Screening for Skin Cancer in Primary Care: Implementation of Dermoscopy
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Abstract
Skin cancer affects millions of individuals each year. Cutaneous malignant melanoma, which only accounts for a small portion of all skin cancers, is the most serious and is associated with the highest mortality. Education on the prevention and identification of skin cancers, for both the public and for healthcare providers, is paramount in stopping the development and progression of skin cancer, especially melanoma. In addition to education and primary prevention, secondary prevention strategies include routine skin examinations. Currently, healthcare providers only perform routine skin examinations at less than 21% of all annual physical examinations (Curiel-Lewandrowski, Chen, & Swetter, 2012). Barriers to performing routine skin examinations include lack of training and lack of a consistent screening methodology (Liebman et al., 2012). Based on these identified barriers and need for a consistent skin cancer screening technique, an educational seminar and resource was created, and presented to healthcare providers at Student Health Services at North Dakota State University. The purpose of this practice improvement project was to educate and train healthcare providers on the practice of dermoscopy with the intent to improve knowledge and comfortability with the clinical application of dermoscopy. Pre- and post-implementation surveys were used to compare healthcare providers’ knowledge of general skin cancer topics, knowledge level of dermoscopy, opinions on the usefulness of dermoscopy and comfortability with the practice of dermoscopy. Comfortability, knowledge, and feelings of usefulness towards the practice of dermoscopy increased among providers by the completion of the three-month implementation period. By delivering a short training course to providers on the use of dermoscopy during routine skin examinations, an increase was also seen in the knowledge of healthcare providers on the topic of general skin