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Table 1. Skin cancer screening accuracy

Author Study sample and setting Recruit-
ment
focus
Patients n Index
test
PCP or d Defn. of susp. lesion Suspi-
cious
lesions
_________
 n         %
Probability of cancera BCC/skin cancer % MM/skin cancer % SCC/
skin
cancer
%
Positive predictive
value b
_________
Low  High
Biopsy rate c Likeli-
hood
ratiob,d
Screening for all skin cancere
de Rooij et al. (45) Rampen et al. (37) Volunteers for skin cancer screening in the Netherlands Patient with skin cancer risks 1961 Lesion-
specific
exam
or TSE
d Skin cancer 93 4.7 0.031 85.1 12.8 2.1 0.51 0.54 0.935 37.32
Limpert (36) Free skin cancer clinic at family physician's office NR 247 TSE PCP Skin cancer 51 20.6 0.057 92.9 7.1 0.0 0.27 0.42 0.647 12.26
de Rooij et al. (46) Volunteer melanoma screenings in the Netherlands following a public campaign on melanoma and risk factors Patients with mel-
anoma risks
4,146 Lesion-
specific
exam
or TSE
d Skin cancer 173 4.2 0.011 73.5 26.5 0.0 0.28 0.30 0.912 37.95
Jonna et al. (43) Free skin cancer screening in San Diego for self-selected high risk Patients with skin cancer risks 464 TSE d Skin cancer 132 28.4 0.060 85.2 11.1 3.7 0.21 0.58 0.364 21.80
Screening for melanoma
Koh et al. (38) Volunteer skin cancer education and screenings by the American Academy of Dermatology Not targeted 282,555 NR d Suspect-
ed melanoma
763 0.3 0.001 NR NR   0.17 0.19 0.890 183.57
Koh et al. (38) Volunteer skin cancer education and screenings by the American Academy of Dermatology Not targeted 282,555 NR d Rule out melanoma 3695 1.3 0.001 NR NR   0.06 0.09 0.690 78.33

[a] The overall probability of cancer was calculated as the total number of cancers diagnosed divided by number of patients screened.
[b] Methods for calculating the high and low estimates of predictive value and likelihood ratios are described in the text.
[c] Proportion of patients referred for biopsy who actually had one.
[d] Method for estimating likelihood ratio of a positive test is described in the text.
[e] For the first group of studies, all skin cancers are included in the numerator. For the Koh studies, only melanomas are included.

Legend: PCP, primary care provider; d, dermatologist; Defn. of susp. lesion, definition of suspicious lesion; BCC, basal cell carcinoma; MM, malignant melanoma; SCC, squamous cell carcinoma; TSE, total skin examination; NR, not reported.

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