Skin cancer screening in primary care: Prevalence and barriers

Background: Skin cancer incidence is increasing, but whether primary care p roviders routinely screen for skin cancer is not known. Objective: We assessed whether primary care practitioners are performing sk in cancer screening within the context of primary care and whether barriers exist that might act as impediments to the implementation of this practice . Methods: A total of 465 primary care providers belonging to their respectiv e county medical societies in either New Haven County, Connecticut, or Miam i-Dade County, Florida were randomly selected and surveyed by mailed questi onnaire regarding their skin cancer screening practices. Results: Only 31% of responding physicians reported performing skin cancer screening on all of their adult patients. Of those not performing skin canc er screening on all adult patients, only 31% report performing screening on high-risk patients. Almost half of physicians reported that they do not pe rform skin cancer screening. We found that physicians' lack of confidence i n identifying suspect lesions was a common barrier. Fear of patient embarra ssment, inadequate lighting, or lack of studies demonstrating mortality ben efits were not frequent deterrents. Furthermore, there was no statistical d ifference in screening rates between the more northern latitude and the mor e southern latitude. Conclusion: Skin cancer screening is not being performed within the context of primary care visits. Barriers exist that may impede skin cancer screeni ng.