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Health Care Screening, Skin Cancer Risk Link Found

JAMA Dermatology; ePub 2018 Dec 26; Drucker, et al

Undergoing health care screening practices increases the likelihood of being diagnosed with skin cancer, a recent study found. Therefore, researchers should be aware of this association and, where appropriate and possible, condition analyses of skin cancer risk on measures of health care use, including screening, to address confounding associated with detection bias. The cohort for this study was drawn from the Nurses’ Health Study (NHS) and Health Professionals Follow-up Study (HPFS). Included were 77,736 women from the NHS who were followed up for 1,388,523 person-years and 39,756 men from the HPFS who were followed up for 635,319 person-years. Researchers found:

  • 14,319 incident basal cell carcinomas (BCCs), 1,517 squamous cell carcinomas (SCCs), and 506 melanomas were identified in the NHS cohort and 8,741 incident BCCs, 1,191 SCCs, and 469 melanomas were identified in the HPFS cohort.
  • Positive associations were seen between various screening practices and diagnoses of BCC and SCC, with similar directions of associations seen with melanoma for some screening practices. In the NHS, the multivariable HR associated with undergoing a physical examination was 1.46 for BCC, 2.32 for SCC, and 1.66 for melanoma.


Drucker AM, Li W-Q, Savitz DA, et al. Association between health maintenance practices and skin cancer risk as a possible source of detection bias. [Published online ahead of print December 26, 2018]. JAMA Dermatology. doi:10.1001/jamadermatol.2018.4216.