Dermoscopy Improves Accuracy of Primary Care Physicians to Triage Lesions Suggestive of Skin Cancer

Argenziano, Giuseppe, Puig, Susana, Iris, Zalaudek, Sera, Francesco, Corona, Rosamaria, Alsina, Mercè, Barbato, Filomena, Carrera, Cristina, Ferrara, Gerardo, Guilabert, Antonio, Massi, Daniela, Moreno-Romero, Juan A., Muñoz-Santos, Carlos, Petrillo, Gianluca, Segura, Sonia, Soyer, H. Peter, Zanchini, Renato and Malvehy, Josep (2006) Dermoscopy Improves Accuracy of Primary Care Physicians to Triage Lesions Suggestive of Skin Cancer. Journal of Clinical Oncology, 24 12: 1877-1882. doi:10.1200/JCO.2005.05.0864


Author Argenziano, Giuseppe
Puig, Susana
Iris, Zalaudek
Sera, Francesco
Corona, Rosamaria
Alsina, Mercè
Barbato, Filomena
Carrera, Cristina
Ferrara, Gerardo
Guilabert, Antonio
Massi, Daniela
Moreno-Romero, Juan A.
Muñoz-Santos, Carlos
Petrillo, Gianluca
Segura, Sonia
Soyer, H. Peter
Zanchini, Renato
Malvehy, Josep
Title Dermoscopy Improves Accuracy of Primary Care Physicians to Triage Lesions Suggestive of Skin Cancer
Journal name Journal of Clinical Oncology   Check publisher's open access policy
ISSN 0732-183X
1527-7755
Publication date 2006-04
Sub-type Article (original research)
DOI 10.1200/JCO.2005.05.0864
Volume 24
Issue 12
Start page 1877
End page 1882
Total pages 6
Place of publication Alexandria, VA
Publisher American Society of Clinical Oncology
Language eng
Subject 110304 Dermatology
Abstract PURPOSE: Primary care physicians (PCPs) constitute an appropriate target for new interventions and educational campaigns designed to increase skin cancer screening and prevention. The aim of this randomized study was to determine whether the adjunct of dermoscopy to the standard clinical examination improves the accuracy of PCPs to triage lesions suggestive of skin cancer. PATIENTS AND METHODS: PCPs in Barcelona, Spain, and Naples, Italy, were given a 1-day training course in skin cancer detection and dermoscopic evaluation, and were randomly assigned to the dermoscopy evaluation arm or naked-eye evaluation arm. During a 16-month period, 73 physicians evaluated 2,522 patients with skin lesions who attended their clinics and scored individual lesions as benign or suggestive of skin cancer. All patients were re-evaluated by expert dermatologists at clinics for pigmented lesions. Referral accuracy of both PCP groups was calculated by their scores, which were compared to those tabulated for dermatologists. RESULTS: Referral sensitivity, specificity, and positive and negative predictive values were 54.1%, 71.3%, 11.3%, and 95.8%, respectively, in the naked-eye arm, and 79.2%, 71.8%, 16.1%, and 98.1%, respectively, in the dermoscopy arm. Significant differences were found in terms of sensitivity and negative predictive value (P = .002 and P = .004, respectively). Histopathologic examination of equivocal lesions revealed 23 malignant skin tumors missed by PCPs performing naked-eye observation and only six by PCPs using dermoscopy (P = .002). CONCLUSION: The use of dermoscopy improves the ability of PCPs to triage lesions suggestive of skin cancer without increasing the number of unnecessary expert consultations.
Keyword dermoscopic evaluation
skin cancer
pigmented lesions
triage
training
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Thu, 22 Jan 2009, 13:25:02 EST by Gina Velli on behalf of Faculty Of Health Sciences