Skin Cancer Screening Program Research Articles

Association of rurality and health professional shortages with the clinicopathologic characteristics of melanoma in North Carolina.

To assess rural-urban and health professional shortage area (HPSA)-related influences on the characteristics of melanoma in North Carolina. We conducted a single-center retrospective cohort study of patients living in North Carolina with an available pathology report for invasive cutaneous melanoma seen in the Duke University Health System from 01/01/2014 to 12/31/2020. Multivariable logistic regression models were employed to compare patient and tumor characteristics between rural versus urban county residence as well between melanoma thicknesses dichotomized into thin (≤1.0mm) and thicker (>1.0mm) tumors. The cohort included 807 patients, and rural patients accounted for 177 (21.9%) of invasive cutaneous melanomas. Rural patients had significantly higher odds of having thicker tumors than urban patients (odds ratio [OR] = 1.78, 95% confidence interval [CI]: 1.17-2.71; P =.008). Rural patients were significantly more likely to be female (OR = 1.59, 95% CI: 1.10-2.28; P =.013) and located in a population-based (OR = 2.66, 95% CI: 1.84-3.84; P<.001) or geographic-based (OR = 8.21, 95% CI: 3.33-20.22; P<.001) HPSA. Living in a medium- or high-shortage population-based HPSA was associated with higher odds of thicker tumors (OR = 2.65, 95% CI: 1.85-3.80; P<.001). Patients living in rural North Carolina counties were more likely than those in urban counties to be diagnosed with melanomas >1.0mm in thickness, a clinically significant difference with important prognostic implications. Interventions at the county- and state-level to address this disparity may include improving access to skin cancer screening and teledermatology programs, increasing partnerships with primary care providers, and targeting interventions to counties with health professional shortages.

Awareness of skin cancer screening coverage in U.S. healthcare plans: Is there a need to better educate the public?

ObjectivesTo understand whether financial barriers or the lack of accessibility to dermatology services was a significant motivation for the public to seek free skin cancer screening. MethodsAn anonymous and voluntary survey was administered to participants of The Sun Bus free skin cancer screening program in 2023 at U.S. outdoor events in Colorado, Texas, Arizona, New Mexico, Iowa, Wyoming, Missouri, and Montana. 491 respondents answered questions on motivation, healthcare coverage, and demographics. Survey data was analyzed using Qualtrics’ crosstab IQ and statistical tests software. ResultsSkin screening found suspicious lesions in 45 % of 1300 participants with 18 % of respondents sharing a previous history of skin cancer. Concern for a lesion or Curiosity were the two top reasons for 60 % of respondents to seek free skin screening and remained the top reasons after data was stratified by gender, age, or income. Only 15 % of respondent were motivated by the cost of dermatology services or a long wait to see a dermatologist. A total of 38 % of people surveyed reported comprehensive plans covering skin screening while 46 % were unaware of the inclusion of screening in their healthcare plan. Notably, this unawareness increased up to 52 % among younger and less affluent respondents. Additionally, females were less likely than males to be aware of skin screening options in their healthcare plans. ConclusionsThis work highlights the significance of promoting public awareness of dermatology services covered by health insurance and the need for continued efforts in skin cancer education and screening programs.

General practitioners' perspectives on statutory skin cancer screening-A questionnaire-based cross-sectional survey in Germany.

In Germany, skin cancer screening (SCS) is available free of charge every two years to all those with statutory health insurance over the age of 35. General Practitioners (GP) can carry out the screening if they have completed an 8-hour training course. GPs play a crucial role in the implementation of SCS and act as gatekeepers between initial patient contact and referral to dermatologists. To record how comprehensively GPs carry out SCS in terms of patient information and body examination, as well as to explore GPs opinions on the feasibility of SCS. A cross-sectional survey was conducted. A questionnaire was sent to GPs with permission to perform SCS in two regions of Germany (Bavaria and Saxony) between August and September 2021. Data were analyzed using descriptive analysis. Subgroup analysis was performed according to regions (federal state, location of physician´s office), professional experience (experience in years, number of monthly screenings, age) and gender. Open questions were evaluated using qualitative content analysis. In the survey, 204 GPs responded. Genitalia (40.7%, 83/203), anal fold (62.3%, 127/204) and oral mucosa (66.7%, 136/204) were the least examined body regions during screening. Information on risks (false-positive findings: 18.6%, 38/203; false-negative findings: 13.2%, 27/203; overdiagnosis: 7.8%, 16/203) and benefits (48.0%, 98/202) were not always provided. GPs who performed screenings more frequently were more likely to provide information about the benefits of SCS (p<0.001; >10 vs. <5 screenings per month). Opinions were provided on uncertainties, knowledge requirements, structural and organizational requirements of SCS, SCS training and evaluation. The organization and remuneration of the SCS programme was seen as a barrier to implementation. GPs expressed uncertainties especially in unclear findings and in dermatoscopy. Uncertainties in the implementation of the SCS should be addressed by offering refresher courses. Good networking between GPs and dermatologists is essential to improve SCS quality.

