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The Three-Dimensional Human Skin Reconstruct Model: a Tool to Study Normal Skin and Melanoma Progression
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Examen de detección para el cáncer de piel: Declaración de recomendación del grupo de trabajo de servicios
, Kirsten Bibbins-Domingo1, David C Grossman2
1University of California, San Francisco.
JAMA
|July 27, 2016
Resumen
La evidencia actual es insuficiente para determinar si los exámenes visuales de la piel realizados por los médicos son efectivos para detectar el cáncer de piel en adultos. Se necesita más investigación para equilibrar los beneficios potenciales con los daños como las biopsias innecesarias y el sobrediagnóstico.
Área de la Ciencia:
- Dermatología
- La medicina preventiva
- En el campo de la oncología
Sus antecedentes:
- El melanoma tiene tasas de mortalidad más altas que el carcinoma de células basales y escamosas.
- En 2016, se estima que 76.400 personas en los Estados Unidos desarrollaron melanoma, con 10.100 muertes.
- El Grupo de Trabajo de Servicios Preventivos de los Estados Unidos (USPSTF) emitió previamente recomendaciones en 2009.
Objetivo del estudio:
- Proporcionar una actualización basada en la evidencia de la recomendación de 2009 de la USPSTF con respecto al cribado del cáncer de piel.
- Evaluar la eficacia de los exámenes clínicos visuales de la piel en la reducción de la morbilidad y mortalidad por cáncer de piel.
Principales métodos:
- Revisión sistemática de las pruebas de los exámenes visuales de la piel para el cribado del cáncer de piel.
- Evaluación de la eficacia del cribado, los daños potenciales, las características del ensayo y la detección temprana en comparación con la atención habitual.
- Inclusión de estudios comparativos entre médicos de atención primaria y dermatólogos.
Principales resultados:
- Existen pruebas directas limitadas sobre la eficacia de los exámenes visuales de la piel para reducir la morbilidad y mortalidad por melanoma.
- La información sobre los daños, como las biopsias innecesarias y el sobrediagnóstico, es escasa, pero se reconocen los daños potenciales.
- La calidad de la evidencia existente, incluido un estudio ecológico clave, tiene limitaciones metodológicas significativas.
Conclusiones:
- La USPSTF concluyó que la evidencia actual es insuficiente para evaluar los beneficios y los daños de los exámenes visuales de la piel realizados por médicos para el cribado del cáncer de piel en adultos.
- Una declaración "I" indica que no hay pruebas suficientes para recomendar el cribado.
- Se necesita más investigación para aclarar el beneficio neto del cribado del cáncer de piel.
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