Factors Associated With the Number of Lesions Excised for Each Skin Cancer

Baade, Peter D.; Youl, Philippa; Janda, Monika; Whiteman, David C.; Mar, Chris Del; Aitken, Joanne F.

doi:10.1001/archderm.144.11.1468

Cited by 51 publications

(71 citation statements)

References 30 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Nevi that exhibit atypical clinical features require excision to rule out melanoma; consequently, much of the economic burden of melanoma screening results from excisions and biopsies of benign lesions, especially in patients with multiple nevi. 1 With the use of digital monitoring, the number of unnecessary excisions of benign lesions in such patients can be markedly reduced. 9,10 Although no data specifically concerning the use of dermatoscopy and digital monitoring procedures were collected from the centers involved in our study, it is likely that these procedures were increasingly adopted in centers dedicated to melanoma screening.…”

Section: Discussionmentioning

confidence: 99%

“…1 One of the most useful metrics for measuring accuracy in melanoma detection is the number needed to excise (NNE), calculated as the number of melanocytic lesions excised for every confirmed melanoma. NNE values vary according to clinician expertise, with reported values ranging from 20 to 40 for general practitioners at nonspecialized clinics, from 19 to 28 for general practitioners at skin cancer clinics, and from 4 to 18 for dermatologists at specialized clinics.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Accuracy in melanoma detection: A 10-year multicenter survey

Argenziano¹,

Cerroni²,

Zalaudek³

et al. 2012

Journal of the American Academy of Dermatology

173

155

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Accuracy in melanoma detection: A 10-year multicenter survey

Argenziano¹,

Cerroni²,

Zalaudek³

et al. 2012

Journal of the American Academy of Dermatology

173

155

View full text Add to dashboard Cite

“…Reported values achieved by general physicians range from 20 to 40 benign lesions excised to detect one melanoma and from 5 to 15 in the context of dermatologists and more experienced clinicians [1,2,3,4,5]. These number needed to excise rates underline the fact that a certain proportion of benign lesions should be excised even in the hands of experts because they closely resemble melanoma from a clinical and dermoscopic point of view.…”

Section: Introductionmentioning

confidence: 99%

Management Rules to Detect Melanoma

et al. 2013

View full text Add to dashboard Cite

Most melanomas are easy to be diagnosed clinically and dermoscopically. The question remains open concerning the correct strategies to detect those melanomas that look morphologically inconspicuous from a clinical and/or dermoscopic point of view. In our estimation, when morphology is not enough to recognize melanoma, one has to use specific management strategies. Herein we summarize the following 7 simple and practical rules that outline the need for a more general approach integrating clinical information with dermoscopic examination: (1) Look basically at all lesions. (2) Undress high-risk patients. (3) Use the 10 seconds rule in single lesions. (4) Compare and monitor multiple moles. (5) Excise doubtful nodular lesions. (6) Combine clinical and dermoscopic criteria. (7) Combine clinical and histopathologic criteria.

show abstract

“…21 A related study collected data on 28,755 skin examinations (resulting in 11,403 excisions or biopsies) from random samples of family medicine physicians excising or performing biopsy of skin lesions of patients in their routine practice, and from family physicians working in the aforementioned centrally-organized skin screening clinics. 22 The number (of pigmented lesions) needing to be excised (NNE) to find one melanoma was 19.6, a number that was significantly higher if there was strong patient pressure to excise the lesion, and significantly lower if the physician thought the lesion was likely to be malignant. The authors admit that determining an ideal number needed to excise is difficult given the risk of missing melanoma versus the need to reduce health care costs.…”

Section: Recent Evidence Regarding Screeningmentioning

confidence: 99%

“…The authors admit that determining an ideal number needed to excise is difficult given the risk of missing melanoma versus the need to reduce health care costs. 22 It may be noted that the NNE generally varies from 20-40 for primary care clinicians in non-specialized clinics, and 4-18 for dermatologists at specialty clinics. 23 A multinational, multicenter prospective trial recruited 14,381 subjects from all willing adult patients seeking dermatology consultation for focused skin lesions.…”

Section: Recent Evidence Regarding Screeningmentioning

confidence: 99%

Primary Care for Melanoma: Should We Be Screaming for Screening?

Baumgardner¹,

Rogers²

2014

Journal of Patient-Centered Research and Reviews

View full text Add to dashboard Cite

Follow this and additional works at: https://aurora.org/jpcrr Part of the Oncology CommonsJournal of Patient-Centered Research and Reviews ( JPCRR) is a peerreviewed scientific journal whose mission is to communicate clinical and bench research findings, with the goal of improving the quality of human health, the care of the individual patient, and the care of populations. Recommended CitationBaumgardner DJ, Rogers A. Primary care for melanoma: should we be screaming for screening?. J Patient Cent Res Rev. 2014;1:33-40. doi: 10.17294/2330-0698.1009 Aurora.org/Journal 33 AbstractThe incidence of cutaneous malignant melanoma continues to rise in the United States. This deadly disease is potentially curable if caught at an early stage, however screening programs remain controversial. The United States Preventive Services Task Force cites insufficient evidence to recommend screening, by total-body skin examination (TBSE), for early detection of cutaneous melanoma. While definitive studies may be cost-prohibitive in the United States, more recent evidence suggests that organized programs to increase TBSE reduce mortality from melanoma. The positive impact of TBSE, and education regarding risk reduction and skin selfexamination, is most likely to be cost-effective in high-risk patients such as middle-aged and older men. This population also includes those with changing moles or those who always or usually sunburn; those with melanoma in a first-degree relative, or dysplastic nevi or extensive moles; and those with high-risk ultraviolet (UV) exposure or other risk factors. The role of new technology, such as in-office and in-home dermoscopy, continues to evolve. Primary care clinicians are challenged in everyday practice to appropriately prioritize TBSE and empower their patients for "skin awareness" and self-detection of melanoma. (J Patient-Centered Res Rev.

show abstract

Factors Associated With the Number of Lesions Excised for Each Skin Cancer

Cited by 51 publications

References 30 publications

Accuracy in melanoma detection: A 10-year multicenter survey

Accuracy in melanoma detection: A 10-year multicenter survey

Management Rules to Detect Melanoma

Primary Care for Melanoma: Should We Be Screaming for Screening?

Contact Info

Product

Resources

About