在许多医学领域，指南建议对年龄较大和寿命有限(LLE)的患者进行癌症筛查的减少。在皮肤科中，目前没有针对LLE患者的角质细胞癌(KC)的调整评估和管理做法的指南。有关这些患者的评估和管理模式以及活检频率的信息很少。我们旨在确定皮肤科医疗保健提供者是否与同龄人一样频繁地对LLE患者进行活检，并量化有关并发症的频率。这是一个回顾性队列研究，对2005-2009年在北德克萨斯退伍军人事务部皮肤科诊所进行的皮肤癌评估量化为皮肤癌皮肤活检频率的3062名患者进行了研究，包括为期5年的随访期。使用经过验证的Charlson共病指数(CCI)和Deyo改编来量化寿命预期。在大多数年龄控制组中，LLE和非LLE患者中KC的活检频率没有显著差异，但65-74岁年龄组的LLE患者活检频率明显增加(p=0.02)。与同龄健康对照相比，在75-84岁(许多合并症亚组：RR=3.27，p=0.002；一些合并症亚组：RR=2.26，p=0.048)和65-74岁(许多合并症亚组：RR=1.52，p=0.004)年龄组中进行活检会增加并发症的风险。与年龄匹配的对照组相比，LLE患者的活检频率相似或增加，并发症频率增加。需要进一步研究以了解支持这些实践模式的基本因素。S. Karger AG, Basel.

In many fields of medicine, guidelines recommend reduced cancer screening in patients of advanced age and limited life expectancy (LLE). In dermatology, there are currently no guidelines for adjusted evaluation and management practices of keratinocyte cancer (KC) in patients with LLE. Little is known regarding evaluation and management patterns and frequency of biopsies in these patients.We sought to determine if dermatology providers biopsy LLE patients with similar frequency to their age-matched peers and quantify frequency of associated complications.This was a retrospective cohort study of evaluations for skin cancer quantified by skin biopsy frequency for skin cancer at the North Texas Veteran Affairs Health System dermatology clinic for 3062 patients between 2005-2009, including a 5-year follow-up period. Life expectancy was quantified by the validated Charlson Comorbidity Index (CCI) with a Deyo adaptation.There was no significant difference in biopsy frequency of KC in LLE vs non-LLE patients in most age-controlled groups, with increased biopsy frequency in LLE patients in the 65-74 age category (p=0.02). There was also an increased risk of complications from biopsy in the 75-84 (many comorbidities subgroup: RR=3.27, p=0.002; some comorbidities subgroup: RR=2.26, p=0.048) and 65-74 (many comorbidities subgroup: RR=1.52, p=0.004) age group when compared to age matched healthy controls.Biopsy frequency is similar or increased in patients with LLE compared with age-matched controls, with increased frequency of complications. Further studies are needed to understand the underlying factors driving these practice patterns.S. Karger AG, Basel.