Original articleTurning the tide? Changes in treatment rates for keratinocyte cancers in Australia 2000 through 2011

BackgroundKeratinocyte cancers (basal cell carcinoma, squamous cell carcinoma) are the commonest cancers in human beings. Population data on incidence trends are scant because few jurisdictions reliably record diagnoses or treatments.ObjectiveWe sought to examine temporal trends of treating keratinocyte cancers in Australia.MethodsWe analyzed Medicare Australia data relating to the diagnosis and treatment of keratinocyte skin cancer between 2000 and 2011. We examined counts and rates for each procedure, and the average annual percentage rate of change.ResultsThere were significant increases in excision rates for keratinocyte cancers (3.3% per annum for men and 2.2% per annum for women), however temporal trends differed significantly by age group. Although annual increases in excision rates were highest for men aged 75 to 84 years (8.6% per annum), they declined significantly for men and women younger than 45 years. Skin biopsy rates increased substantially in all age groups over the study period, suggesting no lessening in skin cancer surveillance in any age group.LimitationsThe Medicare data do not include services provided in public hospitals, however fewer than 2% of skin cancers are treated in these settings.ConclusionsAlthough overall treatment rates for keratinocyte cancers have increased substantially during the past decade, excision rates are declining in younger Australians.