Abstract
Review question/objective The overall research question for this systematic review is: what is the cost effectiveness of Mohs micrographic surgery for non-melanoma skin cancer? More specifically, the objectives are to: Examine the evidence on the cost effectiveness, cost benefit, cost minimization, and cost utility of Mohs micrographic surgery, compared to other surgical/ablative interventions such as excisional surgery and radiation therapy, as well as non-surgical/chemotherapeutic interventions such as topical 5-fluorouracil and imiquimod immunotherapy, for non-melanoma skin cancer clinical care outcomes; Determine the cost effectiveness, cost benefit, cost minimization and cost utility of Mohs micrographic surgery from the patient, provider, healthcare system and societal perspectives in order to elucidate the economic and clinical benefits of the procedure at these various levels; Provide a comprehensive assessment of the relative economic and clinical effectiveness of this procedure for patients with non-melanoma skin cancer in different contexts globally. Inclusion criteria Types of participants This review will consider studies that include participants with an established diagnosis of non-melanoma skin cancer. For the purposes of this review, an established diagnosis of non-melanoma skin cancer will consist of either squamous cell carcinoma or basal cell carcinoma , confirmed histologically or clinically or both, by a healthcare provider trained to do so. Types of intervention(s)/phenomena of interest This review will consider studies that evaluate Mohs micrographic surgery as a treatment for non-melanoma skin cancer. Types of outcomes This review will consider studies that measured any clinical care outcomes related to non-melanoma skin cancer, including but not limited to mortality, quality of life, quality-adjusted life years , incidence and recurrence of non-melanoma skin cancer lesions, and frequency of adverse events. However, to be considered for inclusion, studies must also provide an economic evaluation of the relative costs of using Mohs micrographic surgery as a therapeutic modality when compared to other known treatment modalities.