Redefinition of Skin Cancer as a Chronic Disease

Sutton, Adam; Crew, Ashley; Wysong, Ashley

doi:10.1001/jamadermatol.2015.4215

Cited by 18 publications

(10 citation statements)

References 5 publications

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“…Although Doran and colleagues estimated costs comprehensively, they may be underestimated due to capturing management costs of skin cancer diagnosed in 2010 in New South Wales and they omitted multiply‐affected individuals in subsequent years 24 . Our study highlights the cost burden to government and patients and it supports the call by others that skin cancer should be viewed as a chronic disease 29 . Our observations of patients suffering multiple, repeated skin cancer events suggests that such patients should be viewed as having a chronic condition, particularly for KC.…”

Section: Discussionsupporting

confidence: 61%

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Multiplicity of skin cancers in Queensland and their cost burden to government and patients

Gordon

Elliott

Olsen

et al. 2018

Australian and New Zealand Journal of Public Health

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Objective: To determine the cost burden to government and patients for individuals with multiple skin cancers. Methods:We used self-reported baseline data on socio-demographics, phenotype and sun exposure behaviours from participants in the QSkin Sun and Health Study with at least one histopathologically confirmed keratinocyte cancer or melanoma (n=5,673). Linkage to Australian Medicare data (2011)(2012)(2013)(2014) provided resource data and government and out-ofpocket patient costs. Generalised linear models examined costs by frequency of skin cancer groups separately for melanoma and keratinocyte cancer.Results: Over three years, 539 participants were diagnosed with melanoma (11% had ≥2 melanomas) and 5,134 participants were treated for keratinocyte cancers (10% had ≥6). Median Medicare costs per person were $1,325 (maximum $6,117) for ≥2 melanomas and $2,126 (maximum $54,618) for ≥6 keratinocyte cancers. Increased costs were associated with private health insurance. Conclusions:Individuals who are multiply affected by skin cancers are relatively common and the accompanying individual and government cost burden can be substantial. These findings support skin cancer being classified as a chronic disease.Implications for public health: Over time, the economic burden for skin cancer for individuals and health providers is high and investment in prevention remains important from an economic viewpoint.

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Section: Discussionsupporting

confidence: 61%

“…24 Our study highlights the cost burden to government and patients and it supports the call by others that skin cancer should be viewed as a chronic disease. 29 these new therapies will supersede earlier agents. However, this will only apply to a small number of melanomas because advanced stage melanoma is relatively rare.…”

Section: Discussionmentioning

confidence: 99%

Multiplicity of skin cancers in Queensland and their cost burden to government and patients

Gordon

Elliott

Olsen

et al. 2018

Australian and New Zealand Journal of Public Health

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“…Application of the chronic care model to manage AK and keratinocyte carcinomas is proposed to coordinate care delivery, which may enable field-directed therapies for high-risk patients with severe actinic burden or a history of multiple keratinocyte carcinomas. 34 Clinical decision aids can guide treatment selection by aligning patients' and physicians' understanding of AK, providing individualized prognostic information, and incorporating patients' personal values and preferences about treatment benefits, risks, and costs. 35,36 Research should address the cost-effectiveness of AK surveillance and treatment strategies and optimize their intensity and frequency.…”

Section: Discussionmentioning

confidence: 99%

“…In the current era of value-based care, rising use of AK treatment with unexplained variations in management call for innovations to measure and improve value and patient centeredness in AK treatment and prevention of keratinocyte carcinoma. Application of the chronic care model to manage AK and keratinocyte carcinomas is proposed to coordinate care delivery, which may enable field-directed therapies for high-risk patients with severe actinic burden or a history of multiple keratinocyte carcinomas . Clinical decision aids can guide treatment selection by aligning patients’ and physicians’ understanding of AK, providing individualized prognostic information, and incorporating patients’ personal values and preferences about treatment benefits, risks, and costs .…”

Section: Discussionmentioning

confidence: 99%

Use and Cost of Actinic Keratosis Destruction in the Medicare Part B Fee-for-Service Population, 2007 to 2015

et al. 2018

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ctinic keratosis (AK) was the most common dermatologic diagnosis among all dermatologist visits in the United States for patients 45 years or older during the period from 1993 to 2010. 1 Risk factors for AK development include older age, male sex, fair skin, lifetime UV light exposure, and sunburns. 2 Actinic keratosis is frequently treated to address potential for malignant transformation, relieve patient symptoms, improve quality of life and cosmetic outcomes, and facilitate diagnosis of keratinocyte carcinoma in settings of field cancerization. 3-7 The estimated burden of AK and its treatment have varied significantly. 8,9 The American Academy of Dermatology Burden of Skin Diseases reports showed that 10 million to 39.5 million Americans sought care for actinic damage, which

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“…Association analysis was performed by 70 independent GWAS of chronic conditions. Phenotype selection was derived from the Electronic Health Records registry from the cohort (2012–2017) and chronicity was defined using public guidelines for chronic condition definitions ( 68 ), and the Chronic Condition Indicator (CCI) ( http://www.hcup-us.ahrq.gov/toolssoftware/chronic/chronic.jsp ) ( 69 , 70 ), then grouped considering ICD-9 codes and chapter descriptions. Conditions with more than 50 cases were retained for the GWAS analysis (i.e.…”

Section: Methodsmentioning

confidence: 99%

GCAT|Panel, a comprehensive structural variant haplotype map of the Iberian population from high-coverage whole-genome sequencing

Valls-Margarit

Galván-Femenía

Matías-Sánchez

et al. 2022

Nucleic Acids Research

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The combined analysis of haplotype panels with phenotype clinical cohorts is a common approach to explore the genetic architecture of human diseases. However, genetic studies are mainly based on single nucleotide variants (SNVs) and small insertions and deletions (indels). Here, we contribute to fill this gap by generating a dense haplotype map focused on the identification, characterization, and phasing of structural variants (SVs). By integrating multiple variant identification methods and Logistic Regression Models (LRMs), we present a catalogue of 35 431 441 variants, including 89 178 SVs (≥50 bp), 30 325 064 SNVs and 5 017 199 indels, across 785 Illumina high coverage (30x) whole-genomes from the Iberian GCAT Cohort, containing a median of 3.52M SNVs, 606 336 indels and 6393 SVs per individual. The haplotype panel is able to impute up to 14 360 728 SNVs/indels and 23 179 SVs, showing a 2.7-fold increase for SVs compared with available genetic variation panels. The value of this panel for SVs analysis is shown through an imputed rare Alu element located in a new locus associated with Mononeuritis of lower limb, a rare neuromuscular disease. This study represents the first deep characterization of genetic variation within the Iberian population and the first operational haplotype panel to systematically include the SVs into genome-wide genetic studies.

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Redefinition of Skin Cancer as a Chronic Disease

Cited by 18 publications

References 5 publications

Multiplicity of skin cancers in Queensland and their cost burden to government and patients

Multiplicity of skin cancers in Queensland and their cost burden to government and patients

Use and Cost of Actinic Keratosis Destruction in the Medicare Part B Fee-for-Service Population, 2007 to 2015

GCAT|Panel, a comprehensive structural variant haplotype map of the Iberian population from high-coverage whole-genome sequencing

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