Early Detection Among Benefits of Skin Cancer Screening at Primary Care Visits

The results were presented at the 52nd annual American Society of Clinical Oncology (ASCO) annual meeting (June 3-7, 2016, Chicago, IL, USA). “Our findings suggest that PCP screening is an effective way to improve early detection of melanoma, which could potentially save lives,” said the study’s lead author Laura Ferris, MD, PhD, associate professor, University of Pittsburgh School of Medicine (Pittsburgh, PA, USA) of the University of Pittsburgh Schools of the Health Sciences (UPMC; Pittsburgh, PA, USA).

Skin cancer screenings are one of the most important steps for early detection and treatment. Typically, patients receive skin checks by appointment with a dermatologist. The goal of the new UPMC screening initiative, which was modeled after a promising German program, was to improve detection by making it easier for patients to get screened during routine office visits with their PCPs. PCPs completed training on how to recognize melanomas and were asked to offer annual screening during office visits to all patients aged 35 and older. In 2014, during the first year of the program, 15% of the 333,788 eligible UPMC patients were screened.

On average, the melanomas detected in the group who received a screening at a PCP visit were nearly twice as thin as those detected in the group that was not screened by a PCP. Thinner melanomas have a better prognosis than more advanced thicker ones, so the new findings suggest PCP screening can find melanomas at an earlier, more treatable stage.

In addition, only 5% of people in the screened group versus 20% of the unscreened group had melanomas of over 1 mm thickness, which are more likely to metastasize and require a biopsy of a nearby lymph node. “The PCP screenings prevented a lot of people from needing more aggressive therapy. Additionally, we did not see a high rate of false positive biopsies, in which no skin cancer was present, nor did we see a high rate of unnecessary dermatology referrals or skin surgeries, all of which suggest that the program did not simply drive up health care costs needlessly,” said Dr. Ferris.

Another important finding was that nearly half of the screened patients were men. Men are more likely to get and die from melanoma than women, but have been underrepresented in other skin cancer screenings published to date. “It’s exciting that our approach improves detection in this especially vulnerable population,” said Dr. Ferris.

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University of Pittsburgh School of Medicine
University of Pittsburgh Schools of the Health Sciences