Quality, Understandability and Reliability of YouTube Videos on Skin Cancer Screening

In 2008, a nationwide skin cancer screening (SCS) program was implemented in Germany. However, participation rates remain low. YouTube videos on SCS might educate eligible persons to undergo SCS. Until now, no scientific evaluation of the quality of videos available for German-speaking persons eligible for SCS has been performed. Here, we identified and evaluated videos on SCS provided on YouTube. YouTube was searched in May 2022 for German terms related to SCS. Two authors evaluated the videos of the first three pages that met the predefined eligibility criteria. The quality of the videos´ information was evaluated using DISCERN and the Global Quality Scale (GQS). The understandability and actionability were assessed with the Patient Education Materials Assessment Tool (PEMAT). The reliability was assessed with the Journal of American Medical Association (JAMA) score. Subgroup differences were identified by the Kruskal–Wallis test. Overall, 38 videos were included in the evaluation. Most videos were provided by health professionals (clinics and practices). The average scores (mean (SD)) for the individual tools were as follows: DISCERN 3.1/5 points (± 0.52), GQS 3.72/5 points (± 0.7), understandability 64,27% (± 13.53%), actionability 58.22% (± 15.18%), JAMA 37.17% (± 18.94%). These results indicate a mediocre to good understandability, a mediocre quality and actionability, and a low reliability. Videos that were assessed as useful were of significantly better quality. An improvement of freely available informational videos on SCS, especially with regard to the reliability criteria, is urgently needed.

Skin cancer screening and sun safety education program for high school students in southern California.

e22505 Background: Decreasing unprotected exposure to ultraviolet (UV) radiation during childhood can significantly decrease the risk of developing skin cancer as an adult. School-based sun safety curricula have demonstrated efficacy in teaching young adults about the harms of prolonged, unprotected UV exposure and have been effective in increasing safety practices. This project provided a 50-min sun safety curriculum to high school students at a public high school in San Diego, CA just prior to the summer break in 2022. The curriculum addressed skin cancer risk factors, skin protection methods, the benefits of limiting lifetime UV exposure, and methods for performing a skin self exam. The study objective was to assess sun safety knowledge before and after the class, and measure behavior changes three months thereafter when students returned from summer break. Methods: The sun safety classes were taught in groups of 40-60 students across six class periods in June 2022. Students were asked to complete an anonymous pre-participation online survey assessing their knowledge of common skin cancer types and skin cancer risk factors. Students were taught the curriculum over 45 minutes with 5 minutes reserved for questions. Two follow-ups surveys were conducted with the students, one at the end of the class period and a second follow-up three months later. Follow-up surveys assessed retention of knowledge and changes in sun safety behavior. Students had the option of providing a cell phone number so they could be contacted to participate in the second follow-up survey. Results: The curriculum was taught to nine classes of approximately 300 students in a single day across six class periods. A total of 206 students completed the pre-participation survey. At the first follow-up, 95.1% of students completed the post-participation survey and students showed significant improvement in knowledge of common skin cancer types (12.6% pre-participation to 68.9% post-participation), skin cancer risk factors (11.2% pre-participation to 16.8% post-participation), and skin cancer prevention methods (22.8% pre-participation to 45.9% post-participation). For the second follow-up, 128 students provided contact information and the survey had a response rate of 71.5%. After 3 months, students demonstrated retention of knowledge of skin cancer types and risk factors. A majority (87.2%) of students indicated that their use of sunscreen had increased and 57.4% indicated that their use of sun protective barriers had increased over the summer because of this course. Conclusions: This pilot course demonstrates that targeted sun safety education for teenagers before summer break can significantly increase sun safety awareness, adoption of protective behaviors, and knowledge about skin cancer. Such an intervention can promote skin cancer awareness at a young age where behavior changes can decrease lifetime risk of skin cancer.

Screening motivations among participants of the American Academy of Dermatology's SPOT Skin Cancer screening program from 2018 to 2019: A cross-sectional analysis

To the Editor: The American Academy of Dermatology's SPOT Skin Cancer program provides free skin cancer screenings, detecting thousands of suspected melanomas since 1985. Although little is currently known regarding motivations for screenee participation, 1 “Free Skin Cancer Screenings.” Public health programs, American Academy of Dermatology association. https://www.aad.org/public/public-health/skin-cancer-screenings Google Scholar such information may help evaluate the program's effectiveness in providing screenings to those who may need them and address existing disparities in skin cancer survival among people of color and/or lower socioeconomic status (SES). 2 Buster K.J. Stevens E.I. Elmets C.A. Dermatologic health disparities. Dermatol Clin. 2012; 30 (viii. https://doi.org/10.1016/j.det.2011.08.002): 53-59 Abstract Full Text Full Text PDF PubMed Scopus (104) Google Scholar ,3 National Cancer Institute: Surveillance, Epidemiology, and End Results Program. Melanoma of the skin: recent trends in SEER relative survival rates, 2000-2018. https://seer.cancer.gov/explorer/application.html Google Scholar Herein, we describe screenee demographics and self-reported motivations for American Academy of Dermatology screening attendance from 2018 to 2019.

Cutaneous cancers in the Africans: Systematic review

AbstractIntroductionSkin cancers are uncommon in Africans and dark‐skinned people but when diagnosed they often have a poor prognosis. Darker skin has increased photoprotection against the high‐intensity ultraviolet radiation (UVR) of the tropics and the subtropics due to high eumelanin content. While UVR has been found to play a significant role in the pathogenesis of cutaneous malignancies in Caucasians, it is of less significance in Africans.AimThis study aims to highlight the burden of cutaneous cancers in Africans, the predisposing factors, clinical features, and management challenges.MethodologyThis is a systematic review of literature on skin cancers in Africans. The search included PubMed, African Journal online, Medline, and Google scholar on articles published between January 1968 and December 2017 (a 50‐year period). Reports from institutions, pathology departments, skin clinics, cancer registries, and databases were reviewed. Articles were excluded if they do not specify types of skin cancers and frequencies of occurrence.ResultSquamous cell carcinoma (SCC) was the most documented skin cancer in Sub‐Saharan African countries with darker skin color; and BCC in North African countries with lighter skin color. The highest frequency of cutaneous melanoma was documented in Tanzania. Cancer registries in Uganda and Zimbabwe reported very high prevalence of KS. Albinism is the most common genetic predisposition for cutaneous cancers in Africans. There has been a general increase in the prevalence of skin cancers with the advent of human immunodeficiency virus infection. Africans with albinism present mostly with aggressive, invasive, and multiple SCC. Pigmented BCC and acral lentiginous melanoma were mostly documented in the dark skinned Africans. Management is mostly hindered by high cost and poor infrastructures.ConclusionSquamous cell carcinoma, BCC, and cutaneous melanoma were the most documented skin cancers. Oculocutaneous albinism, immune suppression (HIV), and oncogenic viruses were important risk factors for skin cancers in Africans. Public health strategies such as skin cancer screening programs for susceptible groups; training of health care workers and infrastructure development will help reduce severity.

Benefits of a nationwide population-based skin cancer screening programme - still a controversial debate.

Abstract Linked Article: Datzmann et al. Br J Dermatol 2022; 186:69–77.

Do patients benefit from participating in the German skin cancer screening programme?

Abstract Linked Article: Datzmann et al. Br J Dermatol 2022; 186:69–77. The German skin cancer screening programme began in 2008 with the aim of reducing deaths from skin cancer by detecting skin cancers early, when they are more easily treated. More than 10 years after its launch, the benefits and risks of the programme are still unclear. In this study, we compared deaths in patients with newly diagnosed melanoma who participated in the German skin cancer screening programme between the years of 2010 and 2016 with deaths in patients who did not. Melanoma is a serious form of skin cancer that occurs mostly in older people. In Europe, about 20 new cases of melanoma per 100,000 people are diagnosed per year, with numbers rising over recent years. We used health insurance data from over 1,400,000 people. We identified people with newly diagnosed melanoma and calculated the survival times for those who did and did not participate in the screening programme. Patients who had participated in screening had lower death rates than patients who had not undergone screening. To make the comparison as fair as possible, we took account of differences in age, sex, education, other health conditions, voluntary vaccinations and health check-ups in our analysis, as well as starting treatment within 30 days of their initial melanoma diagnosis. After controlling for these aspects, screening participants still showed a survival advantage. People in the screening programme were initially diagnosed with less severe melanoma and therefore had fewer radical treatments than the other patients. However, we cannot exclude the possibility of bias in the results, for example, because healthier people may have participated in the screening programme as they may be more active and health conscious. Further data on the effectiveness of the programme are needed, however, if our results are confirmed, this would suggest that the German skin cancer screening programme should be continued. Linked Article: Datzmann et al. Br J Dermatol 2022; 186:69–77.

