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<p>Basal cell carcinoma (BCC) is the most common skin cancer in the United States (U.S.) but is notably excluded from all U.S.-based tumor registries. As a result, current estimates largely rely on international data or claims databases, limiting their application to the U.S. population. This study aims to investigate trends in U.S. BCC incidence from 2015 to 2023 using the Epic Cosmos dataset, a compilation of over 200&#xa0;million patient records from over 40,000 locations. The at-risk population included all patients with at least one clinic visit in the defined calendar year and new cases of BCCs were identified by ICD-10 diagnosis codes. Data were stratified by anatomic site, demographic factors, and immunosuppression. Analysis revealed an increase in BCC incidence from 885.0 to 1,197.4 per 100,000 person-years. Incidence increased overall in all anatomic sites and demographics. By site, BCCs were most frequently diagnosed on the nose, trunk/breast, and upper extremity. By demographic, BCCs were most frequently diagnosed in men, patients greater than 85, white non-Hispanics, rural areas, areas with a lower Social Vulnerability Index (SVI), and immunosuppressed patients. Interestingly, solid organ transplant recipients (SOTR) had the greatest incidence of BCC, though rates of BCC are rising most significantly in the hematologic malignancy group. SOTR also demonstrated a predilection for extracephalic BCC. This study is limited by reliance on billing diagnosis, over-representation of privately insured individuals, bias of the Epic Cosmos system toward hospital-based healthcare systems, and lack of tumor-specific variables and treatment data. Nonetheless, this study quantifies the incidence of BCC—the most common cancer in the U.S., yet one that is excluded from national databases—and identifies high-risk patient groups. Further, this study also characterizes specific patient groups at higher risk for BCC development. Our findings accentuate the importance of large-scale U.S.-based datasets to better understand incidence rates of BCC and other malignancies that are currently excluded from national databases.</p>

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Characterizing basal cell carcinoma incidence in the United States using a nationally representative dataset

  • 期刊论文

  • 发表日期：

    2025年10月14日

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  • Akshay N. Pulavarty,
  • Lauren Stone,
  • Michelle C. Juarez,
  • John A. Carucci,
  • Maressa C. Criscito

摘要

Basal cell carcinoma (BCC) is the most common skin cancer in the United States (U.S.) but is notably excluded from all U.S.-based tumor registries. As a result, current estimates largely rely on international data or claims databases, limiting their application to the U.S. population. This study aims to investigate trends in U.S. BCC incidence from 2015 to 2023 using the Epic Cosmos dataset, a compilation of over 200 million patient records from over 40,000 locations. The at-risk population included all patients with at least one clinic visit in the defined calendar year and new cases of BCCs were identified by ICD-10 diagnosis codes. Data were stratified by anatomic site, demographic factors, and immunosuppression. Analysis revealed an increase in BCC incidence from 885.0 to 1,197.4 per 100,000 person-years. Incidence increased overall in all anatomic sites and demographics. By site, BCCs were most frequently diagnosed on the nose, trunk/breast, and upper extremity. By demographic, BCCs were most frequently diagnosed in men, patients greater than 85, white non-Hispanics, rural areas, areas with a lower Social Vulnerability Index (SVI), and immunosuppressed patients. Interestingly, solid organ transplant recipients (SOTR) had the greatest incidence of BCC, though rates of BCC are rising most significantly in the hematologic malignancy group. SOTR also demonstrated a predilection for extracephalic BCC. This study is limited by reliance on billing diagnosis, over-representation of privately insured individuals, bias of the Epic Cosmos system toward hospital-based healthcare systems, and lack of tumor-specific variables and treatment data. Nonetheless, this study quantifies the incidence of BCC—the most common cancer in the U.S., yet one that is excluded from national databases—and identifies high-risk patient groups. Further, this study also characterizes specific patient groups at higher risk for BCC development. Our findings accentuate the importance of large-scale U.S.-based datasets to better understand incidence rates of BCC and other malignancies that are currently excluded from national databases.