KEY BISCAYNE, FLA. — A full-body examination is a quick and useful tool to screen patients and uncover benign and cancerous lesions that would otherwise remain undetected, according to a study presented at the annual meeting of the Noah Worcester Dermatological Society.
Kenneth B. Bielinski, M.D., offered a full-body exam to all new patients and those not previously given the option. Of the 1,148 patients offered a full-body exam during the 4-month study, 634 (55%) declined.
“I was surprised by the high number who said no. Over half the clients—more than I would have thought—said they did not want it or thought they did not need it,” said Dr. Bielinski, a private practice dermatologist in Oak Lawn, Ill.
Of the 514 consenting patients, 399 full-body exams (78%) were negative for clinically significant findings. Of the patients with positive findings, 33 had pathology-proven skin cancers; these included 23 basal cell carcinomas, 4 squamous cell carcinomas, 1 sebaceous carcinoma, and 5 melanomas.
The full-body exam uncovered 12 of the basal cell carcinomas, 3 of the squamous cell carcinomas, and 2 of the melanomas. These lesions would have otherwise remained undetected. “These were in areas we would not normally check,” Dr. Bielinski said. “I was not exactly surprised by the number of skin cancers, but it shows what is being missed.”
Among the consenting patients, 46 had actinic keratoses, 12 of which were detected by the full-body exam. There were 36 people with pathology-proven dysplastic nevi, including 32 found via the full-body exam.
Many physicians do not offer a full-body examination because of a lack of time,. “I thought it was easy to do if a patient is prepped ahead of time.” In his practice, patients are given a gown to change into and are ready for the exam when Dr. Bielinski or a physician assistant enters the room.
Although patients may opt to sign a waiver declining the full-body examination, the exams are required for all of Dr. Bielinski's high-risk patients.
More than 1 million new cases of skin cancer are diagnosed annually. Also, there is a high cure rate for basal cell carcinomas and squamous cell carcinomas if detected early. There are an estimated 91,000 new cases of melanoma each year; melanoma mortality is high, accounting for 7,600 of the 9,800 skin cancer deaths annually.