title: Screening for Skin Cancer: US Preventive Services Task Force Recommendation Statement.
abstract: OBJECTIVE
  Basal and squamous cell carcinoma are the most common types of cancer in the United States and represent the vast majority of all cases of skin cancer; however, they rarely result in death or substantial morbidity, whereas melanoma skin cancer has notably higher mortality rates. In 2016, an estimated 76,400 US men and women will develop melanoma and 10,100 will die from the disease.
  
  
  OBJECTIVE
  To update the 2009 US Preventive Services Task Force (USPSTF) recommendation on screening for skin cancer.
  
  
  METHODS
  The USPSTF reviewed the evidence on the effectiveness of screening for skin cancer with a clinical visual skin examination in reducing skin cancer morbidity and mortality and death from any cause; its potential harms, including any harms resulting from associated diagnostic follow-up; its test characteristics when performed by a primary care clinician vs a dermatologist; and whether its use leads to earlier detection of skin cancer compared with usual care.
  
  
  RESULTS
  Evidence to assess the net benefit of screening for skin cancer with a clinical visual skin examination is limited. Direct evidence on the effectiveness of screening in reducing melanoma morbidity and mortality is limited to a single fair-quality ecologic study with important methodological limitations. Information on harms is similarly sparse. The potential for harm clearly exists, including a high rate of unnecessary biopsies, possibly resulting in cosmetic or, more rarely, functional adverse effects, and the risk of overdiagnosis and overtreatment.
  
  
  CONCLUSIONS
  The USPSTF concludes 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 adults (I statement).
authors.affiliation: University of California, San Francisco.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Bibbins-Domingo
authors.affiliation: Group Health Research Institute, Seattle, Washington.
authors.forename: David C
authors.initials: DC
authors.lastname: Grossman
authors.affiliation: University of Iowa, Iowa City.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Curry
authors.affiliation: Columbia University, New York, New York.
authors.forename: Karina W
authors.initials: KW
authors.lastname: Davidson
authors.affiliation: University of Georgia, Athens.
authors.forename: Mark
authors.initials: M
authors.lastname: Ebell
authors.affiliation: State University of New York Upstate Medical University, Syracuse.
authors.forename: John W
authors.initials: JW
authors.lastname: Epling
authors.affiliation: Pima County Department of Health, Tucson, Arizona.
authors.forename: Francisco A R
authors.initials: FA
authors.lastname: García
authors.affiliation: Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Gillman
authors.affiliation: Duke University, Durham, North Carolina.
authors.forename: Alex R
authors.initials: AR
authors.lastname: Kemper
authors.affiliation: Fairfax Family Practice Residency, Fairfax, Virginia11Virginia Commonwealth University, Richmond.
authors.forename: Alex H
authors.initials: AH
authors.lastname: Krist
authors.affiliation: Yale University, New Haven, Connecticut.
authors.forename: Ann E
authors.initials: AE
authors.lastname: Kurth
authors.affiliation: University of Alabama at Birmingham.
authors.forename: C Seth
authors.initials: CS
authors.lastname: Landefeld
authors.affiliation: University of California, Los Angeles.
authors.forename: Carol M
authors.initials: CM
authors.lastname: Mangione
authors.affiliation: University of Washington, Seattle.
authors.forename: William R
authors.initials: WR
authors.lastname: Phillips
authors.affiliation: Brown University, Providence, Rhode Island.
authors.forename: Maureen G
authors.initials: MG
authors.lastname: Phipps
authors.affiliation: University of Texas at Austin.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Pignone
authors.affiliation: Mount Sinai School of Medicine, New York, New York19James J. Peters Veterans Affairs Medical Center, Bronx, New York.
authors.forename: Albert L
authors.initials: AL
authors.lastname: Siu
mesh_terms: D000328:Adult; D026683:Advisory Committees; D000368:Aged; D002280:Basal Cell Carcinoma / Q000175:diagnosis* / Q000401:mortality / Q000517:prevention & control; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000401:mortality / Q000517:prevention & control; D003880:Dermatology; D055088:Early Detection of Cancer / Q000379:methods / Q000401:mortality / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000401:mortality / Q000517:prevention & control; D008875:Middle Aged; D010808:Physical Examination / Q000379:methods / Q000592:standards; D011320:Primary Health Care; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000517:prevention & control