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And primary care physicians less likely than dermatologists to perform full-body skin exams

Friday, January 21, 2011 (Last Updated: 01/24/2011)

FRIDAY, Jan. 21 (HealthDay News) -- Including patients at high risk for melanoma in follow-up programs can result in detection of early-stage disease, and a lower percentage of primary care physicians than dermatologists perform full-body skin examinations on patients, according two studies published in the January issue of the Archives of Dermatology.

In a retrospective analysis, Gabriel Salerni, M.D., of the Hospital Clinic of Barcelona in Spain, and colleagues evaluated 201 patients (105 men and 96 women) with 215 consecutive melanomas diagnosed between 2007 and 2008, 40 of whom were included in a follow-up program in the clinic and 161 of whom were referred for evaluation. The investigators concluded that including patients at high risk for melanoma in a follow-up program allowed for the detection of melanomas in earlier stages, with good prognosis, even when there were no clinical and dermoscopic features of melanoma. They note that in the general population without specific surveillance, the disease is frequently diagnosed at more advanced stages.

In another study, Susan A. Oliveria, Sc.D., M.P.H., of the Memorial Sloan-Kettering Cancer Center in New York City, and colleagues surveyed 2,999 randomly selected U.S. dermatologists, family practitioners, and internists from the American Medical Association's Medical Marketing Services database between April 1 and Nov. 30, 2005, to determine barriers and facilitating factors to skin cancer screening practices. The investigators found that skin cancer screening occurred at a significantly lower rate among internists and family practitioners as compared with dermatologists (56.4 and 59.6 percent versus 81.3 percent). Physicians cited time constraints, competing comorbidities, and patient embarrassment as the top three barriers to performing full-body skin exams.

"Becoming more knowledgeable about physician barriers to skin cancer screening could help improve primary and secondary practices in the primary care and dermatology settings," Oliveria and colleagues conclude. "This result is not surprising given dermatologists' training and specialized focus on the skin, and it is also consistent with previous studies that have indicated that skin examinations are lacking within primary care settings."

Abstract - Salerni
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Abstract - Oliveria
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Specialties Hematology & Oncology
Psychiatry

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