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Certain demographic factors were predictive for the development of common skin cancers, researchers reported.

In a cross-sectional analysis of nearly 1 million U.S. insurance claims from 2012 to 2016, basal cell carcinoma (BCC) was 1.69 times more likely to be procedurally treated than cutaneous squamous cell carcinoma (SCC), wrote Jeremy Etzkorn, MD, MS, of University of Pennsylvania in Philadelphia, and colleagues in .

When comparing treatment claims for these two types of keratinocyte carcinomas, age seemed to play a prominent role in a person's risk for which type they might develop. For instance, younger patients, ages 18 to 39 years, were significantly more likely to have BCC than SCC, at a rate of 9.63 cases of BCC per case of SCC.

BCC also remained more common than SCC among older patients, occurring at a rate of 2.92 per one SCC for those ages 40 to 64 and 1.33 per each SCC among patients 65 and older.

Diving deeper into predictive demographics, the authors reported that women tended to have a higher likelihood of having keratinocyte carcinomas classified as BCC than men (ratio 12.56 vs 7.22; odds ratio 1.67, 95% CI 1.47-1.88, P<0.001). However, these sex differences leveled off in patients 65 and older.

"These data suggest that BCC is especially prevalent relative to [cutaneous] SCC in young women, and this demographic may benefit from public health education focused on the presentation and management of BCCs," Etzkorn's group recommended.

When keratinocyte carcinoma claims data was broken down by race, 93% of all claims were from white patients, with only 4% from Black patients, 2% from Hispanic patients, and less than 1% from Asian patients.

Across every age group for all races, BCCs were more prevalent than SCCs:

• White patients: BCC:SCC ratio of 1.69
• Black patients: BCC:SCC ratio of 1.45
• Hispanic patients: BCC:SCC ratio of 2.00
• Asian patients: BCC:SCC ratio of 1.60

Etzkorn and colleagues called this finding "particularly noteworthy," and acknowledged that it contradicted prior literature suggesting that SCCs were more common than BCCs in Black patients. "This finding may reflect selection bias in prior studies or differences between the populations studied in this vs prior reports," they pointed out.

The prevalence of specific keratinocyte carcinomas also tended to vary by U.S. geographic region. In the West North Central area of the country, which includes Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and South Dakota, BCC occurred at a rate of 2.12 per every one case of SCC.

On the other hand, the lowest ratio was seen among the South Atlantic area of the U.S. (Delaware, Maryland, Virginia, West Virginia, North Carolina, South Carolina, Georgia, Florida, and the District of Columbia) with 1.35 cases of BCC for every one case of SCC.

A study limitation was that only procedurally treated claims from patients with private insurance and Medicare Advantage were included. The data likely was not representative of patients without insurance or who are covered by Medicaid, the authors noted.

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