%0 Journal Article
%T Ambulatory Melanoma Care Patterns in the United States
%A Andrew L. Ji
%A Michael R. Baze
%A Scott A. Davis
%A Steven R. Feldman
%A Alan B. Fleischer Jr.
%J Journal of Skin Cancer
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/689261
%X Objective. To examine trends in melanoma visits in the ambulatory care setting. Methods. Data from the National Ambulatory Medical Care Survey (NAMCS) from 1979 to 2010 were used to analyze melanoma visit characteristics including number of visits, age and gender of patients, and physician specialty. These data were compared to US Census population estimates during the same time period. Results. The overall rate of melanoma visits increased ( ) at an apparently higher rate than the increase in population over this time. The age of patients with melanoma visits increased at approximately double the rate (0.47 year per interval year, ) of the population increase in age (0.23 year per interval year). There was a nonsignificant decline in the proportion of female patients seen over the study interval. Lastly, ambulatory care has shifted towards dermatologists and other specialties managing melanoma patients and away from family/internal medicine physicians and general/plastic surgeons. Conclusions. The number and age of melanoma visits has increased over time with respect to the overall population, mirroring the increase in melanoma incidence over the past three decades. These trends highlight the need for further studies regarding melanoma management efficiency. 1. Introduction In 2013, the American Cancer Society estimates that there will be 76,690 new cases of melanoma diagnosed, with 61,300 being melanoma in situ [1]. Melanoma management costs the US billions of dollars in direct annual expenses [2]. Worldwide, during the past several decades, there has been a substantial increase in the incidence of melanoma, particularly among white populations [3, 4]. In the US, the incidence of melanoma also continues to rise. From 1973 to 1994, US melanoma incidence rates increased 154.4% in males (from 6.8 to 17.3 per 100,000) and 90.2% in females (from 6.1 to 11.6 per 100,000) [5]. The melanoma incidence rates during 2006 to 2010 reveal a similar trend in males (27.4 per 100,000) and females (16.7 per 100,000), nearly quadrupling in men and tripling in women over the past three to four decades [6]. More specifically, during this period, the incidence rates per 100,000 persons were 31.9 and 20.0 in white men and women, respectively; 4.7 and 4.4 in Hispanic men and women, respectively; 1.6 and 1.1 in Asian men and women, respectively; and 1.1 and 1.0 in black men and woman, respectively [6]. According to the National Cancer Institute Surveillance Epidemiology End Results data, from 2006 to 2010, the median age at diagnosis for melanoma was 61 years, with
%U http://www.hindawi.com/journals/jsc/2013/689261/