title: Earlier detection of patients' second primary basal cell carcinomas: a quantitative analysis.
abstract: BACKGROUND
  Basal cell carcinoma (BCC) is the most common occurring cancer in humans. No studies to date have compared the size of a patient's first and second primary BCC to determine whether we are detecting and treating second primary cancers at earlier stages of development.
  
  
  OBJECTIVE
  The objective was to ascertain whether patients who have had a primary BCC are diagnosed and treated for subsequent BCC at an earlier clinical stage of development.
  
  
  METHODS
  We performed a 4-year retrospective chart review of all patients presenting for Mohs micrographic surgery for two separate primary BCC. We compared the presenting clinical size of patients' first and second primary BCC.
  
  
  RESULTS
  We found a statistically significant decrease in size of the second primary BCC when compared to the first primary BCC (p<.0001). The mean difference was 116.6 mm2 and the median difference was 28.3 mm2.
  
  
  CONCLUSIONS
  Our results provide important quantitative data illustrating our effectiveness in detecting subsequent BCC at an earlier stage of development. Earlier detection of skin cancers can decrease the morbidity and chance of recurrence as well as lead to smaller scars and better cosmetic outcomes and may also allow for various treatment modalities and cost containment.
authors.affiliation: Colorado Permanente Medical Group, Lafayette, Colorado 80026, USA. shawn.allen@kp.org
authors.forename: Shawn B
authors.initials: SB
authors.lastname: Allen
authors.forename: David N
authors.initials: DN
authors.lastname: Lortscher
authors.forename: Roberta D
authors.initials: RD
authors.lastname: Sengelmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000473:pathology* / Q000601:surgery*; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery; D016609:Neoplasms, Second Primary / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery*