Full-body skin examinations - The patient's perspective

Objectives: To determine (1) primary care practitioner (PCP) and dermatologist full-body skin examination (FBSE) rates by using a patient questionnaire and (2) whether patient risk factors for skin cancer alter these rates. Design: Questionnaires pertaining to whether participants underwent regular FBSE, their feelings about this screening test, and their risks for developing skin cancer. Setting: The primary care and dermatology clinics at the West Haven Veterans Affairs Medical Center. Participants: A convenience sample of 356 patients awaiting clinic appointments. Of those asked to participate, 251 (71%) agreed. Main Outcome Measures: Patient report of undergoing FBSE, attitudes regarding this examination, and risk factors for cutaneous malignancy. Results: Thirty-two percent of all respondents reported undergoing regular FBSE by their PCP, whereas 55% of those with a history of skin cancer reported undergoing FBSE. Eight percent of participants reported embarrassment with FBSE, 83% reported that their PCP would be considered thorough by performing FBSE, and 87% would like their PCP to perform FBSE regularly. Only 2% of participants would refuse the examination if the PCP were of the opposite sex, whereas 8% would be more willing to be examined. Conclusions: Although patients report a low incidence of FBSE, those with a personal history of skin cancer are more likely to be screened. A low rate of embarrassment and a high rate of perceived PCP thoroughness are associated with FBSE. Patients have a strong preference to undergo FBSE. A sex difference between the PCP and the patient should not be a barrier to this examination.