The American journal of medicine | 2019
Advances in Prevention and Surveillance of Cutaneous Malignancies.
Abstract
Skin cancer affects one in five Americans, resulting in significant morbidity and mortality. Treatment costs and rates of skin cancer and melanoma continue to rise, making preventative measures increasingly important. However, there is conflicting evidence about efficacy of primary and secondary prevention strategies in decreasing incidence and improving early diagnosis. The U.S. Preventative Services Task Force 2016 guidelines did not endorse routine skin cancer screening due to insufficient evidence. Yet, countries like Australia have shown the feasibility and cost-effectiveness of primary sun safety interventions and secondary prevention measures such as routine skin cancer surveillance. Additional emerging evidence shows that regular skin cancer screening in high-risk populations improves early detection and decreases melanoma mortality. New technology may enhance prevention, promote accurate diagnoses and improve management of melanoma and non-melanoma skin cancers. Here, we place rising rates of melanoma within historical context, review costs, efficacy, and evidence for primary and secondary skin cancer prevention, and examine the evolving role of novel technologies in the field.