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The first 30 years of the American Academy of Dermatology skin cancer screening program: 1985-2014 - 15/10/18

Doi : 10.1016/j.jaad.2018.05.1242 
Jean-Phillip Okhovat, MD, MPH a, b, c, Derek Beaulieu, MD d, Hensin Tsao, MD, PhD e, Allan C. Halpern, MD, MS f, Dominique S. Michaud, ScD g, Shimon Shaykevich, MS h, Alan C. Geller, RN, MPH i,
a Department of Dermatology, Stanford Cancer Center, Stanford Hospital and Clinics, Stanford, California 
b Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 
e Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 
h Division of General Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 
c Department of Biostatistics and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 
i Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 
g Department of Public Health & Community Medicine, Tufts Clinical and Translational Science Institute, Boston, Massachusetts 
d Tufts University School of Medicine, Tufts Clinical and Translational Science Institute, Boston, Massachusetts 
f Dermatology Service of the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York 

Reprint requests: Alan C. Geller RN, MPH, Harvard TH Chan School of Public Health, Kresge 718, 677 Huntington Avenue, Boston MA 02115.Harvard TH Chan School of Public HealthKresge 718, 677 Huntington AvenueBostonMA02115

Abstract

Background

The incidence of melanoma is rising faster than that of any other preventable cancer in the United States. The American Academy of Dermatology has sponsored free skin cancer education and screenings conducted by volunteer dermatologists in the United States since 1985.

Objective

We aimed to assess the American Academy of Dermatology's national skin cancer screening program from 1986 to 2014 by analyzing the risk factor profile, access to dermatologic services, and examination results.

Methods

We conducted several detailed statistical analyses of the screening population.

Results

From 1986 to 2014, records were available for 2,046,531 screenings, 1,963,141 (96%) of which were subjected to detailed analysis. Men comprised 38% of all participants. The number of annual screenings reached approximately 100,000 in 1990 and remained relatively stable thereafter. From 1991 to 2014 (data for 1995, 1996 and 2000 were unavailable), clinical diagnoses were rendered for 20,628 melanomas, 156,087 dysplastic nevi, 32,893 squamous cell carcinomas, and 129,848 basal cell carcinomas. Only 21% of screenees had a regular dermatologist. Those with a clinical diagnosis of skin cancer were more likely than the general screening population to be uninsured.

Limitations

Inability to verify clinical diagnoses histopathologically.

Conclusion

Our findings suggest that the SPOTme program has detected thousands of skin cancers that may have gone undetected or experienced a delay in detection.

Le texte complet de cet article est disponible en PDF.

Key words : access to care, clinical diagnoses, melanoma, risk factors, screening, skin cancer

Abbreviations used : AAD, BCC, DN, NHIS, SCC, USPSTF


Plan


 Dr Okhovat and Dr Beaulieu serve as cofirst authors.
 Funding sources: Supported by the American Academy of Dermatology's SPOTme program, which is made possible through a donation from the Bristol-Myers Squibb Foundation. Dr Beaulieu was supported by the National Center for Advancing Translational Sciences, National Institutes of Health (award No. TL1TR001062), and Dr Tsao was supported by the National Institutes of Health (award No. K24CA149202).
 Conflicts of interest: None disclosed.


© 2018  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 79 - N° 5

P. 884 - novembre 2018 Retour au numéro
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