While skin cancer remains a growing major public health problem, a recent study focusing instead on the disease’s economic impact miscommunicates those treatment costs relative to the price tag of treating other cancers, according to the American Society for Dermatologic Surgery.
Society officials concur with the Centers for Disease Control and Prevention (CDC) that on Monday 10 November called skin cancer a major growing public health problem in the United States and stated a continued focus on skin cancer prevention and detection efforts is critically important.
‘However, we feel the CDC miscommunicates the cost disparity between skin cancer and other cancers,’ said ASDS President George J. Hruza, M.D., M.B.A. ‘This emphasis could mislead the media and public into thinking skin cancer procedures are generally more costly – and that the costs are rising at a higher rate – than other cancer treatments.’
The American Journal of Preventive Medicine study, ‘Prevalence and Costs of Skin Cancer Treatment in the U.S., 2002-2006 and 2007-2011’, sought to examine trends in the number of cases plus treatment figures for both non-melanoma skin cancer and the rarer but more deadly melanoma skin cancer. The CDC, in turn, issued a press release and infographic focusing primarily on rising treatment costs. The release states that skin cancer treatment costs increased 126 percent, five times faster than the 25 percent increase seen for treatments for other cancers.
However, Hruza said this statement does not separate cost averages for melanoma and non-melanoma treatments. For non-melanoma skin cancers, the increase in payment per patient is 25% – exactly in line with the overall increase in the cost of treating all other cancers, he said.
The per-person payment for non-melanoma skin cancer treatment is estimated at $1,105 per year, according to the study, and a figure Hruza cites as ‘very reasonable.’ That figure could include one to five or more skin cancers per person. The yearly per-patient cost to treat all other cancers is $7,705, seven times more, the study notes.
Hruza also pointed out that cure rates for non-melanoma skin cancer that is treated early is nearly 100%, as opposed to survival rates of 17 and 65% for lung and colon cancer patients, respectively, following treatment.
‘While the incidence of non-melanoma skin cancer is staggering, the cost-efficiency of treating such cancers here in the United States is better than almost all other invasive forms of cancer,’ he said. ‘A 2010 review in the National Comprehensive Cancer Network journal showed treating a non-melanoma skin cancer in the physician-office setting provides care at $350 to $500 per episode, compared to $2,000 to $4,000 an episode for the next four most common cancer types.’ Those types are lung, prostate, colorectal and breast cancers.
The main cost difference between the two periods of time studied is for treating the much more deadly melanoma, though the journal article does not address causes, Hruza said. Possible reasons include:
- The number of sentinel lymph node biopsies – ‘a very effective tool for accurate staging to assess a patient’s prognosis,’ Hruza said – have increased. These are conducted in a hospital or ambulatory surgical center, where costs are far higher than in the dermatologist’s office, he said. In addition, the definitive excision normally accompanies the biopsy, increasing the cost even more.
- More effective chemotherapeutic agents, some of which cost $50,000 or more for each treatment course, to treat advanced melanoma patients were introduced in the second 5-year period.
‘When we have techniques, drugs and therapies that are more effective and work better for our patients, they – especially life-extending ones – should be offered, despite the higher cost,’ Hruza said.
‘Approximately 87% of our members perform skin cancer procedures, and we are acutely aware of the health and economic burden of the disease and treatments,’ Hruza said. ‘However, care must be taken not to unduly alarm the general public into thinking the cost is somehow greater than it is, and to put costs into proper context. Indeed, we concur with the study authors that the findings highlight the importance of skin cancer prevention efforts with the hope that these may mean savings to the health care system down the road.’