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Wernli KJ, Henrikson NB, Morrison CC et al. Screening for skin cancer in adults: Updated evidence report and systematic review for the US Preventive Services Task Force JAMA. 2016;316:436-437
Does screening for skin cancer decrease the number of deaths caused by skin cancer? How accurate is skin cancer screening and what harms can it cause? Does screening help detect skin cancer earlier and does earlier detection reduce deaths?
Skin cancer is one of the most common cancers affecting men and women. Certain skin cancers, especially melanomas, can lead to very poor health outcomes, including death. Some doctors screen all patients for skin cancer by visually examining their skin for suspicious spots (called visual skin cancer screening), in hopes of detecting skin cancer early. However, previous research has failed to show that the benefits of screening outweigh the harms.
This is a review of 13 studies conducted from 2000 to 2012, including a total of 88 088 223 participants. All the studies were of fair or good quality, but none were randomized control trials.
In one fair quality study, people screened for skin cancer were less likely to die from melanoma than those who were not screened. Another study showed that screening allowed melanomas to be detected earlier – which, according to a number of studies, might decrease one’s risk of dying.
Some studies found that screening done by dermatologists and plastic surgeons, rather than family physicians, was more accurate. Of the people who screened positive and received skin biopsies, only 1 in 22 to 44 people actually had cancer. Screening and associated biopsies were not without harms – in one study, 7.1% of people felt their biopsy sites had a poor appearance.
There is some limited, poor quality evidence to suggest that screening for skin cancer may reduce deaths and allow for earlier detection of skin cancer. These findings are not enough to prove that the benefits of screening outweigh the harms, as the accuracy of skin cancer screening was not high. More high quality research is needed to study the impact of skin cancer screening, as well as to see if screening might be more effective in people who have a high risk of developing skin cancer.