Subspecialty Clinics: Dermatology
Overview of Skin Cancer Detection and Prevention for the Primary Care Physician

https://doi.org/10.4065/75.5.491Get rights and content

The incidence of both melanoma and nonmelanoma skin cancer is increasing, and an accurate and timely diagnosis is important to reduce the morbidity and mortality associated with these malignancies. Clinical features and examination techniques are discussed, and the need to recognize important secondary tumor characteristics, which supplement the primary diagnosis, is reviewed. Recent evidence on etiologic factors and their importance are addressed to highlight the role of primary prevention. Pediatricians, family physicians, and all primary care physicians are encouraged to promote skin cancer awareness among children and their parents.

Section snippets

ETIOLOGY

As with most malignancies, the risk of development of disease is a combination of inherent host characteristics and exogenous environmental influences.

Background

As with all fields of medical practice, the history of the presenting problem is essential. Dermatologic diagnosis is based on visual pattern recognition, and therefore physical examination of the lesions is appropriate during inquiry about their history. In fact, many questions such as prior therapy, past exposure to carcinogens, and duration of disease may be raised based on initial examination. The history should focus on the development, duration, changes, rapidity of growth, and other

TECHNIQUES OF EXAMINATION

Examination of the skin is not simply looking, but rather touching, stretching, pinching, rubbing, moistening, crossilluminating, and, most importantly, seeing. This skill can be refined by using and practicing various physical examination techniques. Excellent technique and an established routine allow detection of subtle early tumors, the goal in the diagnosis of skin cancers.

Total cutaneous examination is a fundamental requirement when screening for cutaneous tumors. Full body examination

PREVENTION

Along with impeccable clinical skill, the physician should attempt to improve patient awareness of skin cancer to facilitate primary prevention. Opportunity for patient education exists since some estimates are that 85% of the US population sees a physician at least once in a 2-year period.20 Patients must be educated about the importance of reducing unprotected exposure to UVR. In light of the recent evidence of the danger of childhood sunburn, parents in particular should be targeted and

CONCLUSION

The medical profession mentions the increasing epidemic of skin cancer, but the unique nature of the visibility and accessibility of the skin allows easy and rapid assessment of potentially malignant lesions. The only tools required are clinical acumen and a thorough knowledgeable approach. If more medical professionals practice these strategies regularly and routinely, a reduction in this epidemic is certainly an achievable goal. Because many of the etiologic factors are well described,

REFERENCES (34)

  • J Austoker

    Melanoma: prevention and early diagnosis

    BMJ

    (1994)
  • HM Gloster et al.

    The epidemiology of skin cancer

    Dermatol Surg

    (1996)
  • AR Rhodes

    Public education and cancer of the skin: what do people need to know about melanoma and nonmelanoma skin cancer?

    Cancer

    (1995)
  • AM Goldstein et al.

    Etiology, epidemiology, risk factors, and public health issues of melanoma

    Curr Opin Oncol

    (1993)
  • DM Pariser et al.

    Basal cell carcinoma: when to treat it yourself, and when to refer

    Geriatrics

    (1994)
  • J Scotto et al.

    Incidence of Nonmelanoma Skin Cancer in the United States

    (1983)
  • FH Rampen et al.

    Fundamentals of skin cancer/melanoma screening campaigns

    Clin Exp Dermatol

    (1992)
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