Experts Review Current U.S. Guidelines for Detecting Melanoma

Controversies are critiqued and data-derived recommendations are proposed

In a new perspective article led by Sancy Leachman, MD, PhD, and Mariah Johnson, MD, from the Oregon Health & Science University (OHSU) Knight Cancer Institute’s Melanoma Research Program at the OHSU School of Medicine, more than 50 leading members of the skin cancer field combined their expertise to review screening practice in primary care, as recommended by the U.S. Preventive Services Task Force (USPSTF) 2016 Draft Recommendation Statement, in light of recent melanoma epidemiology.

Presently, the safest and most cost-effective method of screening for melanoma, a deadly form of skin cancer, is through total body skin examination. However, there is no national consensus on how to implement the procedure or its benefit.

The group of experts has proposed a series of data-driven guidelines that highlight risk groups for melanoma and provide full screening recommendations for those individuals. To further develop their guidelines, the group also reviewed international screening guidelines from Australia, New Zealand, Germany, and elsewhere, modeling their recommendations appropriately.

A key aspect of the perspective article was the group’s critique of the USPSTF statement and the rationale that led to it. The experts raised a series of questions to assess the guidelines and promote active discourse. They asked why morbidity associated with delayed diagnosis of melanoma was omitted from the USPSTF’s risk estimates; whether it was valid to extrapolate the satisfaction results from cosmetic procedures to results from a diagnostic procedure for a cancer; and challenged the methodology behind the sourcing of publications that formed the reasoning behind the statement.

“In many ways, it’s surprising that our field is currently without a national consensus for skin cancer screening guidelines for patients without symptoms,” Leachman stated. “One of the goals of this paper was to propose data-driven, evidence-based guidelines for screenings that are consistent with the USPSTF guidelines for other cancers and diseases. The guidelines are of course just a starting point based on patient data we’ve reviewed to date, but we’ve identified a strong need to provide providers with initial recommendations outlining when to recommend screenings to their patients.”

The open-access article entitled “Skin Cancer Screening: Recommendations for Data-Driven Screening Guidelines and a Review of the U.S. Preventive Services Task Force Controversy,” published March 27 in Melanoma Management, is available at:

Source: Future Science Group; March 27, 2017.