title: Trends in Mohs surgery from 1995 to 2010: an analysis of nationally representative data.
abstract: BACKGROUND
  In Mohs surgery, the histologic verification of tumor removal results in a lower rate of cancer recurrence compared with simple excision. Factors associated with the increased use of Mohs surgery are not well characterized.
  
  
  OBJECTIVE
  To investigate trends in the utilization of Mohs surgery.
  
  
  METHODS
  The authors performed a retrospective analysis of the National Ambulatory Medical Care Survey for patient visits associated with Mohs surgery from 1995 to 2010. The authors assessed percentage of skin cancers managed with Mohs surgery, the most common locations of skin cancer managed with Mohs surgery, and patient demographics associated with Mohs surgery.
  
  
  RESULTS
  Although there was an upward trend in the use of Mohs surgery (p = .004), a low percentage of skin cancers (average of 10.0%) were managed with this technique. When the surgical location was specified, Mohs surgery was most commonly used for the head and neck region. Demographic groups receiving Mohs surgery at higher rates included African Americans (44.2%) and patients aged 75 to 84 years (12.4%).
  
  
  CONCLUSIONS
  There has been an upward trend in the use of Mohs surgery, particularly in the head and neck region where tissue preservation is essential.
authors.affiliation: Departments of *Dermatology, †Pathology, and ‡Public Health Sciences, Center for Dermatology Research, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Virginia J
authors.initials: VJ
authors.lastname: Reeder
authors.forename: Cheryl J
authors.initials: CJ
authors.lastname: Gustafson
authors.forename: Kenyatta
authors.initials: K
authors.lastname: Mireku
authors.forename: Scott A
authors.initials: SA
authors.lastname: Davis
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Pearce
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery / Q000706:statistics & numerical data* / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult