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Noninvasive Diagnostic Techniques for the Detection of Skin Cancers
Comparative Effectiveness Technical Briefs, No. 11
Investigators: Susan K Parsons, MD, MRP, Jeffery A Chan, BS, Winifred W Yu, MS, RD, Ndidiamaka Obadan, MD, MSc, Sara J Ratichek, MA, Jounghee Lee, PhD, Srila Sen, MA, and Stanley Ip, MD.
Contributor Information and AffiliationsStructured Abstract
Background:
Cancers of the skin are the most common forms of cancer. Timely diagnosis and treatment are critical to reducing the rates of morbidity and mortality. Newer noninvasive imaging technologies may assist with earlier detection.
Objective:
To provide an objective description of noninvasive imaging modalities in diagnosing cancerous tumors of the skin, to proffer an analytic framework for assessing the applications of the imaging modalities, to summarize the state of ongoing research, and to delineate future research needs.
Methods:
We searched the MEDLINE® database for English-language literature published between 1990 and March 2011 for selected noninvasive imaging technologies. We included all publications types and study designs. We extracted data solely from relevant abstracts. Our search also included grey literature (manufacturers’ Web sites, Food and Drug Administration’s relevant databases, and ClinicalTrials.gov), and incorporated expert input from our key informants. Devices were classified as in general clinical use, limited clinical use, or investigational use, based on all available information.
Findings:
We screened in 629 abstracts that were relevant to the noninvasive imaging technologies of interest. Only 11 abstracts were on randomized controlled trials. Of the devices in general clinical use, we found a total of 51 abstracts on photography and 433 on dermoscopy. Of note, only one abstract reported clinical outcomes. None of the abstracts reported adverse events. Photography is principally used in specialty and subspecialty settings (i.e., oncology) and while widely used by dermatologists, dermoscopy is still not used in primary care. We did not identify any consistent guidelines for the assessment of suspicious skin lesions. Devices in limited clinical use are principally used in research settings. Available literature was limited for these devices as well as those still considered investigational.
Summary:
A review of the literature reveals predominant use of noninvasive devices by dermatologists with limited diffusion of this technology in primary care. When compared with the use of biopsy, future research is needed to evaluate the test accuracies, clinical impact, and the potential adverse events associated with the use of noninvasive imaging technologies.
Contents
Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services1, Contract No. 290-2007-10055-1. Prepared by: Tufts University Evidence-based Practice Center, Boston, MA
Suggested citation:
Parsons SK, Chan JA, Yu WW, Obadan N, Ratichek SJ, Lee J, Sen S, Ip S. Noninvasive Diagnostic Techniques for the Detection of Skin Cancers. Technical Brief No. 11. (Prepared by the Tufts University Evidence-based Practice Center under Contract No. 290-2007-1055-1.) AHRQ Publication No. 11-EHC085-EF. Rockville, MD: Agency for Healthcare Research and Quality. September 2011. Available at: www.effectivehealthcare.ahrq.gov/reports/final.cfm.
This report is based on research conducted by the Tufts University Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2007-10055-1). The findings and conclusions in this document are those of the author(s), who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.
The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.
This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.
None of the investigators has any affiliations or financial involvement that conflicts with the material presented in this report.
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.ahrq.gov
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