Are patients benefiting from participation in the German skin cancer screening programme? A large cohort study based on administrative data.

The German programme for skin cancer screening was established in 2008 with the aim of reducing skin cancer mortality. However, the effectiveness and risk-benefit ratio of the programme remain unclear. To compare the mortality rates of patients with melanoma who participate in a screening programme to those who do not. A retrospective cohort study, based on pseudonymized health insurance data of 1 431 327 individuals from Saxony, Germany, was conducted for the period 2010-2016. Patients with prevalent and incident melanoma were defined based on diagnosis, medical procedures and prescriptions. Patients who underwent screening and had a first diagnosis of melanoma within 2 years of screening were assigned to the intervention group. Relative survival and Cox regression were used to assess potential differences in mortality. We identified 4552 individuals with prevalent and 2475 individuals with incident melanoma. The percentage of screening participants (n = 1801) who had locoregional (4·2% vs. 13·5%) and/or distant metastases (4·3% vs. 8·0%), or who were treated with systemic anticancer therapies (11·6% vs. 21·8%) was lower vs. nonparticipants (n = 674). Screening participants had significantly better survival rates. The unadjusted Cox model gave a hazard ratio (HR) of 0·37 [95% confidence interval (CI) 0·30-0·46]. After adjusting for named confounders, the effect remained (HR 0·62, 95% CI 0·48-0·80). Patients who participated in the screening programme had lower mortality than those who had not undergone screening. However, these findings may result from a healthy screen bias and/or overdiagnosis associated with screening, and not from the screening itself.

Increasing Participation Rates in Germany's Skin Cancer Screening Program (HELIOS): Protocol for a Mixed Methods Study.

BackgroundIn 2008, a nationwide skin cancer screening (SCS) program was implemented in Germany. However, participation rates remain low.ObjectiveThe overall objective of the HELIOS study is to identify subgroup-specific invitation and communication strategies to increase informed SCS participation in Germany.MethodsFocus group discussions will be performed in Erlangen, Germany, to explore potential invitation and communication strategies as well as possible barriers and motivating factors to participate in SCS. Male and female patients of different age groups who have already been diagnosed with skin cancer, as well as participants without a prior diagnosis of skin cancer, will be invited. Based on these results, an online questionnaire will be developed to identify subgroup-specific invitation strategies. A random sample of 2500 persons from the general population aged >35 years from the Munich area will be contacted to complete the questionnaire. Besides descriptive analysis, multinomial logistic regression will be performed. Additionally, a cluster analysis will be conducted to discover patterns or similarities among the participants.ResultsRecruitment for the focus group studies started in February 2021 and is ongoing. As of August 2021, we have enrolled 39 participants. We expect to end enrollment in the qualitative study in September 2021 and to finish the analysis in December 2021. The second part of the study will then start in January 2022.ConclusionsThe results of this project will enable us to derive improved and more efficient invitation and communication strategies for SCS. These may be implemented in the future to facilitate increased SCS uptake and early skin cancer detection.International Registered Report Identifier (IRRID)DERR1-10.2196/31860

LB752 A cross sectional survey of skin cancer knowledge, attitudes, and sun care practices in an underserved Phoenix population

The incidence of melanoma and non-melanoma skin cancers is on the rise. The Hispanic population is more likely to be diagnosed with melanoma at an advanced stage and have poorer overall survival. The primary aim of our study was to assess the skin cancer knowledge, attitudes, perceived risk, and sun care practices of an underserved, primarily Hispanic, population in the Phoenix area. A cross sectional survey of 208 patients recruited during a skin cancer screening program was performed. Our population was primarily Hispanic (64.9%), from Mexico (87.9%).

27001 Practices and policies of skin cancer screening throughout history

Skin cancer screenings began at the community level in the 1970s. The first nationwide public skin cancer screening program was started by the American Academy of Dermatology in 1985 after the rising incidence and mortality rate of malignant melanoma gained increasing attention in the early 1980s. In the early years of the program, President Ronald Reagan signed proclamations creating the “National Skin Cancer Prevention and Detection Week,” and the “Older Americans Melanoma/Skin Cancer Detection and Prevention Week,” and the total body skin examination became the gold standard for skin cancer screening.

