US Preventive Services Task Force: Evidence lacking for screening asymptomatic patients for skin cancer

The U.S. Preventive Services Task Force (USPSTF) concludes that the current evidence is insufficient for assessing the balance of benefits and harms of screening asymptomatic adults and adolescents for skin cancer. These findings form the basis of a final recommendation statement published in the April 18 issue of the Journal of the American Medical Association.

Nora B. Henrikson, Ph.D., M.P.H., from the Kaiser Permanente Washington Health Statement Research Institute in Seattle, and colleagues conducted a systematic review of the benefits and harms of screening for skin cancer. Data were included from 20 studies in 29 articles, with 6,053,411 asymptomatic individuals aged 15 years or older.

The researchers found that based on direct evidence on screening effectiveness from three nonrandomized analyses, no melanoma mortality benefit was seen at the population level over four to 10 years of follow-up. Inconsistent evidence on the association between clinician skin examination and lesion thickness or stage at diagnosis was seen in six studies. Routine clinician skin examination was not associated with increased detection of skin cancer or precursor lesions or with stage at melanoma detection compared with usual care.

Based on these findings, the USPSTF concludes that the evidence is inadequate for assessing the balance of benefits and harms of visual skin examination to screen for skin cancer in asymptomatic adolescents and adults (I statement).

"We need more research on whether or not screening for skin cancer in people without symptoms is beneficial," a task force member said in a statement. "To help prevent skin cancer, people should minimize sun exposure, protect their skin when in the sun, and avoid tanning beds."

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