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Full-body skin examinations: the patient's perspective
Daniel G Federman1, Jeffrey D Kravetz, Daniel G Tobin
1Department of Medicine, Veterans Affairs Connecticut Health Care Center, West Haven, CT 06516, USA. daniel.federman@med.va.gov
Objectives:
To determine (1). primary care practitioner (PCP) and dermatologist full-body skin examination (FBSE) rates by using a patient questionnaire and (2). whether patient risk factors for skin cancer alter these rates.
Design:
Questionnaires pertaining to whether participants underwent regular FBSE, their feelings about this screening test, and their risks for developing skin cancer.
Setting:
The primary care and dermatology clinics at the West Haven Veterans Affairs Medical Center.
Participants:
A convenience sample of 356 patients awaiting clinic appointments. Of those asked to participate, 251 (71%) agreed.
Main Outcome Measures:
Patient report of undergoing FBSE, attitudes regarding this examination, and risk factors for cutaneous malignancy.
Results:
Thirty-two percent of all respondents reported undergoing regular FBSE by their PCP, whereas 55% of those with a history of skin cancer reported undergoing FBSE. Eight percent of participants reported embarrassment with FBSE, 83% reported that their PCP would be considered thorough by performing FBSE, and 87% would like their PCP to perform FBSE regularly. Only 2% of participants would refuse the examination if the PCP were of the opposite sex, whereas 8% would be more willing to be examined.
Conclusions:
Although patients report a low incidence of FBSE, those with a personal history of skin cancer are more likely to be screened. A low rate of embarrassment and a high rate of perceived PCP thoroughness are associated with FBSE. Patients have a strong preference to undergo FBSE. A sex difference between the PCP and the patient should not be a barrier to this examination.