Sex disparities in surgery for extramammary Paget disease: a SEER population‐based study

Abstract

Sex disparities in surgery for extramammary Paget disease: a SEER population-based study Dear Editor, Extramammary Paget disease (EMPD) is a rare dermatologic condition most commonly affecting the genital skin. Diagnosis is often delayed, and the incidence of invasive disease is high. Surgery is the gold standard of treatment for EMPD, and Mohs micrographic surgery (MMS) has reported lower recurrence rates. 1 To date, there is a paucity of data pertaining to the management of cutaneous genital carcinomas, including EMPD. 2 We sought to examine the relationships between demographic factors and surgical management of EMPD. This retrospective cohort study was performed utilizing the Surveillance, Epidemiology, and End Results (SEER) database, a population-based registry containing data on approximately 48.0 percent of the United States population. Data variables included surgical modality, age, sex, race, and median household income of EMPD patients between 2000 and 2018. Unadjusted and adjusted multinomial regression analyses for surgical modality with covariates were conducted. Statistical significance was defined at P < 0.05. Of patients diagnosed with EMPD with SEER treatment data available from 2000 to 2018 on MMS and wide local excision (WLE), 54 received MMS, and 89 received WLE. Of the patients who received MMS, only 10 were female (19%) (Figure 1). Males were significantly more likely than females to receive MMS, and females were significantly more likely than males to receive WLE (Table 1). Sex (male/female) was significantly associated with the surgery type received (P = 0.006). In contrast, race, age, median household income, and year of diagnosis showed no significant associations with surgery type received. Figure 1 Sex distribution by surgical modality