Wednesday, July 20, 2016

Skin cancer screenings don’t boost referrals or surgeries

Melanoma can be cured if caught early. Image courtesy
Brown University
CANCER DIGEST – July 20, 2016 – A new study of more than 1,000 primary care melanoma screenings in the western Pennsylvania area suggests that such screenings would not be harmful as some experts had thought.

Melanoma is one of those cancers that can be cured if caught early, which has led to some experts calling for widespread training of primary care providers to conduct screenings at routine visits. Other experts, however, have worried that widespread screening could lead to overtreatment and unnecessary patient distress.

Such competing concerns are always among the factors the U.S. Preventative Services Task Force considers when it prepares new screening recommendations, which are currently under way.

The Brown University study of screening throughout the University of Pittsburgh Medical Center system compared data from tens of thousands of encounters with patients 35 years and older in the first eight months of 2013, before screening training of primary care physicians in 2014, to data collected after the training.

The researchers divided the providers into three comparison groups – one in which about a quarter of providers were trained, one in which only 1 in 11 of the providers were trained, and one in which none were trained. 

They found that neither dermatologist visits nor skin surgeries increased substantially between 2013 and 2014 in any of the groups. Between the groups there was also little difference in how often those outcomes occurred.

The lack of major change however was not because the training had no effect. Between 2013 and 2014, the group of providers with the most training did produce a 79 percent increase in per-patient melanoma diagnoses. The other groups with less or no training showed no significant increase in diagnoses.

The reason why diagnoses rose significantly in the most trained group but dermatologist visits or surgeries did not is because the number of diagnoses was tiny (24 out of 11,238 patients in 2013 and 48 out of 12,560 patients in 2014).

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