Skin cancer screening in primary care: prevalence and barriers.

Background: Skin cancer incidence is increasing, but whether primary care providers routinely screen for skin cancer is not known.

Objective: We assessed whether primary care practitioners are performing skin 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 respective county medical societies in either New Haven County, Connecticut, or Miami-Dade County, Florida were randomly selected and surveyed by mailed questionnaire 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 cancer screening on all adult patients, only 31% report performing screening on high-risk patients. Almost half of physicians reported that they do not perform skin cancer screening. We found that physicians' lack of confidence in identifying suspect lesions was a common barrier. Fear of patient embarrassment, inadequate lighting, or lack of studies demonstrating mortality benefits were not frequent deterrents. Furthermore, there was no statistical difference in screening rates between the more northern latitude and the more southern latitude.

Conclusion: Skin cancer screening is not being performed within the context of primary care visits. Barriers exist that may impede skin cancer screening.