全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Ambulatory Melanoma Care Patterns in the United States

DOI: 10.1155/2013/689261

Full-Text   Cite this paper   Add to My Lib

Abstract:

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

References

[1]  American Cancer Society, Cancer Facts and Figures 2013, American Cancer Society, Atlanta, Ga, USA, 2013.
[2]  D. R. Bickers, H. W. Lim, D. Margolis et al., “The burden of skin diseases: 2004,” Journal of the American Academy of Dermatology, vol. 55, no. 3, pp. 490–500, 2006.
[3]  T. L. Diepgen and V. Mahler, “The epidemiology of skin cancer,” British Journal of Dermatology, vol. 146, 61, pp. 1–6, 2002.
[4]  J. V. Schaffer, D. S. Rigel, A. W. Kopf, and J. L. Bolognia, “Cutaneous melanoma—past, present, and future,” Journal of the American Academy of Dermatology, vol. 51, supplement 1, pp. S65–S69, 2004.
[5]  H. I. Hall, D. R. Miller, J. D. Rogers, and B. Bewerse, “Update on the incidence and mortality from melanoma in the United States,” Journal of the American Academy of Dermatology, vol. 40, no. 1, pp. 35–42, 1999.
[6]  N. Howlader, A. M. Noone, M. Krapcho et al., Eds., SEER Cancer Statistics Review, 1975–2010, National Cancer Institute, Bethesda, MD, USA.
[7]  A. Jemal, R. Siegel, J. Xu, and E. Ward, “Cancer statistics,” CA: A Cancer Journal for Clinicians, vol. 60, no. 5, p. 277, 2010.
[8]  D. S. Rigel and J. A. Carucci, “Malignant melanoma: prevention, early detection, and treatment in the 21st century,” Ca: A Cancer Journal for Clinicians, vol. 50, no. 4, pp. 215–236, 2000.
[9]  K. C. Lee and M. A. Weinstock, “Melanoma is up: are we up to this challenge?” Journal of Investigative Dermatology, vol. 129, no. 7, pp. 1604–1606, 2009.
[10]  D. M. Lipsker, G. Hedelin, E. Heid, E. M. Grosshans, and B. J. Cribier, “Striking increase of thin melanomas contrasts with stable incidence of thick melanomas,” Archives of Dermatology, vol. 135, no. 12, pp. 1451–1456, 1999.
[11]  M. Demierre, C. Chung, D. R. Miller, and A. C. Geller, “Early detection of thick melanomas in the United States: beware of the nodular subtype,” Archives of Dermatology, vol. 141, no. 6, pp. 745–750, 2005.
[12]  A. B. Fleischer Jr., C. Herbert, S. R. Feldman, and F. O'Brien, “Diagnosis of skin disease by nondermatologists,” American Journal of Managed Care, vol. 6, no. 10, pp. 1149–1156, 2000.
[13]  S. C. Chen, M. L. Pennie, P. Kolm et al., “Diagnosing and managing cutaneous pigmented lesions: primary care physicians versus dermatologists,” Journal of General Internal Medicine, vol. 21, no. 7, pp. 678–682, 2006.
[14]  L. K. Dennis, “Melanoma incidence by body site: effects of birth-cohort adjustment,” Archives of Dermatology, vol. 135, no. 12, pp. 1553–1554, 1999.
[15]  A. C. Geller, G. Colditz, S. Oliveria et al., “Use of sunscreen, sunburning rates, and tanning bed use among more than 10,000 US children and adolescents,” Pediatrics, vol. 109, no. 6, pp. 1009–1014, 2002.
[16]  L. Brochez and J.-M. Naeyaert, “Understanding the trends in melanoma incidence and mortality: where do we stand?” European Journal of Dermatology, vol. 10, no. 1, pp. 71–76, 2000.
[17]  A. C. Geller, D. R. Miller, G. D. Annas, M. Demierre, B. A. Gilchrest, and H. K. Koh, “Melanoma incidence and mortality among US whites, 1969–1999,” Journal of the American Medical Association, vol. 288, no. 14, pp. 1719–1720, 2002.
[18]  R. A. Desmond and S. Soong, “Epidemiology of malignant melanoma,” Surgical Clinics of North America, vol. 83, no. 1, pp. 1–29, 2003.
