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Prevalence and Perspective

Daniel G. Federman, MD; Jeffrey D. Kravetz, MD; Sally G. Haskell, MD; Fangchao Ma, MD, PhD; Robert S. Kirsner, MD, PhD

Arch Dermatol. 2006;142:312-316.

Objectives  To determine the frequency of full-body skin examinations (FBSEs) among female veterans and to determine whether patient risk factors for skin cancer alter the frequency of screening. Subjects were also queried as to attitudes about FBSE.

Design  Questionnaires pertaining to whether patients underwent regular FBSE, their opinions and attitudes about this screening test, and their risks for developing skin cancer.

Setting  A primary health care clinic for female veterans at a Veterans Affairs medical center.

Participants  A convenience sample of 245 patients awaiting clinic appointments. Of those asked to participate, 201 agreed, for a participation rate of 82%.

Main Outcome Measures  Patient report of undergoing FBSE, attitudes regarding FBSE, and risk factors for cutaneous malignancy.

Results  Eighteen percent of all respondents reported undergoing regular FBSE by their primary care provider, whereas 9 (45%) of the 20 with a history of skin cancer reported undergoing FBSE. Fifteen percent of subjects reported embarrassment with FBSE. Seventy-nine percent reported that their primary care provider would be considered thorough by performing FBSE, and 69% would like their primary care provider to perform FBSE regularly. We found that 16% of subjects would refuse the examination if the primary care provider were of the opposite sex, whereas 38% would not refuse but be less willing to be examined.

Conclusions  Female veterans report a low incidence of FBSE, although those with a personal history of skin cancer are more likely to undergo screening. Despite embarrassment expressed about a sex difference between the patient and examiner, female veterans have a strong preference to undergo FBSE.

Author Affiliations: Departments of Internal Medicine, Veterans Affairs Connecticut Health Care Center, West Haven, Conn, and Yale University School of Medicine, New Haven, Conn (Drs Federman, Kravetz, and Haskell); and Departments of Dermatology, Miami Veterans Affairs Medical Center and University of Miami School of Medicine, Miami, Fla (Drs Ma and Kirsner).

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