Development of a Prediction Model for Patients at Risk of Incidental Skin Cancer: A Multicentre Prospective Study

Nielsen

2023

Preprint

Purpose To investigate factors related to omitted total body skin examination (TBSE) in skin cancer diagnostics while managing patients using teledermoscopy (TDS) in Swedish primary care. Methods 4,987 TDS referrals from primary care centers were analyzed to identify factors associated with failing to perform TBSE. Data collected included age, gender of patient and physician, and reason for visit. Logistic regression was used to test the association between the variables and risk for failing to complete a TBSE. Results The risk for omitted TBSE is higher in older patients, females, patients whose primary reason for seeking care was not specifically for a complete skin check, and with female physician. Patients > 80 years had more than four times increased risk not to undergo TBSE compared to the youngest (< 30 y). The strongest correlation to omitting TBSE was with other reason for primary care visit than “skin check”. Male gender of the patient and being examined by male physicians decreased the risk of omitted TBSE by 20% and 30%, respectively. There was no evidence of interaction between the gender of the patient and physician. Conclusion Since TDS reduces the opportunities to have a TBSE by dermatologists, the standard management of patients with suspicious skin lesions in primary care must be revised and evidence-based. TBSE is strongly recommended for patients with increased risk of skin cancer, for example old male persons with fair skin and a history of skin cancer, when managing them with TDS.

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Factors for not performing total body skin examinations in primary care in association with teledermoscopy

Nielsen

2023

Preprint

“…However, both these methods have in common that they will result in fewer TBSEs performed by dermatologists and thereby likely lead to a higher risk of missed skin cancer. Risk factors for having incidental skin cancers include older age (> 50), male gender, light skin phototype, having many nevi, living alone, lesion on the trunk, family history of skin cancer, personal history of skin cancer [ 11 , 12 , 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…Since TDS aims at decreasing referrals for a face-to-face consultation with dermatologists, most TDS-managed patients will not receive a TBSE from a dermatologist. It has previously been shown that more than 25% of incidental skin cancers could be missed if only LDS is used in the TDS management of patients [ 11 ]. In a high-risk population, Omara et al [ 12 ] showed that 21.7% of detected skin malignancies in a skin cancer clinic were detected incidentally upon performing a TBSE.…”

Section: Introductionmentioning

confidence: 99%

Factors for not performing total body skin examinations in primary care in association with teledermoscopy

2023

Purpose To investigate factors related to omitted total body skin examination (TBSE) in skin cancer diagnostics while managing patients using teledermoscopy (TDS) in Swedish primary care. Methods 4,987 TDS referrals from primary care centers were analyzed to identify factors associated with failing to perform TBSE. Data collected included age, gender of patient and physician, and reason for a visit. Logistic regression was used to test the association between the variables and risk of failing to complete a TBSE. Results The risk for omitted TBSE is higher in older patients, females, patients whose primary reason for seeking care was not specifically for a complete skin check, and with female physician. Patients > 80 years had more than four times increased risk of not undergoing TBSE compared to the youngest (< 30 y). The strongest correlation to omitting TBSE was with other reasons for primary care visits than “skin check”. Male gender of the patient and being examined by male physicians decreased the risk of omitted TBSE by 20% and 30%, respectively. There was no evidence of interaction between the gender of the patient and the physician. Conclusion Since TDS reduces the opportunities to have a TBSE by dermatologists, the standard management of patients with suspicious skin lesions in primary care must be revised and evidence-based. TBSE is strongly recommended for patients with increased risk of skin cancer, for example old persons with fair skin and a history of skin cancer, when managing them with TDS.

Asian Pac J Cancer Prev

“…In this regard, various types of skin cancer are significantly linked to environmental conditions and the level of ultraviolet (UV) radiation exposure [ 11 ]. The role of environmental components, including pollution, outdoor activities, radiation exposure, and climate changes, has been studied concerning skin cancer [ 12 , 13 ]. Wheeler et al (2013), examined the correlation between skin cancer rates and three factors: Radon, Arsenic, and sunshine hours in England.…”

Section: Introductionmentioning

confidence: 99%

Geospatial Patterns of Non-Melanoma Skin Cancer in Relation to Climate Changes in Iran

Aryan Kya

2024

Objective:The purpose of this study is to examine the impact of climate change factors on the incidence of skin cancer in Iran. Methods: The statistical population for this study comprises skin cancer patients in Iran. All other data used in this research were extracted from Remote Sensing imagery, including Ultraviolet ray, Relative humidity, Cloud cover, incoming short-wave flux, elevation, and total hours of sunshine. Initially, spatial autocorrelation analysis and cluster patterns were calculated using General G and Moran's I indices. Subsequently, a Geographically Weighted Regression Model was used to establish a regression relationship between the climate change data and the detection and forecasting rate of skin cancer. Finally, the model's accuracy was evaluated by estimating the detection coefficient between the reality map and the forecasting map. Results: The study found that UV radiation and relative humidity exhibit the highest positive and negative correlation, respectively, with the skin cancer rate in Iran. Geostatistical analysis revealed a clustered spatial distribution of skin cancer rates, and the proposed GWR model demonstrated high accuracy in predicting the skin cancer rate. The results indicate the highest positive correlation (+0.51) for UV ray and the most negative correlation (-0.43) for relative humidity. The Geostatistical analysis reveals spatial autocorrelation, cluster patterns, and non-randomness of the data. Conclusion: The detection rate of skin cancer increases from north to south and from west to east.