Melanoma detection through total body skin examination is most efficient in patients aged ≥50 years and those with a personal history of melanoma, a recent study found. Researchers conducted a retrospective observational study in order to determine the number needed to screen (NNS) and biopsy (NNB) and cost per skin cancer diagnosed in a large dermatology practice in patients undergoing total body skin examination. They found:
- During 2011-2015, a total of 20,270 patients underwent 33,647 visits for total body skin examination; 9,956 lesion biopsies were performed yielding 2,763 skin cancers, including 155 melanomas.
- The NNS to detect 1 skin cancer was 12.2 and 1 melanoma was 215.
- The NNB to detect 1 skin cancer was 3.0 and 1 melanoma was 27.8.
- In a multivariable model for NNS, age and personal history of melanoma were significant factors.
- Age switched from a protective factor to a risk factor at age 51 years.
- The estimated cost per melanoma detected was $32,594.
Matsumoto M, Secrest A, Anderson A, et al. Estimating the cost of skin cancer detection by dermatology providers in a large health care system. J Am Acad Dermatol. 2018;78(4):701-709.e1. doi:10.1016/j.jaad.2017.11.033.