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Total-Body Skin Examinations to Identify Incidental Skin Cancer

By: Vanessa A. Carter, BS
Posted: Wednesday, January 13, 2021

Skin cancer rates are rapidly increasing due to sun exposure, tanning beds, and aging. Kathy Taghipour, MD, of Churchill Hospital, Headington, Oxford, United Kingdom, and colleagues investigated the rate of incidental skin cancer detection in urgent skin cancer clinics, depending on clinical suspicion of the index lesion for malignancy. The researchers found that total-body skin examinations may be useful in discovering incidental skin cancer. The findings were published in JAMA Network Open.

 “The findings of this study support the use of total-body skin examination for urgent skin cancer referrals, highlighting the potential harms of solitary lesion assessment in a subgroup,” concluded the investigators. “Individuals presenting with a clinically suspicious index lesion requiring biopsy are most likely to benefit from total-body skin examination and should be counseled regarding the benefit.”

This multicenter, retrospective study enrolled a total of 5,944 patients from two urgent clinics who presented with a skin lesion suspicious of malignancy. Of the patients referred, 4,726 underwent a total-body skin exam to be included in the analysis.

The median age of participants was 57, and 54.3% were women. The number of skin cancers identified was 1,117, with 21.7% of them being lesions detected through total-body skin evaluation. Other cancers included basal cell carcinomas, melanomas, and squamous cell carcinomas, which affected 34.6%, 11.6%, and 6.4% of patients, respectively. The rate of individuals with clinically suspicious index lesions requiring biopsy was 35%, and the rate of benign index lesions was 65%. The detection rate of incidental malignant lesions was 5.1%, and the rate for individuals with clinically suspicious index lesions requiring biopsy was 10.9%. For participants presenting with clinically benign index lesions, the detection rate was 2%.

Disclosures: For full disclosures of study authors, visit jamanetwork.com.



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