title: A comparison of the direct medical costs for individuals with or without basal or squamous cell skin cancer: A study from Australia.
abstract: OBJECTIVE
  The composition of the medical costs incurred by people treated for basal cell and squamous cell carcinomas (hereafter keratinocyte cancers) is not adequately understood. We sought to compare the medical costs of individuals with or without keratinocyte cancers.
  
  
  METHODS
  We used national health insurance data to analyze the direct medical costs of 2000 cases and 2000 controls nested within the QSkin prospective cohort study (n = 43,794) conducted in Australia. We reconstructed the medical history of patients using medical and pharmaceutical item codes and then compared the health service costs of individuals treated for keratinocyte cancers with those not treated for keratinocyte cancers.
  
  
  RESULTS
  Individuals treated for keratinocyte cancers consumed on average AUD$1320 per annum more in medical services than those without keratinocyte cancers. Only 23.2% of costs were attributed to the explicit treatment of keratinocyte cancers. The principal drivers of the residual costs were medical attendances, surgical procedures on the skin, and histopathology services. We found significant positive associations between history of treatment for keratinocyte cancers with treatments for other health conditions, including melanoma, cardiovascular disease, lipidemia, osteoporosis, rheumatoid arthritis, colorectal cancer, prostate cancer, and tuberculosis.
  
  
  CONCLUSIONS
  Individuals treated for keratinocyte cancers have substantially higher medical costs overall than individuals without keratinocyte cancers. The direct costs of skin cancer excision account for only one-fifth of this difference.
authors.affiliation: The University of Queensland, Queensland Brain Institute, Asia-Pacific Centre for Neuromodulation, St Andrews War Memorial Hospital, Brisbane, QLD, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Rowell
authors.affiliation: Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia.
authors.forename: Louisa G
authors.initials: LG
authors.lastname: Gordon
authors.affiliation: QIMR Berghofer Medical Research Institute, Population Health Department, Royal Brisbane Hospital, Brisbane, QLD, Australia.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Olsen
authors.affiliation: QIMR Berghofer Medical Research Institute, Population Health Department, Royal Brisbane Hospital, Brisbane, QLD, Australia.
authors.forename: David C
authors.initials: DC
authors.lastname: Whiteman
keywords: Basal cell carcinoma; costs of keratinocyte cancer comorbidities; keratinocyte cancer; squamous cell carcinoma