Introduction/Background: Skin cancer screening could impact mortality and morbidity in US adults; however, the effectiveness of widespread screening remains unclear. Further research is necessary to determine what age groups, with what risk factors, might benefit from routine total body skin exams (TBSE) in the US.
Objective: This study sought to determine, on average, the number of patients, per decade, needed to screen via TBSE to identify one person with skin cancer.
Methods: A retrospective review of Jefferson Dermatology outpatient data in Epic was conducted. All patient charts from 1/1/2017 - 1/1/2018 were reviewed if they received a TBSE. The type of skin cancer diagnosed after each visual skin exam was documented and data on the results of the patient interview and biopsy were collected in RedCap and analyzed in SPSS.
Results: 3153 patients received a TBSE. Skin cancer was identified in 180 people; 8 people were found to have melanoma. By decade, the number needed to screen to identify 1 person with skin cancer was as follows: 20s: 331, 30s: 64, 40s: 60, 50s: 22, 60s: 12, 70s: 10, 80s: 6, 90s: 5. By decade, the number needed to screen to identify 1 person with melanoma was as follows: 20s: 331, 30s: Undefined, 40s: Undefined, 50s: 559, 60s: 153, 70s: 452, 80s: undefined, 90s: undefined.
Conclusion: As patient age increases, less people need to be screened to detect skin cancer. It may be beneficial for Americans over 50 to obtain routine TBSEs. This data can contribute to the growing body of evidence needed for the USPSTF to provide skin cancer screening guidelines.
Hugo, Audra; Bui, Michael; Sherban, Alexander; Waseh, Shayan; and Jones, Elizabeth, "Total Body Skin Exam and Number Needed to Screen" (2019). SKMC JeffMD Scholarly Inquiry, Phase 1, Project 1.