As the U.S. becomes more diverse, determining differences in healthcare utilization and costs of managing skin cancers is fundamental to decision-making in healthcare resource allocation and improving care for underserved populations.

To compare healthcare use and costs among non-Hispanic white, Hispanic white, and non-Hispanic black patients with keratinocyte carcinoma (KC).

We performed a nationwide cross-sectional study using the Medical Expenditure Panel Survey from 1996 to 2015.

Among 54,503,447 patients with KC (weighted) over a 20-year period, 53,134,351 (97%) were non-Hispanic white, 836,030 (1.5%) were Hispanic white, and 170,755 (0.3%) were non-Hispanic black. Compared to non-Hispanic whites, Hispanic whites had significantly more ambulatory visits per person per year (PPPY) (5.4 vs 3.5, p=0.003). Compared to non-Hispanic whites, non-Hispanic blacks had significantly more ambulatory visits (13.1 vs 3.5, p=0.027), emergency department visits (2.3 vs 1.1, p<0.001), and incurred significantly higher ambulatory costs ($5,089 vs $1,131, p=0.05), medication costs ($523 vs $221, p=0.022), and total costs PPPY ($13,430 vs $1,290, p=0.032).

Data for squamous cell carcinomas and basal cell carcinomas are combined.

KC was more costly to treat and required more healthcare resources in non-Hispanic black and Hispanic white patients than in white patients.