Total body skin examination for skin cancer screening among U.S. adults from 2000 to 2010

Abstract

Objective Melanoma incidence and mortality are increasing among United States (U.S.) adults. Currently, routine skin cancer screening total body skin examinations (TBSEs) by a physician are not recommended by the United States Preventive Services Task Force (USPSTF); while organizations such as the American Cancer Society recommend screening. Currently, there are limited data on the prevalence, correlates, and trends of TBSE among U.S. adults. Methods We analyzed data by race/ethnicity, age, and skin cancer risk level, among other characteristics from three different National Health Interview Survey (NHIS) cancer control supplements conducted every five years since 2000 in random U.S. households. High-risk status and middle-risk status were defined based on the USPSTF criteria (age, race, sunburn, and family history). Results Prevalence of having at least one TBSE increased from 14.5 in 2000 to 16.5 in 2005 to 19.8 in 2010 (P = 0.0001). In 2010, screening rates were higher among the elderly, the fair-skinned, those reporting sunburn(s), and individuals with a family history of skin cancer. Approximately 104.7 million (51.1%) U.S. adults are at high-risk for developing melanoma, of which 24.0% had at least one TBSE. Conclusions TBSE rates have been increasing since 2000 both overall and among higher-risk groups. Data on screening trends could help tailor future prevention strategies.

Melanoma burden and recent trends among non-Hispanic whites aged 15–49 years, United States

“…16 Screening for skin cancer has become more common in recent years. 17 However, our study describes increases in both thick and thin lesions, strengthening evidence that while some increases in melanoma are likely attributable to increased surveillance and diagnosis of in situ or early-stage lesions, increases in 1.01 to 2.00 mm melanomas in women and thicker than 4.00 mm melanomas in men are clinically significant and may eventually lead to increasing mortality. 18,19 Although our study did not show increases in mortality among younger men, melanoma mortality is increasing slowly, at about 1% a year, among white males in the United States of all ages.…”

Prevalence and Predictors of Recent Skin Examination in a Population-Based Twin Cohort

“…In addition, we were not able to distinguish setting for clinical exam (dermatological or general practice), nor whether respondents had undergone full-body as opposed to partial skin examination. Further, because these data were collected between 1991–2000 and recent evidence shows increases in skin examination rates from 2000–2010, current rates may be higher than those represented here (25). …”

“…We observed high prevalence rates for recent skin examination among the sample (32% of California twins reported ever screening compared to 21% in recent national estimates) (25). Due to the relative rarity of melanoma, this proportion of individuals screening may be sufficient if those who screen are at highest risk of disease.…”

“…Studies have differed with regards to gender, with some finding greater likelihood and higher prevalence of screening among females (21, 22); others finding higher rates among males (23); and others still observing no differences (24). Prevalence rates for ever having physician skin examination have been uniformly low, ranging from 14 percent to 21 percent of adults in the United States (24, 25) with one study estimating that only 24 percent of individuals considered high-risk for melanoma have ever screened (25). Prevalence of recent skin exam measured within past year was lower, around 8–11 percent for average risk populations (24).…”

“…To date, most population-based studies of skin screening have used the National Health Information Survey (NHIS) as a primary data source (19, 22–25). While such studies have the benefits of a large sample yielding nationally representative estimates, they have not included melanoma risk factors such as nevi and childhood UV exposure.…”