Recognizing the importance of early detection, the American Academy of Dermatology Association (AADA) has responded to the U.S. Preventive Services Task Force Draft Recommendation Statement on Screening for Skin Cancer, which cites insufficient evidence to recommend regular skin cancer screenings by a primary care provider for individuals 15 and older with no history of skin cancer. After issuing an initial statement on Nov. 30, the day the recommendation was released, the AADA followed up on Dec. 28 by submitting comments to the USPSTF.

In addition to providing scientific feedback regarding the evidence used to create the recommendation, the AADA suggests that the USPSTF:

• Reconsider whether there is sufficient data to support the value of skin cancer screening in reducing morbidity.
• Consider whether the standard of evidence required to demonstrate the benefit of skin cancer screenings is too high when compared to other, more invasive cancer screenings.
• Utilize the expertise of a board-certified dermatologist in evaluating the benefits of skin cancer screening.
• Consider targeted recommendations for high-risk populations, including older men and individuals with low health literacy.

While the USPSTF chose to focus the emphasis of its research on melanoma, the deadliest form of skin cancer, the AADA requests that the group acknowledge the importance of detecting all skin cancers, including nonmelanoma skin cancer. Every form of skin cancer, including basal cell carcinoma and squamous cell carcinoma, can have potentially devastating effects, including severe tissue loss and death.

The scope of the USPSTF recommendation is limited to screenings conducted by primary care physicians and does not include skin self-exams conducted by patients or screenings conducted by dermatologists, who are the best-qualified physicians to diagnose and treat skin cancer. In its comments, the AADA requests that the USPSTF makes these distinctions clear in its final recommendation statement.

The AADA encourages all members of the public to regularly examine their skin for signs of skin cancer and see a board-certified dermatologist if they notice any unusual spots on their skin, including anything changing, itching or bleeding. Those with an increased risk of melanoma or a history of skin cancer should consult a dermatologist to determine how often they should receive a skin exam from a doctor.

“The AADA hopes the USPSTF considers our comments on their draft recommendation and acknowledges of the importance of early detection in the fight against skin cancer,” says board-certified dermatologist Mark Lebwohl, MD, FAAD, president of the AADA. “In the meantime, we encourage everyone to serve as your own health advocate by regularly conducting skin self-exams and visiting a board-certified dermatologist if you notice any suspicious spots on your skin.”

In addition to weighing in on the draft recommendation, the AADA also has supported federal legislation designed to improve the transparency of the USPSTF’s recommendation development process and bring in a broad range of stakeholder perspectives.

—Stefanie Tuelya