Association between income and suspected nonmelanoma and melanoma skin cancers among participants of the American Academy of Dermatology's SPOT Skin Cancer screening program: A cross-sectional analysis

To the Editor: Lower income and socioeconomic status (SES) have been associated with a worse prognosis of cutaneous melanoma, partly due to poorer skin cancer awareness and screening, resulting in thicker tumors at diagnosis.1 Meanwhile, higher SES populations in selected European countries (Denmark, the Netherlands, Italy) have a greater incidence of nonmelanoma skin cancer, particularly basal cell carcinoma (BCC). However, no association between SES and survival has been found.2,3 While prior research focused on the American Academy of Dermatology's SPOT skin cancer screening program reported risk factors for suspected melanoma, BCC, and squamous cell carcinoma (SCC),4 income as a proxy for SES has not been studied as an independent predictor of skin cancer risk among this population.

Costs of routine skin cancer screening in Germany: a claims data analysis.

In 2008, a routine skin cancer screening (rSCS) programme was implemented in Germany. Since then, its medical and economical effects have been evaluated and critically discussed. To compare costs for patients diagnosed with skin cancer with preceding rSCS vs. those diagnosed without rSCS. We conducted a retrospective observational study using claims data from a large German health insurance company for the period 2013-2016. We applied entropy balancing, difference-in-differences estimation and generalized linear models to compare costs for patients with cancer with and without rSCS. We conducted sensitivity analyses to test for the robustness of results. In total, 12790 patients with skin cancer were included in the analyses, of whom 6041 were diagnosed by rSCS. Treatment costs were €467 higher for patients in the control group (without rSCS). However, the screening costs were higher. For all people covered by the health insurance company, there were additional costs of €1339-1431 per patient with skin cancer diagnosed by rSCS. Thus, total costs, including costs for treatment and screening, were €872-964 higher for patients diagnosed by rSCS. Based on our analysis, rSCS has the potential to reduce treatment costs; however, the screening costs exceed these savings.

Abstract IA13: Opportunities and challenges in melanoma early detection

Abstract It is well established that survival outcomes for melanoma are highest when these tumors are diagnosed and surgically removed at their earliest stages, prior to the escape of tumor cells to regional and distant anatomic sites. Screening efforts in other malignancies such as colorectal and cervical cancers have yielded benefits in reducing the incidence of invasive cancers and their respective mortalities. Therefore, early detection through broad-based skin cancer screening appears to be a logical step to reduce melanoma mortality. To date, this strategy has not been endorsed by the United States Preventative Services Task Force (USPSTF) due to a lack of conclusive evidence. For example, the initially promising reductions in melanoma mortality observed during a skin cancer screening program in Schleswig-Holstein, Germany, were not replicated in subsequent years in Schleswig-Holstein itself or throughout Germany when the screening program was extended countrywide. The lack of solid evidence demonstrating the benefits of skin screening on melanoma mortality, coupled with the potential harms of screening, and the phenotypic heterogeneity of melanoma raise important concerns regarding the utility of broad-based skin cancer screening programs. Nevertheless, melanoma’s visibility on the skin compared to internal malignancies, and the development of new diagnostic technologies, may help balance the benefits and harms of melanoma screening when considering the varied patient populations in which screening could be deployed. In this presentation we will review current data in the context of developing early-detection strategies to reduce melanoma mortality and/or the cost of care while minimizing potential harms. Citation Format: David Polsky. Opportunities and challenges in melanoma early detection [abstract]. In: Proceedings of the AACR Special Conference on Melanoma: From Biology to Target; 2019 Jan 15-18; Houston, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(19 Suppl):Abstract nr IA13.

Overdiagnosis of melanoma - causes, consequences and solutions.

