Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
J Am Acad Dermatol. 2015 Feb;72(2):310-3. doi: 10.1016/j.jaad.2014.10.030. Epub 2014 Dec 4.
There are increasing demands to demonstrate and report on outcomes in dermatology. Skin cancer diagnosis through skin examination has been well studied, and is promising as a value-delivering intervention.
This study seeks to identify the rate of skin cancer diagnosis during routine visits to a large tertiary dermatology clinic.
Medical records of patients presenting for routine dermatologic care at Massachusetts General Hospital between March 28 and September 28, 2012, were retrospectively reviewed. All patients given a diagnosis of nonmelanoma skin cancer (NMSC) confirmed on biopsy specimen were identified. Billing data were used to identify the total number of patients evaluated during the study period.
NMSC was diagnosed in 1266 skin biopsy specimens from 1047 (7.0%) of the 14,829 patients who presented for routine care. In all, 55% of patients with NMSC were men (mean age 70 years). Chief symptoms of patients with NMSC included general dermatologic concerns (37%), routine cancer screening (43%), and specific lesion(s) of concern (19%).
Retrospective design and restriction to a single institution may limit the generalizability of our findings.
The incidence of NMSC in routine dermatology is high; these findings validate the value of care provided by dermatologists and highlight the likely increasing need for their diagnostic skills as the population ages in the United States.
人们对展示和报告皮肤科的成果有越来越高的要求。皮肤镜检查诊断皮肤癌已得到充分研究，并且有望成为一种有价值的干预手段。
本研究旨在确定在大型三级皮肤科诊所的常规就诊中诊断皮肤癌的比例。
回顾性分析 2012 年 3 月 28 日至 9 月 28 日期间在马萨诸塞州总医院常规就诊的皮肤科患者的病历。所有经活检证实为非黑素瘤皮肤癌（NMSC）的患者均被识别。通过计费数据来确定研究期间接受评估的患者总数。
在 14829 例常规就诊的患者中，共有 1047 例（7.0%）患者接受了 1266 例皮肤活检，其中诊断出 NMSC。NMSC 患者中，男性占 55%（平均年龄 70 岁）。NMSC 患者的主要症状包括一般皮肤科问题（37%）、常规癌症筛查（43%）和特定病变（19%）。
回顾性设计和仅限制于单一机构可能会限制我们研究结果的普遍性。
常规皮肤科的 NMSC 发病率较高；这些发现验证了皮肤科医生所提供的护理的价值，并强调了随着美国人口老龄化，他们的诊断技能可能会越来越需要。
