BACKGROUND: Within a randomized trial of population screening for melanoma, primary care physicians conducted whole-body skin examinations and referred all patients with suspect lesions to their own doctor for further treatment. OBJECTIVE: Our aim was to describe characteristics of skin screening participants, clinical screening diagnoses, management following referral, and specificity and yield of screening examinations. METHODS: Information collected from consent forms, referral forms, and histopathological reports of lesions that had been excised or undergone biopsy was analyzed by means of descriptive statistics. RESULTS:A total of 16,383 whole-body skin examinations resulted in 2302 referrals (14.1% overall; 15.5% men, 18.2% > or = 50 years of age) for 4129 suspect lesions (including 222 suspected melanoma, 1101 suspected basal cell carcinomas [BCCs], 265 suspected squamous cell carcinomas [SCCs]). Histopathologic results were available for 94.8% of 1417 lesions excised and confirmed 33 melanomas (23 in men; 24 in participants > or = 50 years of age), 259 BCCs, and 97 SCCs. The probability of detecting skin cancer of any type within the program was 2.4%. The estimated specificity of whole-body skin examinations for melanoma was 86.1% (95% confidence interval = 85.6-86.6). The positive predictive value (number of confirmed/number of lesions excised or biopsied x 100) for melanoma was 2.5%, 19.3% for BCC, and 7.2% for SCC (overall positive predictive value for skin cancer, 28.9%). LIMITATIONS: Follow-up of participants with a negative screening examination has not been conducted for the present investigation. CONCLUSIONS: The rate of skin cancer detected per 100 patients screened was higher than previously reported and men and attendees older than 50 years more frequently received a referral and diagnosis of melanoma. The specificity for detection of melanoma through whole-body skin examination by a primary care physician was comparable to that of other screening tests, including mammography.
RCT Entities:
BACKGROUND: Within a randomized trial of population screening for melanoma, primary care physicians conducted whole-body skin examinations and referred all patients with suspect lesions to their own doctor for further treatment. OBJECTIVE: Our aim was to describe characteristics of skin screening participants, clinical screening diagnoses, management following referral, and specificity and yield of screening examinations. METHODS: Information collected from consent forms, referral forms, and histopathological reports of lesions that had been excised or undergone biopsy was analyzed by means of descriptive statistics. RESULTS: A total of 16,383 whole-body skin examinations resulted in 2302 referrals (14.1% overall; 15.5% men, 18.2% > or = 50 years of age) for 4129 suspect lesions (including 222 suspected melanoma, 1101 suspected basal cell carcinomas [BCCs], 265 suspected squamous cell carcinomas [SCCs]). Histopathologic results were available for 94.8% of 1417 lesions excised and confirmed 33 melanomas (23 in men; 24 in participants > or = 50 years of age), 259 BCCs, and 97 SCCs. The probability of detecting skin cancer of any type within the program was 2.4%. The estimated specificity of whole-body skin examinations for melanoma was 86.1% (95% confidence interval = 85.6-86.6). The positive predictive value (number of confirmed/number of lesions excised or biopsied x 100) for melanoma was 2.5%, 19.3% for BCC, and 7.2% for SCC (overall positive predictive value for skin cancer, 28.9%). LIMITATIONS: Follow-up of participants with a negative screening examination has not been conducted for the present investigation. CONCLUSIONS: The rate of skin cancer detected per 100 patients screened was higher than previously reported and men and attendees older than 50 years more frequently received a referral and diagnosis of melanoma. The specificity for detection of melanoma through whole-body skin examination by a primary care physician was comparable to that of other screening tests, including mammography.
Authors: Mary K Tripp; Meg Watson; Sophie J Balk; Susan M Swetter; Jeffrey E Gershenwald Journal: CA Cancer J Clin Date: 2016-05-27 Impact factor: 508.702
Authors: Jeremy R Etzkorn; Rajiv P Parikh; Suroosh S Marzban; Kimberly Law; Ashley H Davis; Bhupendra Rawal; Michael J Schell; Vernon K Sondak; Jane L Messina; Lois E Rendina; Jonathan S Zager; Mary H Lien Journal: Cancer Control Date: 2013-10 Impact factor: 3.302
Authors: Karen M Emmons; Alan C Geller; Elaine Puleo; Sanghamitra S Savadatti; Stephanie W Hu; Susan Gorham; Andrew E Werchniak Journal: J Am Acad Dermatol Date: 2010-12-15 Impact factor: 11.527
Authors: Clara Curiel-Lewandrowski; Caroline C Kim; Susan M Swetter; Suephy C Chen; Allan C Halpern; John M Kirkwood; Sancy A Leachman; Ashfaq A Marghoob; Michael E Ming; James M Grichnik Journal: J Invest Dermatol Date: 2012-02-16 Impact factor: 8.551
Authors: Loraine A Escobedo; Ashley Crew; Ariana Eginli; David Peng; Michael R Cousineau; Myles Cockburn Journal: Health Place Date: 2017-04-06 Impact factor: 4.078