title: Nonmelanoma skin cancer: is the incidence really increasing among patients younger than 40? A reexamination using 25 years of U.S. outpatient data.
abstract: OBJECTIVE
  An increasing incidence of basal cell carcinomas and squamous cell carcinomas in patients younger than 40 years old diagnosed during years 1973 to 2003 was found in a recent population-based study in Olmsted County, Minnesota. We performed additional analyses using nationally representative patient samples to confirm these trends.
  
  
  METHODS
  We analyzed a cross-sectional survey data on outpatient diagnoses, the National Ambulatory Medical Care Survey data from 1979 to 2003, for melanoma skin cancer.
  
  
  RESULTS
  A total of 4,100 office visits for nonmelanoma skin cancers were recorded, including 230 in patients younger than 40. Multivariate analysis indicated no significant increase in the number of office visits related to nonmelanoma skin cancer in younger patients [odds ratio (OR), 2.77; 95% CI, 0.75-10.26]. The mean age of office visits for nonmelanoma skin cancer did not change significantly. The ages of the office visit patients were 64.7 years and 69.02 years in the years 1979 and 2003, respectively.
  
  
  CONCLUSIONS
  Based on a representative sample of outpatient visit diagnoses, visits are not increasing for nonmelanoma skin cancer among patients 40 years and younger in the United States, albeit direct measurement of tumor incidence was not possible with this database.
authors.affiliation: Center for Dermatology Research, Department of Dermatology, Wake Forest University School of medicine, Winston-Salem, North Carolina 27157, USA.
authors.forename: Mary-Margaret
authors.initials: MM
authors.lastname: Bivens
authors.forename: Monali
authors.initials: M
authors.lastname: Bhosle
authors.forename: Rajesh
authors.initials: R
authors.lastname: Balkrishnan
authors.forename: Fabian T
authors.initials: FT
authors.lastname: Camacho
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
authors.forename: Alan B
authors.initials: AB
authors.lastname: Fleischer
mesh_terms: D000328:Adult; D002280:Basal Cell Carcinoma / Q000453:epidemiology*; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000453:epidemiology; D008910:Minnesota / Q000453:epidemiology; D015999:Multivariate Analysis; D012878:Skin Neoplasms / Q000453:epidemiology*