Epidemiology and etiology

NMSC accounts for nearly half of all newly diagnosed cancers in the United States each year, and it is estimated that more than 1 million cases will be diagnosed in 2008. The true prevalence of NMSC may be underestimated because it is treated in outpatient settings, and no formal reporting to cancer registries is required.54 BCC is the most common form of NMSC in Caucasians and comprises 75% of newly diagnosed NMSC. SCC accounts for 20% of NMSC.54 NMSCs occur at a lower incidence in darker-skinned people or in descendants of African, Asian, and Mediterranean coun-

tries. In African Americans, the most common form of NMSC is SCC. The majority of NMSCs are curable and the mortality rate is low; cure rates approach 98%, and the overall 5-year survival rate is greater than 95%.18 Metastasis occurs in less than 0.1% of BCCs compared with an average of 3.6% of SCCs. Seventy-five percent of all NMSC deaths are attributed to SCC.18 NMSC is associated with considerable morbid ity owing to functional and cosmetic deformity. In addition, it is an economic burden to the health care system because costs associated with NMSC treatment are estimated at approximately $426 million per year.55

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