Original articleDelivering value in dermatology: Insights from skin cancer detection in routine clinical visits
Section snippets
Methods
This study was approved by the Massachusetts General Hospital Institutional Review Board. Medical records of patients presenting for routine dermatologic care between March 28 and September 28, 2012, at the Massachusetts General Hospital, a busy multiprovider urban practice setting, were retrospectively reviewed. All patients given a diagnosis of NMSC histopathologically confirmed by skin biopsy specimen were identified. Demographic information was abstracted from patient medical records, and
Results
In all, 14,829 patients (42% male, mean age 51.1 years) were evaluated for routine care among 27 medical dermatology providers. NMSC was detected in 1266 (32%) of the 4217 total skin biopsy specimens during the study period.
The incidence of NMSC was 7.1%, diagnosed in 1047 of 14,829 unique patients who presented for care. The NMSC subpopulation consisted of patients evaluated for general dermatologic issues, specific lesions of concern, and routine skin cancer screening examinations. Of the
Discussion
Skin examination is highly accurate when performed by dermatologists (sensitivity 93.3%, specificity 97.8%), mirroring the efficacy of other routinely used cancer screening modalities.7 Given that the skin cancer burden is substantial with 3.5 million cases of NMSC and 76,000 cases of melanoma expected to be discovered in 2014 and that dermatologists are in short supply, determining the best way to detect these cancers is important.4, 8
In this study a sizeable proportion of routine dermatology
References (13)
- et al.
False-negative findings in skin cancer and melanoma screening
J Am Acad Dermatol
(1995) - et al.
Increasing supplies of dermatologists and family physicians are associated with earlier stage of melanoma detection
J Am Acad Dermatol
(2000) - et al.
Why patients visit their doctors: assessing the most prevalent conditions in a defined American population
Mayo Clin Proc
(2013) - Rosenthal E. Patients' costs skyrocket; specialists' incomes soar. New York Times. Jan 19, 2014, Health:...
- et al.
Screening for skin cancer: an update of the evidence for the US Preventive Services Task Force
Ann Intern Med
(2009) - National Cancer Institute. Breast cancer screening concepts. Cancer topics: breast cancer screening. Available from:...
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Funding sources: None.
Conflicts of interest: None declared.