Screening for Skin Cancer. Table 1. Skin cancer screening accuracy

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Table 1. Skin cancer screening accuracy

Author	Study sample and setting	Recruit- ment focus	Patients n	Index test	PCP or d	Defn. of susp. lesion	Suspi- cious lesions _________ n %		Probability of cancer^a	BCC/skin cancer %	MM/skin cancer %	SCC/ skin cancer %	Positive predictive value ^b _________ Low High		Biopsy rate ^c	Likeli- hood ratio^b,d
Screening for all skin cancer^e
de Rooij et al. (45) Rampen et al. (37)	Volunteers for skin cancer screening in the Netherlands	Patient with skin cancer risks	1961	Lesion- specific exam or TSE	d	Skin cancer	93	4.7	0.031	85.1	12.8	2.1	0.51	0.54	0.935	37.32
Limpert (36)	Free skin cancer clinic at family physician's office	NR	247	TSE	PCP	Skin cancer	51	20.6	0.057	92.9	7.1	0.0	0.27	0.42	0.647	12.26
de Rooij et al. (46)	Volunteer melanoma screenings in the Netherlands following a public campaign on melanoma and risk factors	Patients with mel- anoma risks	4,146	Lesion- specific exam or TSE	d	Skin cancer	173	4.2	0.011	73.5	26.5	0.0	0.28	0.30	0.912	37.95
Jonna et al. (43)	Free skin cancer screening in San Diego for self-selected high risk	Patients with skin cancer risks	464	TSE	d	Skin cancer	132	28.4	0.060	85.2	11.1	3.7	0.21	0.58	0.364	21.80
Screening for melanoma
Koh et al. (38)	Volunteer skin cancer education and screenings by the American Academy of Dermatology	Not targeted	282,555	NR	d	Suspect- ed melanoma	763	0.3	0.001	NR	NR		0.17	0.19	0.890	183.57
Koh et al. (38)	Volunteer skin cancer education and screenings by the American Academy of Dermatology	Not targeted	282,555	NR	d	Rule out melanoma	3695	1.3	0.001	NR	NR		0.06	0.09	0.690	78.33

^[a] The overall probability of cancer was calculated as the total number of cancers diagnosed divided by number of patients screened.
^[b] Methods for calculating the high and low estimates of predictive value and likelihood ratios are described in the text.
^[c] Proportion of patients referred for biopsy who actually had one.
^[d] Method for estimating likelihood ratio of a positive test is described in the text.
^[e] For the first group of studies, all skin cancers are included in the numerator. For the Koh studies, only melanomas are included.

Legend: PCP, primary care provider; d, dermatologist; Defn. of susp. lesion, definition of suspicious lesion; BCC, basal cell carcinoma; MM, malignant melanoma; SCC, squamous cell carcinoma; TSE, total skin examination; NR, not reported.

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