Predictors of skin cancer screening practice and attitudes in primary care

Rodriguez, Georgette; Ma, Fangchao; Federman, Daniel G.; Rouhani, Panta; Chimento, Stacy; Multach, Mark; Kirsner, Robert S.

doi:10.1016/j.jaad.2007.04.023

Cited by 28 publications

(23 citation statements)

References 19 publications

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“…There is equivocal evidence from prior studies regarding potential differences in total skin examination rates between men and women 13, 14, 21. We found men to have a significantly higher skin examination rate than women (16% and 13%, respectively), although the absolute difference in screening rates was small.…”

Section: Discussioncontrasting

confidence: 74%

Prevalence and Correlates of Skin Cancer Screening among Middle-aged and Older White Adults in the United States

Coups¹,

Geller²,

Weinstock³

et al. 2010

The American Journal of Medicine

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Background Total skin examinations performed by a physician have the potential to identify skin cancers at an early stage, when they are most amenable to successful treatment. This study examined the prevalence rates of, and factors associated with, receipt of a total skin examination by a dermatologist or other doctor during the past year. Methods The participants were 10,486 white men and women aged 50 years and older drawn from a random sample of 31,428 adults aged 18 years and older who took part in the 2005 National Health Interview Survey (NHIS). The data were collected via in-person interviews, and participants answered questions regarding their receipt of total skin examinations, their demographic characteristics, health and healthcare access, receipt of other cancer screenings, and personal and family history of skin cancer. Results Sixteen percent of men and 13% of women reported having a skin examination in the past year. The factors associated with lowest skin examination rates in multivariable analyses included younger age (50–64 years), lower education level, lack of screening for colorectal, breast (women only), and prostate cancers (men only), and lack of a personal history of skin cancer. Conclusions Rates of having a skin examination in the past year were low among men and women and among all sub-groups. Systematic efforts are needed to increase screening rates among higher risk individuals. Physicians should be particularly aware of the need to consider skin cancer screening examinations for their male, elderly patients, as well as individuals with less education.

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Section: Discussioncontrasting

confidence: 74%

Prevalence and Correlates of Skin Cancer Screening among Middle-aged and Older White Adults in the United States

Coups¹,

Geller²,

Weinstock³

et al. 2010

The American Journal of Medicine

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“…122 It is possible that placing additional responsibilities on a primary care visit may actually interfere with secondary detection of conditions such as skin cancers or depression. [123][124][125] Finally, there are limitations in the methods used in this review. The quality of each study was subjectively determined and could not be analyzed in the aggregate because most studies and evaluations used different interventions and approaches to data collection.…”

Section: Limitations Of This Reviewmentioning

confidence: 99%

The Medical Home: Growing Evidence to Support a New Approach to Primary Care

Rosenthal¹

2008

The Journal of the American Board of Family Medicine

448

341

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Introduction:A medical home is a patient-centered, multifaceted source of personal primary health care. It is based on a relationship between the patient and physician, formed to improve the patient's health across a continuum of referrals and services. Primary care organizations, including the American Board of Family Medicine, have promoted the concept as an answer to government agencies seeking political solutions that make quality health care affordable and accessible to all Americans.Methods: Standard literature databases, including PubMed, and Internet sites of numerous professional associations, government agencies, business groups, and private health organizations identified over 200 references, reports, and books evaluating the medical home and patient-centered primary care.Findings: Evaluations of several patient-centered medical home models corroborate earlier findings of improved outcomes and satisfaction. The peer-reviewed literature documents improved quality, reduced errors, and increased satisfaction when patients identify with a primary care medical home. Patient autonomy and choice also contributes to satisfaction. Although industry has funded case management models demonstrating value superior to traditional fee-for-service reimbursement adoption of the medical home as a basis for medical care in the United States, delivery will require effort on the part of providers and incentives to support activities outside of the traditional face-to-face office visit.Conclusions: Evidence from multiple settings and several countries supports the ability of medical homes to advance societal health. A combination of fee-for-service, case management fees, and quality outcome incentives effectively drive higher standards in patient experience and outcomes. Community/ provider boards may be required to safeguard the public interest.

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“…In contrast, a 2006 survey of 426 patients in waiting rooms of primary care and dermatology clinics reported that these patients described receiving a regular (annually or every other year) full-body skin examination at a lower rate; only about 20% of patients in both settings reported a regular skin examination. 54 Whole-body screening for skin cancer should also include a focus on the most superficial manifestation of malignant transformation, the AK lesion. At the conclusion of a whole-body screening, the patient should be instructed to monitor his or her own skin for evidence of photodamage, including the presence of AKs.…”

Section: Status Of Current Screening For Malignant Changes Of the Skinmentioning

confidence: 99%