Malignant melanoma is the skin tumor that causes most deaths in Germany. At an early stage, melanoma is well treatable, so early detection is essential. However, the skin cancer screening program in Germany has been criticized because although melanomas have been diagnosed more frequently since introduction of the program, the mortality from malignant melanoma has not decreased. This indicates that the observed increase in melanoma diagnoses be due to overdiagnosis, i.e. to the detection of lesions that would never have created serious health problems for the patients. One of the reasons is the challenging distinction between some benign and malignant lesions. In addition, there may be lesions that are biologically equivocal, and other lesions that are classified as malignant according to current criteria, but that grow so slowly that they would never have posed a threat to patient's life. So far, these "indolent" melanomas cannot be identified reliably due to a lack of biomarkers. Moreover, the likelihood that an in-situ melanoma will progress to an invasive tumor still cannot be determined with any certainty. When benign lesions are diagnosed as melanoma, the consequences are unnecessary psychological and physical stress for the affected patients and incurred therapy costs. Vice versa, underdiagnoses in the sense of overlooked melanomas can adversely affect patients' prognoses and may necessitate more intense therapies. Novel diagnostic options could reduce the number of over- and underdiagnoses and contribute to more objective diagnoses in borderline cases. One strategy that has yielded promising results in pilot studies is the use of artificial intelligence-based diagnostic tools. However, these applications still await translation into clinical and pathological routine.

Decreasing sunbed use in the German population between 2001 and 2015: survey in 155679 working persons.

UV radiation is a proven cause of skin cancer. Use of sunbeds has been shown to provide an attributable risk. To evaluate the proportion of regular sunbed use in Germany based on large-scale population-based surveys over 15years. Skin cancer screenings by dermatologists were conducted between 2001 and 2015 in more than 500 German companies, including a clinical examination and interviews on the risk behaviour related to sunburns and sunbeds. Among 155679 persons included regular sunbed use significantly declined from 11.0% in 2001 to 1.6% in 2015 (P<0.001). There were significantly higher rates of sunbed use in women (12.5%/2.0%) vs. men (7.3%/1.3%; P<0.001), in younger persons and in participants with darker skin (type II and III) vs. fair skin (type I). Individuals with sunburns in childhood were significantly more often sunbed users (5.1% vs. 4.6%; P=0.002). A remarkable decline of sunbed use was observed after 2009 (7.0% in 2001-2008 and 2.2% in 2009-2015). This reduction occurred in the time of a legal ban of sunbed use for minors but also with the start of the national skin cancer screening programme. Use of sunbeds in the German adult population has dropped by more than 85% in the past decade. Primary prevention, including the large public awareness following the legal ban of sunbed use for young people and the effects of the statutory skin cancer screening programme may have contributed to this.

Primary prevention in the context of skin cancer screening

The skin cancer screening program in Germany is used for early identification of skin tumours with the aim of alower-risk removal and avoidance of progression. The aim of the study is to investigate the extent to which skin cancer screening (SCS) has an additional effect on dissemination of information on primary prevention. This question was examined from the point of view of screening participants and dermatologists. The proportion of appropriately informed persons among persons who have been screened was determined based on asurvey of arepresentative sample of the German standard population of 1004 persons; the provision of information on primary preventive behaviour was based on asurvey of dermatological practices (n = 444). Both surveys were evaluated descriptively. Of those who underwent SCS (n = 397), the majority (74%) stated that information on protection against UV radiation was provided during the screening. Among dermatologists offering SCS (n = 424), 70% stated that they personally informed all SCS participants about measures preventing skin cancer, and 46% always or predominantly provided written material after conducting SCS. In addition to secondary prevention, SCS also has an important primary preventive function; however there is potential for improvement, since about aquarter of the SCS participants do not receive any information on preventive behaviour from the examining physician. The extent to which this information is actually applied by the SCS participants should be investigated in alongitudinal study.

Factors associated with suspected nonmelanoma skin cancers, dysplastic nevus, and cutaneous melanoma among first-time SpotMe screening program participants during 2009-2010

There have been no studies of the American Academy of Dermatology's SpotMe skin cancer screening program to collectively analyze and determine the factors associated with suspected basal cell carcinoma (BCC), squamous cell carcinoma (SCC), dysplastic nevus (DN), and cutaneous melanoma (CM) diagnoses. Describe the demographics, risk factors, and access to care profiles associated with suspected diagnoses of BCC, SCC, DN, and CM among first-time SpotMe screenees during 2009-2010. We conducted a cross-sectional analysis of data from the SpotMe skin cancer screenings conducted in 2009 and 2010. We performed multivariable logistic regression analysis for each diagnosis, incorporating standard demographic, access to care, and risk factor variables in the models. Men, those without a regular dermatologist, persons reporting recently changing moles, and those with a personal history of melanoma were at increased risk for each of the suspected diagnoses analyzed. Uninsured persons were at increased risk for suspected malignancies (BCC, SCC, and CM). Lack of histologic confirmation for diagnoses and cross-sectional design. Among first-time SpotMe participants, suspected diagnoses of BCC, SCC, DN, and CM shared several associated factors, which may be considered when planning outreach and screening for populations at risk for skin cancer.