Downstream consequences of melanoma screening in a community practice setting: First results. Issue 20 (8th July 2016) - Weinstock, Martin A.
Abstract : BACKGROUND: Population‐based screening for the early detection of melanoma holds great promise for reducing melanoma mortality, but evidence is needed to determine whether benefits outweigh risks. Skin surgeries and dermatology visits after screening were assessed to indicate potential physical, psychological, and financial consequences. METHODS: Targeted primary care providers (PCPs) at the University of Pittsburgh Medical Center were trained to detect early melanoma using the INFORMED (INternet course FOR Melanoma Early Detection) program. The authors analyzed aggregated administrative data describing 3 groups of patients aged ≥35 years who had received an annual physical examination by PCPs: group A1 included patients of PCPs from the group with the highest percentage of INFORMED‐trained providers, group A2 included patients of PCPs from the group with a lower percentage of INFORMED‐trained providers, and group B included patients of PCPs without INFORMED training. RESULTS: INFORMED‐trained PCPs screened 1572 of 16, 472 patients in groups A1 or A2 and none of the 56, 261 patients in group B. In group A1, there was a 79% increase (95% confidence interval, 15%‐138%) in melanoma diagnoses noted; no increase was observed for the other groups, and no substantial increase in skin surgeries or dermatology visits occurred in any group. CONCLUSIONS: A large‐scale melanoma screening using the INFORMED program was conducted in Pennsylvania. To the best of the authors' knowledge, the current study is the first analysis of downstream results and the findings indicate increased melanoma diagnoses but little impact on skin surgeries or dermatology visits. This result provides some reassurance that such efforts can be conducted without major adverse consequences, at least as measured by these parameters, and therefore should be considered for more widespread use. Cancer 2016;122:3152–6 . © 2016 American Cancer Society . Abstract : The risks of melanoma screening after training primary care providers with the INFORMED (INternet course FOR Melanoma Early Detection) program appear minimal, because screening a large population appears to lead to increased diagnoses of melanoma but has little impact on either surgeries on the skin or dermatology visits. This provides some reassurance that such efforts can be conducted without major adverse consequences, at least as measured by these parameters, and therefore should be considered for more widespread use. See also pages 3102‐5.