Screening for skin cancer US preventive services task force recommendation statement

Kirsten Bibbins-Domingo, David C. Grossman, Susan J. Curry, Karina W. Davidson, Mark H. Ebell, John W. Epling, Francisco A.R. García, Matthew W. Gillman, Alex R. Kemper, Alex H. Krist, Ann E. Kurth, C. Seth Landefeld, Carol M. Mangione, William R. Phillips, Maureen G. Phipps, Michael P. Pignone, Albert L. Siu

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Abstract

Importance Basal and squamous cell carcinoma are the most common types of cancer in the United States and represent the vast majority of all cases of skin cancer; however, they rarely result in death or substantial morbidity, whereas melanoma skin cancer has notably higher mortality rates. In 2016, an estimated 76 400 US men and women will develop melanoma and 10 100 will die from the disease. OBJECTIVE To update the 2009 US Preventive Services Task Force (USPSTF) recommendation on screening for skin cancer. EVIDENCE REVIEW The USPSTF reviewed the evidence on the effectiveness of screening for skin cancer with a clinical visual skin examination in reducing skin cancer morbidity and mortality and death from any cause; its potential harms, including any harms resulting from associated diagnostic follow-up; its test characteristics when performed by a primary care clinician vs a dermatologist; and whether its use leads to earlier detection of skin cancer compared with usual care. FINDINGS Evidence to assess the net benefit of screening for skin cancer with a clinical visual skin examination is limited. Direct evidence on the effectiveness of screening in reducing melanoma morbidity and mortality is limited to a single fair-quality ecologic study with important methodological limitations. Information on harms is similarly sparse. The potential for harm clearly exists, including a high rate of unnecessary biopsies, possibly resulting in cosmetic or, more rarely, functional adverse effects, and the risk of overdiagnosis and overtreatment. CONCLUSIONS AND RECOMMENDATION The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in adults (I statement).

Original languageEnglish (US)
Pages (from-to)429-435
Number of pages7
JournalJAMA - Journal of the American Medical Association
Volume316
Issue number4
DOIs
StatePublished - Jul 26 2016

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Skin Neoplasms
Advisory Committees
Melanoma
Morbidity
Skin
Mortality
Basal Cell Carcinoma
Early Detection of Cancer
Cosmetics
Cause of Death
Squamous Cell Carcinoma
Primary Health Care
Biopsy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Bibbins-Domingo, K., Grossman, D. C., Curry, S. J., Davidson, K. W., Ebell, M. H., Epling, J. W., ... Siu, A. L. (2016). Screening for skin cancer US preventive services task force recommendation statement. JAMA - Journal of the American Medical Association, 316(4), 429-435. https://doi.org/10.1001/jama.2016.8465

Screening for skin cancer US preventive services task force recommendation statement. / Bibbins-Domingo, Kirsten; Grossman, David C.; Curry, Susan J.; Davidson, Karina W.; Ebell, Mark H.; Epling, John W.; García, Francisco A.R.; Gillman, Matthew W.; Kemper, Alex R.; Krist, Alex H.; Kurth, Ann E.; Seth Landefeld, C.; Mangione, Carol M.; Phillips, William R.; Phipps, Maureen G.; Pignone, Michael P.; Siu, Albert L.

In: JAMA - Journal of the American Medical Association, Vol. 316, No. 4, 26.07.2016, p. 429-435.

