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TOPLINE:

Many asymptomatic patients who are screened for skin cancer have a lower risk for detection than older patients with prior skin cancer, a study found.

METHODOLOGY:

• Researchers conducted a secondary analysis of previsit survey data from new patients seen at the Emory Healthcare Dermatology Clinic, Atlanta, between March 2021 and October 2022.
• The study included 1074 asymptomatic patients (mean age, 50.3 years; 59.9% women; 66% White and 10% Black) who requested comprehensive skin examinations because of general concerns about skin cancer.
• A total of 52.6% of patients completed a survey assessing personal and family history of skin cancer, skin phototype, sunburn tendency, hair color, eye color, and organ transplant status.
• The researchers calculated the number needed to examine (NNE) to diagnose one skin cancer across age and risk-based subgroups.

TAKEAWAY:

• Overall, 131 patients (12.2%) underwent 146 biopsies, and 38 skin cancers were diagnosed; 35 of these 38 patients with skin cancer were aged 50 years or older, and 37 were skin phototype I-III.
• The NNE to diagnose one skin cancer was 7 in patients older than 70 years compared with 181 in those aged 50 years or younger (P < .001).
• Patients with a personal history of skin cancer had an NNE of 12, whereas those without prior skin cancer had an NNE of 52.
• Patients with lighter skin phototypes (I-III) had lower NNEs than those with darker phototypes (IV-VI); patients with blue, green, or hazel eyes had lower NNEs than those with brown eyes.

IN PRACTICE:

In the study, “we found that the population of people seeking SC [skin cancer] surveillance care includes a substantial percentage of individuals who are at low risk for diagnosis of SC,” the authors concluded. “The implementation of triage criteria for asymptomatic patients seeking SC surveillance, based on risk factors such as age, skin phototype, and SC history,” they added, “may be beneficial for selecting individuals who are at higher risk for SC diagnosis and therefore most likely to benefit from routine surveillance.”

SOURCE:

The study was led by Yin Li, PhD, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, and was published online on May 20 in JAMA Dermatology.

LIMITATIONS:

The single-center design means that some observations may not be generalizable, and just over 50% of participants completed the survey. Data were collected over a short term, which did not allow assessment of long-term outcomes.

DISCLOSURES:

The authors did not report study funding sources and disclosed having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.