A dermatologist-performed total-body skin examination (TBSE) identifies more than two times the number of skin cancers than patients or other providers discovered, researchers reported in the International Journal of Women’s Dermatology. The cancers may otherwise have gone undiagnosed, leading to later-stage disease and poorer outcomes.
Researchers reviewed dermatology records for 1,010 patients with biopsy-proven melanoma, basal cell carcinoma (BCC), or squamous cell carcinoma (SCC). They found that of the 1,563 biopsy-proven cutaneous malignancies, 51% were first identified by a dermatologist whereas 49% were identified by the patient or the referring provider. Of the 797 dermatologist-identified tumors, 69% were BCC, 28% were SCC, and 3% were melanomas. Dermatology skin exams were significantly more likely to identify BCC; however, SCC was more often identified by patients or their primary care providers.
Because a high percentage of malignant skin tumors are discovered only during dermatologist-performed TBSE, the researchers recommended referral to dermatology for any identified lesion of concern. TBSE also has been shown to improve diagnostic accuracy and decrease the number of unnecessary procedures. They added that all providers should educate patients about safe sun practices.
“When compared with skin biopsies performed by dermatologists, those by primary care providers are less sensitive for the detection of skin malignancy,” the authors said. “Additionally, dermatologist-performed TBSEs are associated with a low false-negative rate. That said, any type of skin examination by any willing provider should be encouraged as a first step in detecting skin cancer as a means to reduce morbidity and mortality; at-risk individuals may further benefit from TBSEs.”
For more information on melanoma prevention, screening, treatment, and survivorship recommendations, including an overview of its associated diagnostic biomarkers, read ONS Voice’s Melanoma Prevention, Screening, Treatment, and Survivorship Recommendations.