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False-negative findings in skin cancer and melanoma screening
F H Rampen1, J I Casparie-van Velsen, B E van Huystee
1Department of Dermatology, Sint Anna Hospital, Oss, The Netherlands.
Background:
Few data are available on the accuracy of visual skin examination by dermatologists as a skin cancer and melanoma screening tool.
Objective:
The purpose of this study was to assess the number of false-negative findings in a skin cancer-melanoma screening program.
Methods:
We obtained follow-up information regarding 1551 persons with a negative screening result in a skin cancer-melanoma screening program in 1990. Follow-up was established by record linkage with two different population-based registries.
Results:
Fifteen persons had new skin cancers. Three of their lesions had been present at the original screening and had probably been missed; 12 were genuinely new. No melanomas were among the missed cases. The calculated sensitivity of the screening was 93.3%, its specificity was 97.8%, its positive predictive value was 54.0%, and its negative predictive value was 99.8%.
Conclusion:
Visual examination by dermatologists as a screening tool for skin cancer and melanoma is appropriate.