Screening for skin cancer in primary care settings.
OBJECTIVE
To estimate the frequency of recorded screening for skin cancer in primary care settings.


METHODS
Retrospective observational cohort study.


METHODS
Two academically affiliated Department of Veterans Affairs Medical Centers.


METHODS
Two hundred randomly selected patients at least 50 years old and receiving care at outpatient medical clinics.


METHODS
Frequency of documented skin examinations, in comparison with other tests routinely done as screening, during a 2-year period.


METHODS
Medical record review to identify how often selected components of the physical examination and specific procedures were documented during ambulatory visits.


RESULTS
Among the 200 subjects, the frequency of documented examinations and procedures included fecal occult blood testing in 120 (60%), rectal examination in 128 (64%), and sigmoidoscopy in 93 (47%), prostate examination was performed in 114 (59%) of 193 men. In contrast, skin examination was documented in only 56 (28%) of 200 subjects (P < .001 for each comparison with other tests). As an estimate of the "true" frequency of screening for skin cancer, 35 (18%) of 165 patients without skin-related complaints had a documented skin examination.


CONCLUSIONS
Skin cancer screening is infrequently documented and therefore possibly omitted in the context of primary care visits.
Federman
D G
DG
Department of Medicine, Yale University School of Medicine, New Haven, Conn., USA.
Concato
J
J
Caralis
P V
PV
Hunkele
G E
GE
Kirsner
R S
RS
D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D011320:Primary Health Care; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000175:diagnosis*