Table 3. Application of the 4 Domains: Skin Cancer Screening Using Visual Inspection
| Domain | Information |
|---|---|
| Potential preventable burden | About 1,000,000 cases of non-melanoma skin cancers and 52,000 cases of melanoma are diagnosed each year in the United States.23
About 11,000 deaths per year are attributable to skin cancer, about 8,000 of which are from melanomas. Melanomas detected at a late stage have a poor prognosis. |
| Potential harms | Screening identifies suspicious skin lesions that are ultimately shown not to be cancer.
Evaluation of suspicious skin lesions may require biopsy, which can be painful. Waiting for a definitive diagnosis after a suspicious lesion is found may cause anxiety. |
| Costs | The primary care infrastructure to screen for skin cancer by inspection exists.
The amount of time that a primary care provider would need to do a screening examination is at least 10 minutes. Provision of this service may allow for less time for provision of preventive services that have proven value (opportunity costs). |
| Current practice | Skin cancer screening using visual inspection is not widespread.
In clinical settings where many patients have had extensive sun exposure, or in patients with risk factors, skin inspection is sometimes done routinely by physicians with special skills in skin inspection or a particular interest in this condition. |
Current as of: February 2009