USPSTF Final Recommendation: There’s Not Enough Evidence to Support Skin Cancer Screening in Folks Without Symptoms

For this recommendation, screening is defined as a visual skin exam by a primary care professional.

It’s officiay official:. The U.S. Preventive Services Task Force (USPSTF) concluded that the current evidence is insufficient to assess the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in adolescents and adults. 

This statement is consistent with its 2016 recommendation.

This is an I statement.  The balance of benefits and harms cannot be determined. For this recommendation, screening is defined as a visual skin exam by a primary care professional. The recommendation does not apply to people with a family history of skin cancer or those with signs or symptoms, such as irregular moles or any changes in the size, shape, or color of skin growths.

“The Task Force wanted to see if visual skin exams by primary care professionals reduce complications or deaths from skin cancer in people without symptoms,” says Task Force member Katrina Donahue, M.D., M.P.H., in a news release. She is a professor and vice chair of research at the University of North Carolina at Chapel Hill Department of Family Medicine and a family physician and senior research fellow at the Cecil G. Sheps Center for Health Services Research, and the co-director of the North Carolina Network Consortium, a meta-network of six practice-based research networks and four academic institutions in North Carolina.

“Unfortunately, there is not enough evidence to recommend for or against screening, and healthcare professionals should use their judgment when deciding whether or not to screen.”

"We need more research on whether or not screening for skin cancer in people without symptoms is beneficial,” says Task Force member John Ruiz, Ph.D. “To help prevent skin cancer, people should minimize sun exposure, protect their skin when in the sun, and avoid tanning beds.” Dr. Ruiz is a professor of clinical psychology in the Department of Psychology at the University of Arizona, where he is also director of diversity, equity, and inclusivity.

While evidence on screening is limited in all people, the Task Force is using this recommendation to draw attention to the need for future research to be reflective of the United States, both in terms of including study populations with a diversity of skin tones and settings where access to healthcare varies.

The Task Force has a separate, related recommendation on counseling to prevent skin cancer that provides additional guidance to primary care professionals and patients.

The Task Force’s final recommendation statement and corresponding evidence summary have been published online in the Journal of the American Medical Association, as well as on the Task Force website at: https://www.uspreventiveservicestaskforce.org.

A draft version of the recommendation statement and evidence review were available for public comment from October 25, 2022, to November 21, 2022.