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Screening for Skin Cancer: US Preventive Services Task Force Recommendation Statement
Journal article   Open access   Peer reviewed

Screening for Skin Cancer: US Preventive Services Task Force Recommendation Statement

Kirsten Bibbins-Domingo, David C Grossman, Susan J Curry, Karina W Davidson, Mark Ebell, John W Epling Jr, Francisco A R García, Matthew W Gillman, Alex R Kemper, Alex H Krist, …
JAMA : the journal of the American Medical Association, Vol.316(4), pp.429-435
07/26/2016
DOI: 10.1001/jama.2016.8465
PMID: 27458948
url
https://doi.org/10.1001/jama.2016.8465View
Published (Version of record) Open Access

Abstract

Basal and squamous cell carcinoma are the most common types of cancer in the United States and represent the vast majority of all cases of skin cancer; however, they rarely result in death or substantial morbidity, whereas melanoma skin cancer has notably higher mortality rates. In 2016, an estimated 76,400 US men and women will develop melanoma and 10,100 will die from the disease. To update the 2009 US Preventive Services Task Force (USPSTF) recommendation on screening for skin cancer. The USPSTF reviewed the evidence on the effectiveness of screening for skin cancer with a clinical visual skin examination in reducing skin cancer morbidity and mortality and death from any cause; its potential harms, including any harms resulting from associated diagnostic follow-up; its test characteristics when performed by a primary care clinician vs a dermatologist; and whether its use leads to earlier detection of skin cancer compared with usual care. Evidence to assess the net benefit of screening for skin cancer with a clinical visual skin examination is limited. Direct evidence on the effectiveness of screening in reducing melanoma morbidity and mortality is limited to a single fair-quality ecologic study with important methodological limitations. Information on harms is similarly sparse. The potential for harm clearly exists, including a high rate of unnecessary biopsies, possibly resulting in cosmetic or, more rarely, functional adverse effects, and the risk of overdiagnosis and overtreatment. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in adults (I statement).
 Dermatology Adult Advisory Committees Aged Carcinoma, Basal Cell - diagnosis Carcinoma, Basal Cell - mortality Carcinoma, Basal Cell - prevention & control Carcinoma, Squamous Cell - diagnosis Carcinoma, Squamous Cell - mortality Carcinoma, Squamous Cell - prevention & control Early Detection of Cancer - methods Early Detection of Cancer - mortality Early Detection of Cancer - standards Female Humans Male Melanoma - diagnosis Melanoma - mortality Melanoma - prevention & control Middle Aged Physical Examination - methods Physical Examination - standards Primary Health Care Skin Neoplasms - diagnosis Skin Neoplasms - mortality Skin Neoplasms - prevention & control

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