Skin cancer screening by dermatologists: Prevalence and barriers

被引:75
作者
Federman, DG
Kravetz, JD
Kirsner, RS
机构
[1] VA Connecticut Hlth Care Syst, West Haven, CT 06516 USA
[2] Yale Univ, Sch Med, Dept Med, New Haven, CT 06510 USA
[3] Univ Miami, Sch Med, Dept Epidemiol & Publ Hlth, Dept Dermatol & Cutaneous Surg, Coral Gables, FL 33124 USA
关键词
D O I
10.1067/mjd.2002.120531
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Background: The incidence of skin cancers is increasing at an alarming rate, and there is currently no consensus by major health policy organizations regarding Skin cancer screening, It has previously been shown that primary care physicians do not screen a majority of patients for skin cancer. Objective. This study was undertaken to determine the prevalence of skin cancer screening among dermatologists and to detect barriers to screening. As a secondary objective, we set out to determine the prevalence of dermatoscopy Use. Methods. With the use of membership data from the 1999-2000 directory of the American Academy of Dermatology, a random sample of 464 American dermatologists was surveyed to assess their skin cancer screening practices and perceived obstacles to this practice. We then determined whether differences in knowledge of skin cancer screening recommendations, emphasis of Skin cancer screening in training, or physician age affected the prevalence of screening. Results. A total of 190 dermatologists responded (41%). Fifty-seven respondents (30%) reported performing full-body skin cancer screening on all Of their adult patients and 93 more reported screening only patients perceived to be at increased risk. Eighty respondents (42%) reported lack of time as an impediment to screening. Only 18 (9%) did not screen patients because of potential patient embarrassment, whereas 17 did not perform screening because of lack of financial reimbursement. Sixty-two dermatologists (33%) reported being aware of official skin cancer screening recommendations, but they were not more likely to screen all patients (P = .64) or partake in screening of all patients or only those at increased risk (P = .84). One hundred nineteen respondents (63%) reported that skin cancer screening was emphasised during their medical training and they were more likely to screen all patients (P = .04) or either all or high-risk patients (P = .02). Younger age groups of dermatologists were significantly more likely to screen all patients for skin cancer (P = .03). Twenty-two percent of respondents reported using dermatoscopy for suspicious lesions. Conclusion: Dermatologists report a high rate of screening for skin cancer despite not having knowledge of skin cancer screening recommendations. Inadequate time to perform full-body skin examinations and lack of emphasis during training were identified as possible harriers to this practice.
引用
收藏
页码:710 / 714
页数:5
相关论文
共 18 条
[1]  
*ACS, 1993, GUID CANC REL CHECK
[2]  
[Anonymous], 1996, GUID CLIN PREV SERV
[3]   TOTAL SKIN EXAMINATION - PATIENT REACTIONS [J].
BOYCE, JA ;
BERNHARD, JD .
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 1986, 14 (02) :280-280
[4]  
*CAN TASK FORC PER, 1994, CAN GUID CLIN PREV H, P850
[5]   Screening for skin cancer in primary care settings [J].
Federman, DG ;
Concato, J ;
Caralis, PV ;
Hunkele, GE ;
Kirsner, RS .
ARCHIVES OF DERMATOLOGY, 1997, 133 (11) :1423-1425
[6]   Full proceedings from the National Conference to Develop a National Skin Cancer Agenda [J].
Goldsmith, LA ;
Koh, HK ;
Bewerse, BA ;
Reilley, B ;
Wyatt, SW ;
Bergfeld, WF ;
Geller, AC ;
Walters, PF .
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 1996, 35 (05) :748-756
[7]   Skin cancer screening in primary care: Prevalence and barriers [J].
Kirsner, RS ;
Muhkerjee, S ;
Federman, DG .
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 1999, 41 (04) :564-566
[8]  
MacKie RM, 1997, BRIT MED J, V315, P1117, DOI 10.1136/bmj.315.7116.1117
[9]  
MARKS R, 1995, CANCER-AM CANCER SOC, V75, P607, DOI 10.1002/1097-0142(19950115)75:2+<607::AID-CNCR2820751402>3.0.CO
[10]  
2-8