Internet resources for researching nonmelanoma skin cancers

AORN Journal, March, 2000 by Cynthia Drake

Skin cancer is common in the United States--more than 800,000 people were diagnosed with the disease in 1998.(1) Prevention, diagnosis, and treatment of nonmelanoma skin cancers continues to be debated among specialists. More research may help educate nursing staff members and patients. This column will discuss Internet locations that offer more information on this subject and others.

The Internet's increasing popularity provides more resources for nurse researchers. One new resource is at www.karnak.com, where searching one topic is free of charge. Follow instructions to create an account before searching for "nonmelanoma skin cancer." The service searches government publications, Medline, and other sources. Subscribers are notified via e-mail after the initial search is complete. Updates are provided as well.

Searching www.karnak.com provided more than 65 results. One abstract notes,

   The use of lymphatic mapping and sentinel lymph node biopsy has profoundly
   changed the management of patients with malignant melanoma. This technique
   may also be useful to identify patients with micrometastases of other skin
   cancers in the regional lymph nodes.(2)

The article also reviews the rationale and initial experience of lymphatic mapping for nonmelanoma skin cancers. The article can be ordered on this page from PubMed.

GEOGRAPHIC VARIATIONS IN INCIDENCE OF NONMELANOMA SKIN CANCERS

This search also found an article that discussed the mysteries of geographic variability in nonmelanoma skin cancer incidence.(3) The author observes substantial differences in the risk of these tumors among native people of Europe, Asia, and Africa. Also, the incidence of people diagnosed with basal cell carcinoma (BCC) and squamous cell carcinoma varies much more than for people diagnosed with other form of cancer. Skin cancer risk factors, preventive strategy efficacy, and cost-effectiveness of alternative treatments must be assessed to provide optimal treatment of nonmelanoma skin cancer.

COST-EFFECTIVENESS ISSUES

Search results from www .karnak.com also found a study that shows a comparison of diagnostic screening versus no screening.(4) The authors found each person who underwent diagnostic screening saved an average of $29,170 per year of life saved. They concluded that skin cancer screening of high-risk patients may be associated with slightly increasing reduced life expectancies and is cost-effective compared with other cancer screening strategies. Authors of another study provide cost comparisons for various therapeutic options. They found average costs were

* $652 for tumor destruction,

* $1,167 for outpatient surgical excision and detailed pathology report,

* $1,243 for Mohs micrographic surgery to remove tumors, and

* $4,558 for radiation therapy?

CALL FOR MULTICENTER STUDIES

These authors believe evidence-based guidelines to treat primary basal cell carcinoma cannot be developed at the present time because of the need for the randomized study of primary BCCs treated by different methods.(6) Experts skeptical of Mohs micrographic surgery advocate multicenter studies to research managing primary facial BCC, costs, volume of tissue excised, cosmetic results, and 10-year recurrence rates for patients who underwent surgical excision and Mohs micrographic procedures. They also suggest examining other innovative techniques that seem to achieve high cure rates, such as combined curettage, excision, or combined curettage and cryosurgery.(7)

OTHER INTERESTING WEB SITES

Perioperative nurses interested in orthopedics may choose to review www.orthoworld.com. The web site has information for surgeons, patients, and industry representatives as well. According to one executive of the sponsoring Institute for Orthopaedic Enlightenment,

   The next millennium will be characterized by the electronic dialogue
   intimately joining all entities of the orthopaedic health care system,
   including the patient. OrthoWorld will provide the gateway to such
   discussion as well as the platform for orthopedic: e-commerce.(8)

Conducting research on the Internet often uncovers serendipitous information, such as www.gator.com. After people download the gator program and enter requested information, this free Internet-based program will provide that information in other forms automatically. The program remembers sign-in names, passwords, and address and credit card information. When opening password-protected web sites, www.gator.com automatically appears and offers to provide necessary information.

Consultants and clients may be interested in www.guru.com. This free site brings together companies searching for freelance employees with individuals interested in various freelance projects.

The "Online Connections" column does not include all related web sites for our readers. The content is intended to supplement references related to AORN Journal content. AORN does not endorse web sites.

NOTES

(1.) S Strom, Y Yamamura, "Epidemiology of nonmelanoma skin cancer," Clinics in Plastic Surgery 24 (October 1997) 627-636.