USPSTF Issues Recommendation for Skin Cancer Screening in Primary Care

Evidence is insufficient to recommend that primary care providers conduct visual skin examinations to screen for skin cancer in asymptomatic adults, according to the US Preventive Services Task Force (USPSTF).

In order to update the 2009 USPSTF recommendation on skin cancer screening, the group reviewed evidence on the effectiveness of visual screening in reducing skin cancer morbidity and mortality and the potential harms of screening. It also reviewed data on the difference in test characteristics when performed by a primary care clinician vs a dermatologist, and whether visual screening leads to earlier detection.
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Overall, they found that evidence to assess the benefit of screening with visual skin examination is limited. Evidence on the effectiveness of screening in reducing mortality was limited to a single fair-quality study with “important methodological limitations,” and little information on the harms of screening was available.

“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,” the group wrote.

“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.”

—Michael Potts

Reference:
US Preventive Services Task Force. Screening for skin cancer: US Preventive Services Task Force recommendation statement. JAMA. 2016;316(4):429-435.