title: Use of nonphysician health care providers for skin cancer screening in the primary care setting.
abstract: BACKGROUND
  Nonphysician health care providers are in an optimal position to provide cancer prevention and screening services.
  
  
  METHODS
  We conducted a survey of primary care physicians to determine physician use and amenability to use of nonphysician health care providers to perform skin cancer screening in comparison with other cancer screening examinations.
  
  
  RESULTS
  A total of 1,363 eligible physicians completed the survey. Of these, 631 physicians (46%) reported a nurse practitioner or physician assistant performing at least one type of cancer screening examination on their patients. Twenty-nine and 22% of all physicians reported nurse practitioners or physician assistants performing skin cancer screening, respectively. Family physicians were more likely to use nurse practitioners and physician assistants to perform these cancer screening examinations than internists (chi(2) test, P = 0.001 for each examination). Skin examinations were performed less frequently by nurse practitioners and physician assistants than all other cancer screening examinations. A total of 73-79% of family physicians and 60-70% of internists were amenable to having a nonphysician health care provider perform one or more of these examinations.
  
  
  CONCLUSIONS
  Primary care physicians are currently utilizing nonphysician health care providers to perform cancer screening examinations and the majority of those surveyed are amenable to the use of these providers for such examinations. This suggests that one possible strategy for increasing skin cancer screening is through an expanded role of nonphysician health care providers.
authors.affiliation: Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA. oliveri1@mskcc.org
authors.forename: Susan A
authors.initials: SA
authors.lastname: Oliveria
authors.forename: Jamie F
authors.initials: JF
authors.lastname: Altman
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Christos
authors.forename: Allan C
authors.initials: AC
authors.lastname: Halpern
mesh_terms: D002983:Clinical Competence; D016001:Confidence Intervals; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000592:standards*; D009722:Nurse Practitioners / Q000592:standards / Q000706:statistics & numerical data*; D016017:Odds Ratio; D010823:Physician Assistants / Q000592:standards / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000592:standards; D011336:Probability; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D014481:United States; D000078329:Workforce