Patients with skin of color experience disparities in non-melanoma skin cancer

Patients with skin of color are more likely to have larger Mohs micrographic surgery defect sizes than white patients, highlighting disparities in non-melanoma skin cancer, according to a presentation.

“The objective of our study was to examine racial and ethnic disparities in non-melanoma skin cancer using Mohs micrographic surgery defect sizes as a close approximation of carcinoma size,” Julia Arzeno, MD, a micrographic surgery and dermatologic oncology fellow at the University of California, Los Angeles, said during the presentation at the American Society for Dermatologic Surgery virtual meeting.

A multicenter, retrospective study compared Mohs micrographic surgery sizes between white and Hispanic/Latino patients.

Of 3,486 patients with basal cell carcinoma, squamous cell carcinoma or basosquamous carcinoma, 76% identified as white or non-Hispanic, 8.8% identified as Hispanic or Latino, 1.7% identified as Asian and 13.5% identified as unknown or mixed race.

The Hispanic/Latino patients had 17% larger Mohs micrographic surgery defect sizes compared with white patients, and when comparing squamous cell carcinomas with basal cell carcinomas, the Hispanic/Latino patients had 80% larger defect sizes.

The study also compared defect sizes considering insurance type, using Medicare as the baseline.

Those with HMO insurance had 22% larger defect size and those with Medi-Cal insurance had 52% larger defect sizes. Those with preferred provider organization insurance had the smallest defect sizes at 10% smaller than those with Medicare, according to Arzeno.

“These findings of larger Mohs defect sizes are critical as they are a further indication of health disparities based on race, ethnicity and type of insurance,” she said. “Patients and the medical community need to be cognizant that patients can develop skin cancer regardless of their race and ethnicity.”