Preliminary results of skin cancer screening in West Virginia

Although skin cancer screening is theoretically of value, its effectiveness has not been firmly established because few studies have systematically followed persons with a positive screen to obtain pathologically confirmed diagnoses. From the 799 persons screened at Charleston Area Medical Center in 1988 and 1989, 153 screenees with suspected skin cancer, dysplastic nevi, and congenital nevi were followed to determine their final diagnosis. Follow-up was done by letter and telephone calls to both the individuals who screened positive and their treating physicians. Eighty-four (54 percent) then sought medical attention as a result of letters and calls. Thirty-one basal cell carcinomas, three squamous cell carcinomas, three dysplastic nevi, two melanomas, and one congenital nevus were pathologically confirmed. The predictive value positive of the screenings was 32 percent to 60 percent for non-melanoma skin cancer, 9 percent to 25 percent for dysplastic nevi, and 15 percent for melanoma. This study suggests that post-screening follow-up of those with suspected premalignant and malignant skin lesions is feasible and should be encouraged so that more definitive evaluation and treatment can potentially be performed and skin cancer screenings more accurately assessed.