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JAMA. 2016 Jul 26;316(4):429-35. doi: 10.1001/jama.2016.8465.

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

Author information

1
University of California, San Francisco.
2
Group Health Research Institute, Seattle, Washington.
3
University of Iowa, Iowa City.
4
Columbia University, New York, New York.
5
University of Georgia, Athens.
6
State University of New York Upstate Medical University, Syracuse.
7
Pima County Department of Health, Tucson, Arizona.
8
Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.
9
Duke University, Durham, North Carolina.
10
Fairfax Family Practice Residency, Fairfax, Virginia11Virginia Commonwealth University, Richmond.
11
Yale University, New Haven, Connecticut.
12
University of Alabama at Birmingham.
13
University of California, Los Angeles.
14
University of Washington, Seattle.
15
Brown University, Providence, Rhode Island.
16
University of Texas at Austin.
17
Mount Sinai School of Medicine, New York, New York19James J. Peters Veterans Affairs Medical Center, Bronx, New York.

Abstract

IMPORTANCE:

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.

OBJECTIVE:

To update the 2009 US Preventive Services Task Force (USPSTF) recommendation on screening for skin cancer.

EVIDENCE REVIEW:

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.

FINDINGS:

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.

CONCLUSIONS AND RECOMMENDATION:

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).

Summary for patients in

PMID:
27458948
DOI:
10.1001/jama.2016.8465
[Indexed for MEDLINE]

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