Abstract：
OBJECTIVE: The incidence of melanoma has increased dramatically over the past four decades, while overall mortality has remained stable. This increase in incidence without a change in overall mortality may be due to overdiagnosis through skin cancer screening. Despite the USPSTF citing insufficient evidence for or against professional skin cancer screening in average-risk adults, U.S. skin cancer screening practices may be leading to overdiagnosis of skin cancers.
METHODS: Two reviewers examined the online recommendations for skin cancer screening of 1113 U.S. cancer centers accredited by the Commission on Cancer, including 66 designated by the National Cancer Institute (NCI). Recommendations on skin cancer screening, such as age, frequency, and patient population (i.e. high-risk of developing skin cancer, \"people of color\") were documented.
RESULTS: We found that 18% of centers (202) recommended professional screening in average-risk adults, 35.8% (399) advised regular self-examination, and only 3.4% (38) cited insufficient evidence for screening practices; 49% of NCI centers (32/66) recommended screening in high-risk adults compared to 13% of non-NCI centers (135/1047; p = 0.0004); 0.45% of centers (5) mentioned the potential harms of screening, while 3.5% (39) specifically recommended screening for people of color.
CONCLUSIONS: Our study reveals that many U.S. cancer centers advise some form of skin cancer screening despite a lack of evidence for or against these practices. Few centers mentioned the potential harms of screening, including overdiagnosis. This indicates a need for stronger evidence for specific screening guidelines and for greater public awareness of the potential benefits and harms of routine skin cancer screening.
METHODS: Two reviewers examined the online recommendations for skin cancer screening of 1113 U.S. cancer centers accredited by the Commission on Cancer, including 66 designated by the National Cancer Institute (NCI). Recommendations on skin cancer screening, such as age, frequency, and patient population (i.e. high-risk of developing skin cancer, \"people of color\") were documented.
RESULTS: We found that 18% of centers (202) recommended professional screening in average-risk adults, 35.8% (399) advised regular self-examination, and only 3.4% (38) cited insufficient evidence for screening practices; 49% of NCI centers (32/66) recommended screening in high-risk adults compared to 13% of non-NCI centers (135/1047; p = 0.0004); 0.45% of centers (5) mentioned the potential harms of screening, while 3.5% (39) specifically recommended screening for people of color.
CONCLUSIONS: Our study reveals that many U.S. cancer centers advise some form of skin cancer screening despite a lack of evidence for or against these practices. Few centers mentioned the potential harms of screening, including overdiagnosis. This indicates a need for stronger evidence for specific screening guidelines and for greater public awareness of the potential benefits and harms of routine skin cancer screening.
摘要：
目的：在过去的四十年中，黑色素瘤的发病率急剧增加，而总死亡率保持稳定。这种发病率的增加而没有总死亡率的变化可能是由于皮肤癌筛查的过度诊断。尽管USPSTF没有足够的证据支持或反对在平均风险的成年人中进行专业皮肤癌筛查，美国皮肤癌筛查实践可能导致皮肤癌的过度诊断。
方法：两名评审人员审查了由癌症委员会认可的1113个美国癌症中心进行皮肤癌筛查的在线建议，包括国家癌症研究所（NCI）指定的66个。关于皮肤癌筛查的建议，比如年龄,频率,和患者群体(即患皮肤癌的高风险，“有色人种”）被记录下来。
结果：我们发现18％的中心（202）建议对平均风险的成年人进行专业筛查，35.8%(399)建议定期自我检查，只有3.4%(38)的人提到筛查实践的证据不足；49%的NCI中心(32/66)建议在高风险成人中进行筛查，而13%的非NCI中心(135/1047;p=0.0004)；0.45%的中心(5)提到了筛查的潜在危害，而3.5%（39）特别建议对有色人种进行筛查。
结论：我们的研究表明，许多美国癌症中心建议进行某种形式的皮肤癌筛查，尽管缺乏支持或反对这些做法的证据。很少有中心提到筛查的潜在危害，包括过度诊断。这表明有必要为特定的筛查指南提供更强有力的证据，并提高公众对常规皮肤癌筛查的潜在益处和危害的认识。
方法：两名评审人员审查了由癌症委员会认可的1113个美国癌症中心进行皮肤癌筛查的在线建议，包括国家癌症研究所（NCI）指定的66个。关于皮肤癌筛查的建议，比如年龄,频率,和患者群体(即患皮肤癌的高风险，“有色人种”）被记录下来。
结果：我们发现18％的中心（202）建议对平均风险的成年人进行专业筛查，35.8%(399)建议定期自我检查，只有3.4%(38)的人提到筛查实践的证据不足；49%的NCI中心(32/66)建议在高风险成人中进行筛查，而13%的非NCI中心(135/1047;p=0.0004)；0.45%的中心(5)提到了筛查的潜在危害，而3.5%（39）特别建议对有色人种进行筛查。
结论：我们的研究表明，许多美国癌症中心建议进行某种形式的皮肤癌筛查，尽管缺乏支持或反对这些做法的证据。很少有中心提到筛查的潜在危害，包括过度诊断。这表明有必要为特定的筛查指南提供更强有力的证据，并提高公众对常规皮肤癌筛查的潜在益处和危害的认识。
