Reports by patients and dermatologists of skin cancer preventive services provided in dermatology offices

Objective: To learn how often patients receive skin cancer preventive services in dermatologists' offices. Design: Survey of dermatology patients and dermatologists. Setting: Dermatology practices of full- and part-time faculty at a midwestern medical school. Participants: Patients were randomly selected from clinical sessions of 11 dermatologists. Of 200 patients enrolled, 162 (81%) responded to the survey. Ten (91%) of the dermatologists responded, and 4 additional dermatologists from the faculty were also surveyed. Main Outcome Measures: Patients' and dermatologists' reports of the provision of skin cancer prevention counseling and screening for skin cancer. Results: Most patients (93%) had been informed about the risks of sun exposure, but for only 27% was a dermatologist the main source of information. Although 76% of patients had seen a dermatologist at least twice in the last 5 years, only 34% reported that they had ever received a total-body screening examination for skin cancer. Most patients (55%) would like to learn more about skin cancer prevention, and responded that they would learn best from a brochure (43%) or from a dermatologist (42%). All dermatologists believed that some skin cancer preventive services should be provided to each patient, but they varied widely in the proportion of their white adult patients to whom they provide such services. For example, with respect to counseling about sunscreens, the same number of dermatologists (4 [29%]) responded that they counsel 25% or less of their patients, and more than 75% of their patients. Conclusion: There is nide variation in how often skin cancer preventive services are provided in dermatologists' offices.