Hindawi Publishing Corporation Journal of Skin Cancer Volume 2013, Article ID 689261, 6 pages http://dx.doi.org/10.1155/2013/689261 Research Article Ambulatory Melanoma Care Patterns in the United States Andrew L. Ji, 1 Michael R. Baze, 2 Scott A. Davis, 1 Steven R. Feldman, 1,3,4 and Alan B. Fleischer Jr. 1,5 1 Galderma Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC 27157-1071, USA 2 Nova Southeastern University/Broward Health Medical Center, Department of Dermatology, Fort Lauderdale, FL 33315, USA 3 Galderma Center for Dermatology Research, Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC 27157-1071, USA 4 Galderma Center for Dermatology Research, Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157-1071, USA 5 Wake Forest University School of Medicine, Department of Dermatology, Medical Center Boulevard, Winston-Salem, NC 27157-1071, USA Correspondence should be addressed to Alan B. Fleischer Jr.; afeisch@wfubmc.edu Received 3 June 2013; Accepted 22 July 2013 Academic Editor: Mark Lebwohl Copyright © 2013 Andrew L. Ji et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. To examine trends in melanoma visits in the ambulatory care setting. Methods. Data from the National Ambulatory Medical Care Survey (NAMCS) from 1979 to 2010 were used to analyze melanoma visit characteristics including number of visits, age and gender of patients, and physician specialty. Tese data were compared to US Census population estimates during the same time period. Results. Te overall rate of melanoma visits increased ( < 0.0001) at an apparently higher rate than the increase in population over this time. Te age of patients with melanoma visits increased at approximately double the rate (0.47 year per interval year,  < 0.0001) of the population increase in age (0.23 year per interval year). Tere was a nonsignifcant ( = 0.19) decline in the proportion of female patients seen over the study interval. Lastly, ambulatory care has shifed towards dermatologists and other specialties managing melanoma patients and away from family/internal medicine physicians and general/plastic surgeons. Conclusions. Te number and age of melanoma visits has increased over time with respect to the overall population, mirroring the increase in melanoma incidence over the past three decades. Tese trends highlight the need for further studies regarding melanoma management efciency. 1. Introduction In 2013, the American Cancer Society estimates that there will be 76,690 new cases of melanoma diagnosed, with 61,300 being melanoma in situ [1]. Melanoma management costs the US billions of dollars in direct annual expenses [2]. Worldwide, during the past several decades, there has been a substantial increase in the incidence of melanoma, particu- larly among white populations [3, 4]. In the US, the incidence of melanoma also continues to rise. From 1973 to 1994, US melanoma incidence rates increased 154.4% in males (from 6.8 to 17.3 per 100,000) and 90.2% in females (from 6.1 to 11.6 per 100,000) [5]. Te melanoma incidence rates during 2006 to 2010 reveal a similar trend in males (27.4 per 100,000) and females (16.7 per 100,000), nearly quadrupling in men and tripling in women over the past three to four decades [6]. More specifcally, during this period, the incidence rates per 100,000 persons were 31.9 and 20.0 in white men and women, respectively; 4.7 and 4.4 in Hispanic men and women, respec- tively; 1.6 and 1.1 in Asian men and women, respectively; and 1.1 and 1.0 in black men and woman, respectively [6]. According to the National Cancer Institute Surveillance Epidemiology End Results data, from 2006 to 2010, the median age at diagnosis for melanoma was 61 years, with approximately 65% of cases occurring in those 55 years and older [6]. Current estimates of lifetime risk for Americans experiencing melanoma are 1 in 37 for men and 1 in 56 for women, which contrasts with the lifetime risk of 1 in 1,500