USPSTF: Evidence lacking to determine benefits, harms of skin cancer self-exams

In a draft recommendation statement, the U.S. Preventive Services Task Force said there is insufficient evidence to determine if the benefits outweigh the harms from counseling adults about skin self-examinations for the prevention of skin cancer.

The task force added that medical professionals should counsel young adults, adolescents, children and parents of young children on minimizing ultraviolet radiation exposure for fair-skinned individuals aged 6 months to 24 years to reduce skin cancer risk (B recommendation). For adults with fair skin aged more than 24 years, the task force recommended clinicians selectively offer counseling about minimizing ultraviolet radiation exposure to reduce skin cancer risk (C recommendation).

“Skin cancer is the most common type of cancer in the U.S., affecting millions of people every year,” Karina Davidson, PhD, MASc, task force member and professor at Columbia University Medical Center, New York, told Healio Family Medicine. “Due to the vast population affected and the multiple risk factors for skin cancer, counseling on skin cancer remains an important issue for primary care providers to consider when trying to provide the best possible care for their patients.”

Although none of these recommendations received an A grade, she said PCPs should still discuss skin cancer with their patients.

“Clinicians should continue to use their clinical judgment and talk with their patients about their health and preferences based on their individual needs,” Davidson said in the interview.

“[PCPs] should also be clear that these grades from the task force are about the value of counseling about these activities — not an assessment of the activities themselves — because the USPSTF only looks at research around services provided in a primary care setting, not the behavior of patients in their daily life,” she continued.

Davidson identified gaps in the research that if filled, could potentially change future task force recommendations.

“One: the effectiveness of counseling on the use of sun-protective behaviors in adults, including young adults,” she said. “Two: whether people continue skin protective behaviors after trials have concluded. Studies need to have a long-term follow-up period and should include racially and ethnically diverse populations. Three: the benefits and harms of skin self-examination, as well as the benefits and harms of clinicians counseling adults about skin self-examination.”

The draft recommendation statement can be viewed on the task force’s website: www.uspreventiveservicestaskforce.org. Comments will be accepted until Nov. 6, 2017.

According to the Skin Cancer Foundation, although skin cancer is the most prevalent form of cancer, it is the easiest to treat if caught early.

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Reference:

Skin Cancer Foundation. Early Detection and Self Exams. http://www.skincancer.org/skin-cancer-information/early-detection. Accessed Oct. 6, 2017.

Disclosure: Davidson reports no relevant financial disclosures.