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ASCO 2016: Early Detection, Detection of Smaller Cancers Among Benefits of a Primary Care–Based Skin Cancer Screening Program

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Key Points

  • On average, the melanomas detected in the group who received a screening at a primary care visit were nearly twice as thin as those detected in the group that was not screened by a primary care physician.
  • Only 5% of people in the screening group had especially worrisome melanomas that were thicker than 1 mm—which are more likely to metastasize and require a biopsy of a nearby lymph node—vs 20% of the unscreened group.
  • Nearly half of the screened patients were men, who are more likely to develop and die from melanoma than women but have been underrepresented in other skin cancer screenings published to date.

Skin cancer screenings performed by primary care physicians during routine office visits improve the detection of potentially deadly melanomas and find them in earlier stages, according to new research from the University of Pittsburgh School of Medicine. The results were presented by Ferris et al at the 2016 ASCO Annual Meeting (Abstract 1508).

“Our findings suggest that [screening by a primary care physician] is an effective way to improve early detection of melanoma, which could potentially save lives,” said lead author Laura Ferris, MD, PhD, Associate Professor in the Department of Dermatology, University of Pittsburgh Medical Center (UPMC),  and member of the Melanoma Program, University of Pittsburgh Cancer Institute.

Rates of melanoma are on the rise, and skin cancer screenings are among the most important steps for early detection and treatment, said Dr. Ferris. Typically, patients receive skin checks by setting up an appointment with a dermatologist.

The goal of the new UPMC screening initiative, which was modeled after a promising German program, was to improve the detection of melanomas by making it easier for patients to get screened during routine office visits with their primary care physicians, explained Dr. Ferris.

Study Findings

Primary care physicians completed training on how to recognize melanomas and were asked to offer annual screening during office visits to all patients aged 35 years and older. In 2014, during the first year of the program, 15% of the 333,788 eligible UPMC patients were screened in this fashion.

On average, the melanomas detected in the group who received a screening at a primary care visit were nearly twice as thin as those detected in the group that was not screened by a primary care physician. Thinner melanomas have a better prognosis than thicker ones that are more advanced, so the new findings suggest that screening by a primary care physician is able to find melanomas at an earlier, more treatable stage, said Dr. Ferris.

In addition, only 5% of people in the screening group had especially worrisome melanomas that were thicker than 1 mm—which are more likely to metastasize and require a biopsy of a nearby lymph node—compared with 20% of the unscreened group.

“The [primary care physician] screenings prevented a lot of people from needing more aggressive therapy. Additionally, we did not see a high rate of false-positive biopsies, 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,” Dr. Ferris said.

Another important finding was that nearly half of the screened patients were men, who 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,” concluded Dr. Ferris.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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