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Clinical outcomes from skin screening clinics within a community-based melanoma screening program

Aitken, Joanne, Elwood, Mark , Janda, Monika, Lowe, John , Ring, Ian T. , & Youl, Philippa (2006) Clinical outcomes from skin screening clinics within a community-based melanoma screening program. Journal of the American Academy of Dermatology, 54(1), pp. 105-114.

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Abstract

Background: Within a randomized trial of population screening for melanoma, primary care physicians conducted whole-body skin examinations and referred all patients with suspect lesions to their own doctor for further treatment.

Objective: Our aim was to describe characteristics of skin screening participants, clinical screening diagnoses, management following referral, and specificity and yield of screening examinations.

Methods: Information collected from consent forms, referral forms, and histopathological reports of lesions that had been excised or undergone biopsy was analyzed by means of descriptive statistics.

Results: A total of 16,383 whole-body skin examinations resulted in 2302 referrals (14.1% overall; 15.5% men, 18.2% $50 years of age) for 4129 suspect lesions (including 222 suspected melanoma, 1101 suspected basal cell carcinomas [BCCs], 265 suspected squamous cell carcinomas [SCCs]). Histopathologic results were available for 94.8% of 1417 lesions excised and confirmed 33 melanomas (23 in men; 24 in participants $50 years of age), 259 BCCs, and 97 SCCs. The probability of detecting skin cancer of any type within the program was 2.4%. The estimated specificity of whole-body skin examinations for melanoma was 86.1% (95% confidence interval = 85.6-86.6). The positive predictive value (number of confirmed/number of lesions excised or biopsied 3 100) for melanoma was 2.5%, 19.3% for BCC, and 7.2% for SCC overall positive predictive value for skin cancer, 28.9%).

Limitations: Follow-up of participants with a negative screening examination has not been conducted for the present investigation.

Conclusions: The rate of skin cancer detected per 100 patients screened was higher than previously reported and men and attendees older than 50 years more frequently received a referral and diagnosis of melanoma. The specificity for detection of melanoma through whole-body skin examination by a primary care physician was comparable to that of other screening tests, including mammography. (J Am Acad Dermatol 2006;54:105-14.)

Impact and interest:

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37 citations in Web of Science®

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ID Code: 22340
Item Type: Journal Article
Additional URLs:
Keywords: Melanoma, Screeing
DOI: 10.1016/j.jaad.2005.08.072
ISSN: 0190-9622
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > ONCOLOGY AND CARCINOGENESIS (111200) > Oncology and Carcinogenesis not elsewhere classified (111299)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > OPTOMETRY AND OPHTHALMOLOGY (111300)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Preventive Medicine (111716)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Primary Health Care (111717)
Divisions: Current > Research Centres > Centre for Health Research
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Public Health & Social Work
Copyright Owner: 2005 by the American Academy of Dermatology, Inc.
Deposited On: 17 Jun 2009 23:10
Last Modified: 29 Feb 2012 23:25

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