in practice — the observed differences cannot solely be attributed to differences in practice settings: There was no significant association between years in practice and practice setting,” Julia Arzeno, MD, of the division of dermatology, University of California, Los Angeles, and colleagues wrote. “Studies that directly compare the efficacy of preventative interventions for NMSCs and establish guidelines regarding the threshold for initiating such therapies are needed.”