[19]  A. Jemal, S. S. Devesa, P. Hartge, and M. A. Tucker, “Recent trends in cutaneous melanoma incidence among whites in the United States,” Journal of the National Cancer Institute, vol. 93, no. 9, pp. 678–683, 2001.
[20]  R. M. Pinkhasov, J. Wong, J. Kashanian et al., “Are men shortchanged on health? Perspective on health care utilization and health risk behavior in men and women in the United States,” International Journal of Clinical Practice, vol. 64, no. 4, pp. 475–487, 2010.
[21]  K. D. Bertakis, R. Azari, L. J. Helms, E. J. Callahan, and J. A. Robbins, “Gender differences in the utilization of health care services,” Journal of Family Practice, vol. 49, no. 2, pp. 147–152, 2000.
[22]  P. D. Cleary, D. Mechanic, and J. R. Greenley, “Sex differences in medical care utilization: an empirical investigation,” Journal of Health and Social Behavior, vol. 23, no. 2, pp. 106–119, 1982.
[23]  J. L. Schwartz, T. S. Wang, T. A. Hamilton, L. Lowe, V. K. Sondak, and T. M. Johnson, “Thin primary cutaneous melanomas: associated detection patterns, lesion characteristics, and patient characteristics,” Cancer, vol. 95, no. 7, pp. 1562–1568, 2002.
[24]  E. S. Smith, S. R. Feldman, A. B. Fleischer Jr., B. Leshin, and A. McMichael, “Characteristics of office-based visits for skin cancer: dermatologists have more experience than other physicians in managing malignant and premalignant skin conditions,” Dermatologic Surgery, vol. 24, no. 9, pp. 981–985, 1998.
[25]  K. P. Friedman, D. L. Whitaker-Worth, C. Grin, and J. M. Grant-Kels, “Melanoma screening behavior among primary care physicians,” Cutis, vol. 74, no. 5, pp. 305–311, 2004.
[26]  R. S. Kirsner, S. Muhkerjee, and D. G. Federman, “Skin cancer screening in primary care: prevalence and barriers,” Journal of the American Academy of Dermatology, vol. 41, no. 4, pp. 564–566, 1999.
[27]  M. Lee, C. S. Hodgson, and L. Wilkerson, “Predictors of self-perceived competency in cancer screening examinations,” Journal of Cancer Education, vol. 17, no. 4, pp. 180–182, 2002.
[28]  M. M. Moore, A. C. Geller, Z. Zhang et al., “Skin cancer examination teaching in US medical education,” Archives of Dermatology, vol. 142, no. 4, pp. 439–444, 2006.
[29]  E. Wise, D. Singh, M. Moore et al., “Rates of skin cancer screening and prevention counseling by US medical residents,” Archives of Dermatology, vol. 145, no. 10, pp. 1131–1136, 2009.
[30]  W. Chang, T. Li, and C. Lin, “The effect of physician experience on costs and clinical outcomes of laparoscopic-assisted vaginal hysterectomy: a multivariate analysis,” Journal of the American Association of Gynecologic Laparoscopists, vol. 10, no. 3, pp. 356–359, 2003.
[31]  J. A. Sosa, H. M. Bowman, J. M. Tielsch, N. R. Powe, T. A. Gordon, and R. Udelsman, “The importance of surgeon experience for clinical and economic outcomes from thyroidectomy,” Annals of Surgery, vol. 228, no. 3, pp. 320–330, 1998.
[32]  D. B. Mckenna, J. C. Marioni, R. J. Lee, R. J. Prescott, and V. R. Doherty, “A comparison of dermatologists', surgeons' and general practitioners' surgical management of cutaneous melanoma,” British Journal of Dermatology, vol. 151, no. 3, pp. 636–644, 2004.
[33]  M. M. Todd, J. J. Miller, and C. T. Ammirati, “Dermatologic surgery training in residency,” Dermatologic Surgery, vol. 28, no. 7, pp. 547–550, 2002.

Full-Text

comments powered by Disqus

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133