Note: Separate PDQ summaries on Skin Cancer Prevention, Skin Cancer Treatment, and Levels of Evidence for Cancer Screening and Prevention Studies are also available.

Interventions

The only widely proposed screening procedure for melanomatous skin cancer is visual examination of the skin, including both self examination and clinical examination.

Benefits

In asymptomatic populations, the effect of visual skin examination on mortality from nonmelanomatous skin cancers is unknown. Further, the evidence is inadequate to determine whether visual examination of the skin in asymptomatic individuals would lead to a reduction in mortality from melanomatous skin cancer.

Description of the Evidence

• STUDY DESIGN: Evidence obtained from a single case-control study.
• INTERNAL VALIDITY: Poor.
• CONSISTENCY: N/A
• MAGNITUDE OF EFFECTS ON HEALTH OUTCOMES: N/A
• EXTERNAL VALIDITY: N/A

Harms

Based on fair though unquantified evidence, visual examination of the skin in asymptomatic individuals may lead to unavoidable increases in harmful consequences. These include complications of diagnostic or treatment interventions (including extensive surgery) and the psychological effects of being labeled with a potentially fatal disease. Another harmful consequence is overdiagnosis leading to the detection of biologically benign disease that would otherwise go undetected.

Description of the Evidence

• STUDY DESIGN: Opinions of respected authorities based on clinical experience, descriptive studies, or reports of expert committees.
• INTERNAL VALIDITY: Fair.
• CONSISTENCY: Multiple studies; small number of participants-no consistency.
• MAGNITUDE OF EFFECTS ON HEALTH OUTCOMES: Unknown.
• EXTERNAL VALIDITY: Fair.