Development and Validation of a Simple Model to Predict the Risk of Nonmelanoma Skin Cancer on Screening Total Body...

Area of Science:

• Dermatology
• Epidemiology
• Oncology

Background:

• Population-level guidelines for skin cancer screening are lacking, leading to inconsistent patient selection.
• Screening total body skin examinations (TBSE) are crucial for early detection of nonmelanoma skin cancer (NMSC).

Purpose of the Study:

• To develop a simple, predictive model for NMSC risk assessment during screening TBSE.
• To create an easy-to-use scoring system for clinical decision-making in NMSC screening.

Main Methods:

• An epidemiologic assessment utilized data from a prospective, international, multicenter study.
• A multivariable model was generated using predictors of NMSC and converted into a point-based scoring system.
• Model performance was validated using a separate dataset from two US healthcare institutions.

Main Results:

• The study included 8,501 patients.
• Key predictors of NMSC identified were: history of NMSC, age, and skin phototype.
• The developed model demonstrated high predictive discrimination (AUC = 0.82).

Conclusions:

• A three-variable model, CAP (cancer history, age, phototype), accurately predicts NMSC risk for screening TBSE.
• This CAP tool can enhance clinical decision-making and improve the yield of screening TBSE in dermatology.