Kirsner R S, Muhkerjee S, Federman D G
Department of Dermatology, University of Miami School of Medicine, Miami, FL 33136, USA.
J Am Acad Dermatol. 1999 Oct;41(4):564-6.
Skin cancer incidence is increasing, but whether primary care providers routinely screen for skin cancer is not known.
We assessed whether primary care practitioners are performing skin cancer screening within the context of primary care and whether barriers exist that might act as impediments to the implementation of this practice.
A total of 465 primary care providers belonging to their respective county medical societies in either New Haven County, Connecticut, or Miami-Dade County, Florida were randomly selected and surveyed by mailed questionnaire regarding their skin cancer screening practices.
Only 31% of responding physicians reported performing skin cancer screening on all of their adult patients. Of those not performing skin cancer screening on all adult patients, only 31% report performing screening on high-risk patients. Almost half of physicians reported that they do not perform skin cancer screening. We found that physicians' lack of confidence in identifying suspect lesions was a common barrier. Fear of patient embarrassment, inadequate lighting, or lack of studies demonstrating mortality benefits were not frequent deterrents. Furthermore, there was no statistical difference in screening rates between the more northern latitude and the more southern latitude.
Skin cancer screening is not being performed within the context of primary care visits. Barriers exist that may impede skin cancer screening.
皮肤癌发病率呈上升趋势，但初级保健提供者是否常规筛查皮肤癌尚不清楚。
我们评估了初级保健从业者是否在初级保健背景下进行皮肤癌筛查，以及是否存在可能阻碍这种做法实施的障碍。
随机选择了465名分别隶属于康涅狄格州纽黑文县或佛罗里达州迈阿密 - 戴德县各自县医学会的初级保健提供者，并通过邮寄问卷对他们的皮肤癌筛查做法进行了调查。
只有31%的回复医生报告对所有成年患者进行皮肤癌筛查。在那些没有对所有成年患者进行皮肤癌筛查的医生中，只有31%报告对高危患者进行了筛查。几乎一半的医生报告说他们不进行皮肤癌筛查。我们发现医生对识别可疑病变缺乏信心是一个常见障碍。担心患者尴尬、照明不足或缺乏证明有死亡率益处的研究并不是常见的阻碍因素。此外，北纬地区和南纬地区的筛查率没有统计学差异。
在初级保健就诊过程中未进行皮肤癌筛查。存在可能阻碍皮肤癌筛查的障碍。