Research output: Contribution to journalArticle

Bibbins-Domingo, K, Grossman, DC, Curry, SJ, Davidson, KW, Ebell, MH, Epling, JW, García, FAR, Gillman, MW, Kemper, AR, Krist, AH, Kurth, AE, Seth Landefeld, C, Mangione, CM, Phillips, WR, Phipps, MG, Pignone, MP & Siu, AL 2016, 'Screening for skin cancer US preventive services task force recommendation statement', JAMA - Journal of the American Medical Association, vol. 316, no. 4, pp. 429-435. https://doi.org/10.1001/jama.2016.8465
Bibbins-Domingo, Kirsten ; Grossman, David C. ; Curry, Susan J. ; Davidson, Karina W. ; Ebell, Mark H. ; Epling, John W. ; García, Francisco A.R. ; Gillman, Matthew W. ; Kemper, Alex R. ; Krist, Alex H. ; Kurth, Ann E. ; Seth Landefeld, C. ; Mangione, Carol M. ; Phillips, William R. ; Phipps, Maureen G. ; Pignone, Michael P. ; Siu, Albert L. / Screening for skin cancer US preventive services task force recommendation statement. In: JAMA - Journal of the American Medical Association. 2016 ; Vol. 316, No. 4. pp. 429-435.
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abstract = "Importance Basal and squamous cell carcinoma are the most common types of cancer in the United States and represent the vast majority of all cases of skin cancer; however, they rarely result in death or substantial morbidity, whereas melanoma skin cancer has notably higher mortality rates. In 2016, an estimated 76 400 US men and women will develop melanoma and 10 100 will die from the disease. OBJECTIVE To update the 2009 US Preventive Services Task Force (USPSTF) recommendation on screening for skin cancer. EVIDENCE REVIEW The USPSTF reviewed the evidence on the effectiveness of screening for skin cancer with a clinical visual skin examination in reducing skin cancer morbidity and mortality and death from any cause; its potential harms, including any harms resulting from associated diagnostic follow-up; its test characteristics when performed by a primary care clinician vs a dermatologist; and whether its use leads to earlier detection of skin cancer compared with usual care. FINDINGS Evidence to assess the net benefit of screening for skin cancer with a clinical visual skin examination is limited. Direct evidence on the effectiveness of screening in reducing melanoma morbidity and mortality is limited to a single fair-quality ecologic study with important methodological limitations. Information on harms is similarly sparse. The potential for harm clearly exists, including a high rate of unnecessary biopsies, possibly resulting in cosmetic or, more rarely, functional adverse effects, and the risk of overdiagnosis and overtreatment. CONCLUSIONS AND RECOMMENDATION The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in adults (I statement).",
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AU - Grossman, David C.

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AU - Ebell, Mark H.

AU - Epling, John W.

AU - García, Francisco A.R.

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AU - Kemper, Alex R.

AU - Krist, Alex H.

AU - Kurth, Ann E.

AU - Seth Landefeld, C.

AU - Mangione, Carol M.

AU - Phillips, William R.

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AU - Pignone, Michael P.

AU - Siu, Albert L.

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N2 - Importance Basal and squamous cell carcinoma are the most common types of cancer in the United States and represent the vast majority of all cases of skin cancer; however, they rarely result in death or substantial morbidity, whereas melanoma skin cancer has notably higher mortality rates. In 2016, an estimated 76 400 US men and women will develop melanoma and 10 100 will die from the disease. OBJECTIVE To update the 2009 US Preventive Services Task Force (USPSTF) recommendation on screening for skin cancer. EVIDENCE REVIEW The USPSTF reviewed the evidence on the effectiveness of screening for skin cancer with a clinical visual skin examination in reducing skin cancer morbidity and mortality and death from any cause; its potential harms, including any harms resulting from associated diagnostic follow-up; its test characteristics when performed by a primary care clinician vs a dermatologist; and whether its use leads to earlier detection of skin cancer compared with usual care. FINDINGS Evidence to assess the net benefit of screening for skin cancer with a clinical visual skin examination is limited. Direct evidence on the effectiveness of screening in reducing melanoma morbidity and mortality is limited to a single fair-quality ecologic study with important methodological limitations. Information on harms is similarly sparse. The potential for harm clearly exists, including a high rate of unnecessary biopsies, possibly resulting in cosmetic or, more rarely, functional adverse effects, and the risk of overdiagnosis and overtreatment. CONCLUSIONS AND RECOMMENDATION The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in adults (I statement).

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