Related Experiment Video
Updated: Jun 4, 2026
Measuring Psoriasis Severity at Home
Published on: March 1, 2024
High Accuracy in Patient Self-Reporting of Keratinocyte Carcinoma, but Reduced Sensitivity for Squamous Cell
Ashley Riddle1, Cassidy M Nguyen1, Emily Karn2
1Division of Dermatology, The University of Texas at Austin, Dell Medical School, Austin, Texas.
Background:
Accurate self-reporting of keratinocyte carcinoma (KC) informs clinical decision-making, but real-world performance in dermatology clinics is understudied.
Objective:
To evaluate the sensitivity, specificity, and accuracy of patient-reported facial or scalp KC, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC) during routine dermatology encounters.
Patients And Methods:
In this multicenter cohort study, 338 adults with Fitzpatrick phototypes I-III and visible actinic damage were prospectively enrolled at 6 academic centers. Participants self-reported their history of KC, BCC, and SCC within the prior 2 years. Chart review served as the reference standard. Diagnostic accuracy metrics were calculated, including worst-case sensitivity analyses.
Results:
Self-reported KC showed high accuracy (92.2%), sensitivity (93.8%), and specificity (91.2%). SCC sensitivity was lower (78.3%) despite high specificity (95.9%). In worst-case analyses, SCC sensitivity declined to 64.3%. Negative predictive values exceeded positive predictive values across all cancer types.
Conclusion:
Patient self-reporting of KC is generally reliable, particularly for excluding disease. However, SCC is more likely to be underreported, underscoring the need to verify cancer history in high-risk patients or those at risk for poor recall.
