Increased burden of melanoma and nonmelanoma skin cancer in young women.

BACKGROUND: A higher and increasing incidence of skin cancer has been noted in younger women as compared with men. OBJECTIVE: To assess the relative gender burden of basal cell carcinoma, squamous cell carcinoma, and malignant melanoma in various age groups, particularly in young adult women. MATERIALS AND METHODS: A total of 16,994 biopsy-proven skin cancers in 9,376 patients in a single private dermatologic surgery practice was included in this study. RESULTS: Men constituted the majority (63.7%, p < .0001) of patients, accounting for 68.7% of squamous cell carcinomas (p < .0001), 60.8% of basal cell carcinomas (p < .0001), and 57.5% of malignant melanomas (p < .0001). However, a statistically significant majority of melanomas (67.3%, p < .0001) and basal cell carcinomas (60.4%, p < .0001) were seen in women in patients aged 10 to 49 years. There was also a statistically significant increase in the female representation in patients aged 10 to 49 years as compared with those aged 50 to 99 years with respect to squamous cell carcinoma. CONCLUSION: Women comprise a statistically significant majority of patients with melanoma and basal cell carcinoma in the younger (10-49 years) age groups. This raises a concern regarding an increased future incidence of skin cancer in this population group and a demographic shift to increased female representation among patients with skin cancer.

Clinical and Cost Comparison Evaluation of Inpatient Versus Outpatient Administration of EPOCH-Containing Regimens in Non-Hodgkin Lymphoma.

BACKGROUND: Etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin (EPOCH)-containing regimens are frequently utilized in non-Hodgkin's lymphoma, however, the incidence of febrile neutropenia (FN) in patients receiving inpatient versus outpatient EPOCH has not been described. Additionally, no comparisons have been made regarding financial implications of EPOCH administration in either setting. This study's primary objective was to compare hospital admissions for FN in patients receiving inpatient or outpatient EPOCH. METHODS: A single-center, institutional review board-approved review was conducted for adults receiving EPOCH beginning January 2010. Clinical and financial data were collected through chart review and the institution's financial department. Descriptive statistics were utilized for analysis. RESULTS: A total of 25 patients received 86 cycles of an EPOCH-containing regimen (61 [70.9%] inpatient). Five (8.2%) inpatient cycles resulted in an admission for FN compared to 4 (16%) outpatient cycles. Prophylactic antifungal and antiviral agents were prescribed more often after inpatient cycles (>80%) compared to outpatient cycles (<50%). Overall, 27 (31.4%) of 86 cycles did not receive granulocyte colony-stimulating factor support. Outpatient EPOCH administration was associated with a cost savings of approximately US$141 116 for both chemotherapy costs and hospital day avoidance. CONCLUSION: EPOCH-containing regimens can be safely administered in the outpatient setting, which may result in cost savings for healthcare institutions.