| 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 cancera | BCC/skin cancer % | MM/skin cancer % | SCC/ skin cancer % |
Positive
predictive value b _________ Low High |
Biopsy rate c | Likeli- hood ratiob,d |
||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Screening for all skin cancere | ||||||||||||||||
| 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.