Validation of a Melanoma Prognostic Model

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.

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“… Uncited references Aitken et al, 2010 Ekwueme et al, 2011 Guy and Ekwueme, 2011 Margolis et al, 1998 U.S. Cancer Statistics Working Group, 2013 …”

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confidence: 99%

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

Lakhani

Saraiya

Thompson

et al. 2014

Preventive Medicine

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“…Melanoma survival rates are inversely related to tumor thickness at diagnosis,5 and physicians are able to detect thinner melanomas than patients or their family members 6, 7. Full-body skin cancer screening is a safe, non-invasive, painless procedure that can be performed by dermatologists as well as primary care physicians 8, 9.…”

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confidence: 99%

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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“…Lesion thickness (Breslow depth), a reflection of tumor volume, has been identified as one of the most important prognostic factors for primary cutaneous melanoma with survival inversely related to lesion thickness [12,72,94]. In fact, the 5-year relative survival rate for people with melanoma is 91%, and the 10-year survival rate is 87% [3].…”

Section: Secondary Prevention Effortsmentioning

confidence: 99%