Screening for skin cancer in primary care settings

Federman, Daniel G.

doi:10.1001/archderm.133.11.1423

Cited by 8 publications

(5 citation statements)

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“…Our rate of 32% is similar to skin cancer screening rates obtained using different methods: 28% with medical chart review of patients seen in primary care 9 and 31% by questionnaires administered to PCPs. 10 Those with a personal history of skin cancer were more likely to recall undergoing an FBSE than were those without such a history.…”

Section: Commentsupporting

confidence: 76%

“…We cannot determine whether patient self-report was equivalent to actual practice, although our rates of FBSE are similar to those of other studies using different methods. 9,10 Although most patients do not undergo regular skin cancer screening, we found that patients have a considerable desire to undergo screening, either by their PCP or by a dermatologist. It is interesting that when given the choice of undergoing FBSE within the context of their regular primary care visits or making an additional visit to a dermatologist, patient convenience was not a major influential factor as more patients preferred the dermatologist, and almost a quarter had no preference.…”

Section: Commentmentioning

confidence: 80%

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Full-Body Skin Examinations

et al. 2004

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Section: Commentsupporting

confidence: 76%

Section: Commentmentioning

confidence: 80%

Full-Body Skin Examinations

et al. 2004

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“…Having more knowledge about the determinants of patient counseling and screening could guide interventions on physician characteristics that are amenable to change and potentially improve the promotion of physicians' prevention practices. 6 Several studies of physicians' practices [6][7][8][9][10][11][12] have identified characteristics of clinicians who tend to be more avid preventionists, but prevention practices specifically related to skin cancer have been examined [13][14][15][16][17][18] in limited populations (eg, single specialties, small geographic regions). Furthermore, these studies have often lacked adequate control for confounding factors and have not extensively addressed issues surrounding both skin cancer prevention and screening.…”

mentioning

confidence: 99%

Personal and Clinical Skin Cancer Prevention Practices of US Women Physicians

Saraiya

Frank²,

Elon³

et al. 2000

Arch Dermatol

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“…40,41 This lack of confidence is recognized as a major barrier to the conduct of early detection activities, and 1 consequence is that primary care clinicians typically do not carefully examine the skin. 42 In a recent survey, most patients reported that their primary care clinician rarely or never examined the skin of their back (the most common site of melanoma among men) or of their legs (the most common site among women). 28 While time constraints in primary care practice are not about to disappear, the barriers of skills and confidence are not an unalterable feature of the medical landscape.…”

Section: The Role Of Primary Care Cliniciansmentioning

confidence: 99%

Early Detection of Melanoma

Weinstock¹

2000

JAMA

105

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ELANOMA HAS BEEN INCREASING IN INCIDENCE ANDmortality in recent decades and represents a substantial public health problem. Because melanoma trends tend to follow a cohort pattern, deaths from melanoma occur at a younger age than most other cancers, and melanoma is among the most common sites of cancer in young adults.1 Early detection is feasible because melanoma is usually visible on the skin surface when in a curable stage. Invasive melanomas excised when less than 0.76 mm in Breslow thickness are about 96% curable.2 However, if melanoma is not removed before it reaches 3.6 mm in thickness, case fatality is greater than 70%.2 Death due to melanoma is a tragedy that should not be occurring so frequently.Admittedly, there is no reliable and precise measure of the magnitude of survival benefit that can be achieved by early detection; no randomized trials have reported on its effectiveness. Nevertheless, clinical experience, expert opinion, and knowledge of the stages of melanoma progression indicate that the potential to substantially reduce melanoma mortality is huge. Furthermore, reports from populations subject to intensive early detection campaigns have associated those campaigns with reduced mortality 3 and suggest that they are cost-effective. 4 These indications are supported by the trend of improved survival among melanoma patients in recent decades, presumably due in large part to early detection efforts. Procedure for Early Detection: Skin InspectionThe vast majority of melanomas that have not already metastasized are completely asymptomatic, although visible on the skin surface to the naked eye. Early detection requires inspection of the skin. The skin is already being examined by dermatologists, by primary care physicians, by other professionals who provide primary care, and by patients and their families. The question is not whether it is worthwhile for anyone to look at the skin. Rather, the question is whether and how these skin examinations can and should be improved for the purpose of reducing mortality from melanoma. The Role of DermatologistsDermatologists have the greatest expertise in diagnosis and treatment of skin lesions and have developed their skills during 3 years of residency training and subsequent experience in practice. For high-risk patients, dermatologists are providing cutaneous examinations and are making increasing use of tools, such as photography and in vivo epiluminescence microscopy, which aid in the early detection of melanoma by those with appropriate training. 5,6 High-risk patients, such as those with multiple dysplastic nevi, a history of melanoma, or a significant family history of melanoma, frequently obtain periodic dermatologic surveillance. These surveillance programs generally involve periodic dermatologic examination as well as patient and family education about warning signs and skin self-examination. Studies of patients in these programs have noted that melanomas occurring in enrolled patients are substantially thinner and hence of better prognosis than the me...

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Screening for skin cancer in primary care settings

Cited by 8 publications

References 0 publications

Full-Body Skin Examinations

Full-Body Skin Examinations

Personal and Clinical Skin Cancer Prevention Practices of US Women Physicians

Early Detection of Melanoma

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