Disparities in non-melanoma skin cancer in Hispanic/Latino patients based on Mohs micrographic surgery defect size, a multicenter retrospective study

Background There is limited literature regarding potential disparities in non-melanoma skin cancer for skin of color patients. Objective To examine disparities in non-melanoma skin cancer among Hispanic/Latino patients using Mohs micrographic surgery defect sizes, with a secondary aim of examining effect of insurance type. Methods We conducted a multicenter retrospective study using data from three major institutions in Los Angeles County. A total of 3,486 Mohs micrographic surgeries of basal cell, squamous cell, and basosquamous cell carcinomas were analyzed. Results Hispanic/Latino patients had 17% larger Mohs micrographic surgery defect sizes as compared to non-Hispanic white patients. More notably, when comparing defect sizes of squamous cell carcinomas to basal cell carcinomas, Hispanic/Latino patients had 80% larger defect sizes compared to non-Hispanic white patients who had 25% larger defect sizes. Compared to Medicare, patients with HMO and Medicaid/HMO had 22% and 52% larger defect sizes, respectively, whereas patients with PPO had 10% smaller defect sizes. Limitations The data included was from a single county population. Conclusion Disparities exist between skin of color and white patients regarding non-melanoma skin cancer. Patients and the medical community need to be cognizant that patients can develop skin cancer regardless of their race and ethnicity.