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Using nurse practitioners for skin cancer screening: a pilot study.
S A Oliveria1, K S Nehal, P J Christos
1Department of Medicine, Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA. oliveri1@mskcc.org
American Journal of Preventive Medicine
|September 25, 2001
Summary
Trained nurse practitioners can effectively identify suspicious skin lesions, showing high sensitivity and specificity in preliminary screenings. This training is crucial for improving early skin cancer detection and reducing mortality.
Area of Science:
- Dermatology
- Medical Education
- Public Health
Background:
- Skin cancer screening is vital for early detection of precancerous lesions.
- Early detection may significantly reduce melanoma-related mortality.
- Assessing the efficacy of trained healthcare professionals in lesion identification is crucial.
Purpose of the Study:
- To evaluate the accuracy of nurse practitioners (NPs) in identifying suspicious skin lesions.
- To determine the effectiveness of a structured training program for NPs in skin cancer detection.
- To assess NP performance in a clinical setting for lesion triage.
Main Methods:
- Five NPs with no prior skin lesion evaluation experience underwent a training program (workshop, apprenticeship, lectures).
- NP competency was assessed via three methods: slide evaluation, paired patient assessment with a dermatologist, and independent clinical examination.
- Performance metrics included sensitivity and specificity for referring benign and malignant lesions.
Main Results:
- Slide assessment showed 100% sensitivity and 53%-100% specificity for lesion referral.
- Clinical assessments demonstrated referral sensitivity ranging from 67%-100% and specificity from 62%-100%.
- Final clinical evaluations indicated high detection sensitivity (50%-100%) and specificity (99%-100%) for significant skin lesions.
Conclusions:
- Nurse practitioners can be effectively trained to accurately identify and triage suspicious skin lesions.
- These findings support the integration of trained NPs into skin cancer screening programs.
- The study highlights the potential for NPs to improve early detection rates and reduce skin cancer mortality.