Head and neck basal cell carcinoma excisions across specialities in hospital and practice settings.

Abstract

Introduction: The rising burden of basal cell carcinoma (BCC) in Denmark challenges healthcare resources, highlighting the importance of optimal patient treatment and effective resource management. Therefore, this study aimed to compare BCC excisions across specialities in practices and hospitals.

Methods: Data from the Patobank included histopathology records of standard BCC excisions on the head and neck from 1 January 2022 to 31 December 2022, performed by plastic surgeons, dermatologists, ophthalmologists and general practitioners (GPs) in practice and hospital settings. Excisions with intraoperative margin control were excluded. We analysed the number of excisions, BCC subtypes and odds ratios of incomplete BCC excisions across treatment settings. The intended purpose of excision was not registered.

Results: Among 7,774 BCC excisions, most were performed by plastic surgeons in hospitals (43%) and practices (38%), followed by dermatologists in practices (14%). Hospital-based specialists, including plastic surgeons, dermatologists and ophthalmologists, had lower odds of incomplete BCC excision than their practice-based counterparts and GPs.

Conclusions: Substantial variations in excision counts and odds of incomplete BCC excisions are observed across specialities and settings. Addressing this variation is important to ensuring that patients are treated in the appropriate arena and that resources are allocated optimally.

Funding: This work was funded by the Danish Research Center for Skin Cancer, a public-private research partnership between Private Hospital Mølholm, Aalborg University Hospital, and Copenhagen University Hospital - Bispebjerg and Frederiksberg Hospital.

Trial registration: Study and data approval were provided by the Danish Research Act and the Team for Records Data.