USPTSF Updates Guidelines on Skin Cancer Screenings

The United States Preventative Services Task Force (USPSTF) recently issued a draft recommendation statement with updated guidelines on skin cancer screenings. The draft document will be open to the public until November 21, 2022, for public comments. However, the statement revealed that the USPSTF believes that there is “insufficient evidence to assess the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in adults.”

According to the CDC, skin cancer affects approximately 4.3 million adults in the US who are impacted by skin cancer each year, making it the most common type of cancer in the country. The economic burden of skin cancer in the US is nearly $4.8 billion annually.

Risk factors for skin cancer included fairer skin and hair, sensitivity to sunburn, a family history of skin cancer, and age. Additionally, environmental factors may contribute to the risk of developing skin cancer. Prolonged exposure to UV rays has been proven to correlate with a greater likelihood of developing skin cancer.

The updated draft recommendation by the USPSTF coincides with their 2016 findings of insufficient evidence to balance the benefits of the visual skin examination. According to the published statement, “the USPSTF commissioned a systematic review to evaluate the benefits and harms of screening for skin cancer in asymptomatic adolescents and adults. The review included evidence for both keratinocyte carcinoma and cutaneous melanoma. The USPSTF used foundational evidence from previous reviews to assess the diagnostic accuracy of visual skin examination by a clinician for detecting skin cancer.”

According to the research, visual skin exams were 40–70% specific and 86–98%. Additionally, the organization looked at the harms of screening and treatment. Among the harms, 7% of patients had poor cosmetic outcomes.

Beyond the data presented, the USPTSF highlights gaps in research, including the impacts of the social determinants of health, risk assessment tools, and the correlation between screening and morbidity and mortality.