A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Background: One out of every three cancer diagnoses is a skin cancer, and the incidence of
both melanoma and non‐melanoma type skin cancers is increasing. Skin cancers, including
melanoma, are typically treatable if detected early. However, there is insufficient evidence to
support recommendations to establish population based skin cancer screening programs. The
specific aims of this study are 1) to evaluate characteristics of participants who attend a
community skin cancer screening event and who are referred for follow up due to suspicious
lesions, 2) to determine the proportion of participants with suspicious lesions identified at a
community skin cancer screening event who complied with a request to visit a dermatologist or
primary care physician, and 3) to evaluate attitudes toward sun protection practices, and
perceived risk of developing skin cancer among participants who attend a community skin
cancer screening and have a suspicious skin lesion. Methods: The Skin Cancer Institute
sponsored a series of community skin cancer screening events in Tucson, Arizona from 2006 to
2013. Participants completed an American Academy of Dermatology screening form prior to a
skin examination by a dermatologist. Participants with suspicious lesions identified at the
examination who agreed to be contacted again received questionnaires 4 months after the
initial screening to assess compliance with follow‐up recommendations, and their sun
protection practices and risk perceptions. Results: 1979 community members attended the
skin cancer screenings. The majority of the participants were Caucasian, females, had blue eyes
and brown hair, were college educated, had no prior personal or family history of skin cancer,
had health insurance but did not have a regular dermatologist, reported that they had never
been to a skin cancer screening before, and stated that without this screening that they would
not have their skin examined. 748 (37.8%) of community members were referred and
instructed to see a dermatologist for further evaluation of a skin lesion. Of the 441 participants
with a suspicious lesion who consented to participate in the follow‐up study, 120 returned a
questionnaire; 90 (75%) reported that they followed up with a dermatologist or physician, and
30 (25%) did not. Of the 90 participants who followed up, 53% received a skin biopsy. The self reported diagnoses from the biopsies of the suspicious skin lesions were the following: 1%
atypical or dysplastic nevus, 21% actinic keratosis, 16% basal cell carcinoma, 8% squamous cell carcinoma, 2% melanoma, and 38% did not have skin cancer. Conclusions/Impact: This study demonstrated that 38% of community skin cancer screening participants were referred for
follow up due to a suspicious skin lesion being identified during a skin cancer screening event.
It also appeared that 75% of those who responded to the follow‐up questionnaire complied
with the request within four months, although the response rate for the follow‐up
questionnaire was low. Therefore, implementing a formal reminder system following the skin
cancer screenings may increase the percentage of participants who follow up with a primary
care physician or dermatologist after the screening for further evaluation of their suspicious
skin lesion.
| Identifer | oai:union.ndltd.org:arizona.edu/oai:arizona.openrepository.com:10150/603662 |
| Date | 25 March 2016 |
| Creators | Romano, Gianna |
| Contributors | The University of Arizona College of Medicine - Phoenix |
| Publisher | The University of Arizona. |
| Source Sets | University of Arizona |
| Language | en_US |
| Detected Language | English |
| Type | Thesis |
| Rights | Copyright © is held by the author. Digital access to this material is made possible by the College of Medicine - Phoenix, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author. |
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