New Publication on Treatments of Primary Basal Cell Carcinoma of the Skin

Thomas Trikalinos, MD, Associate Professor in Health Services, Policy, and Practice and the Director of the Center for Evidence Synthesis in Health, led an AHRQ Evidence-based Practice Center project on Treatments for Basal Cell and Squamous Cell Carcinoma of the Skin with Aaron Drucker, MD, ScM, FRCPC, CESH Research Associates; Gaelen Adam. MLIS, Valerie Rofeberg, ScM and other collegues.

A publication titled "Treatments of Primary Basal Cell Carcinoma of the Skin: A Systematic Review and Network Meta-analysis"  was published in Annals of Internal Medicine on September 18, 2018.

Check out the publication through the Brown School of Public Health website here.


Basal cell carcinoma (BCC) is the most common cancer in the United States, with an annual incidence approaching 2 million cases (1). Most cases are not aggressive, but the tumors and their treatment can cause disfigurement or disability, which can adversely affect quality of life (2). The Surgeon General's recent call to action to prevent skin cancer at the population level emphasizes the public health importance of dealing with BCC (3).

Choosing a management strategy for an individual patient with a specific type of BCC from among the many available interventions is complex. Considerations include patient factors (such as age, frailty, immunosuppression, and personal preference), tumor factors (such as histologic subtype, size, and location), and the availability and cost of health care resources.

The lack of clarity about the comparative efficacy and safety of the available options overall and in specific circumstances further complicates treatment decision making for both physicians and patients. Surgical removal is widely considered the gold standard and is therefore the most common treatment. However, despite several dozen randomized controlled trials (RCTs) and nonrandomized comparative studies (NRCSs), the relative performance of various surgical techniques and other therapeutic options is unclear. Payers are faced with increased use of costly therapies, such as brachytherapy, without clear evidence about relative benefits to justify increased costs (4). The purpose of this systematic review and network meta-analysis is to evaluate the comparative effectiveness and safety of treatments of primary BCC.

The accompanying editorial can be found here: Much Choice, Much Confusion: Treating Basal Cell Carcinoma

The full report on Treatments for Basal Cell and Squamous Cell Carcinoma of the Skin can be found here.