Beneficiary demographics suggest possible disparities in access to skin cancer screening. Ninety percent of SPOTme screenees were white, compared to approximately 2% and 4% who were black and Hispanic, respectively, although it is important to note that fair skin is a key risk factor for melanoma.6 Close to two-thirds (62%) of screenees were women.6 Nearly half (48%) of screenees with melanoma had never previously had their skin checked for cancer.6

“[T]he SPOTme population is older and whiter than the general US population, both of which are independent risk factors for skin cancer,” the researchers noted.6

Hundreds of smart-phone applications are now available for skin self-examinations, tracking the growth of suspicious moles, teledermatology, and patient education about skin cancer, but few well-designed studies have been conducted to evaluate their safety or efficacy.7,8 A 2016 systematic review concluded that more objective measures are needed to evaluate smart phone skin cancer apps.7 For example, of 6 reviewed studies that measured sunburn incidence in evaluating skin cancer education apps, only one found a significant reduction in consumers’ self-reported sunburns.7


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In 2018, the USPSTF recommended that clinicians counsel young children and their parents, adolescents, and young adults with fair skin to minimize sun exposure, and that adults older than 24 be counseled “selectively” despite evidence that the benefits of counseling are lower for adults older than 24.9

References

1. Cancer Stat Facts: Melanoma of the skin. National Cancer Institute website. https://seer.cancer.gov/statfacts/html/melan.html. Accessed September 19, 2018.

2. US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, Curry SJ, et al. Screening for skin cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2016;316(4):429-435. 

3. Shellenberger RA, Kakaraparthi S, Tawagi K. Melanoma screening: thinking beyond the guidelines. Mayo Clin Proc. 2017;92(5):692-698.

4. Ebell MH, Thai TN, Royalty KJ. Cancer screening recommendations: an international comparison of high income countries. Public Health Rev. 2018;39:7.

5. Stang A, Garbe C, Autier P, Jöckel KH. The many unanswered questions related to the German skin cancer screening programme. Eur J Cancer. 2016;64:83-88.

6. Okhovat JP, Beaulieu D, Tsao H, et al. The first 30 years of the American Academy of Dermatology skin cancer screening program: 1985-2014 [published online July 26, 2018]. J Am Acad Dermatol. doi: 10.1016/j.jaad.2018.05.1242

7. Finch L, Janda M, Loescher LJ, Hacker E. Can skin cancer prevention be improved through mobile technology interventions? A systematic review. Prev Med. 2016;90:121-132.

8. Chao E, Meenan CK, Ferris LK. Smartphone-based applications for skin monitoring and melanoma detection. Dermatol Clin. 2017;35(4):551-557.

9. US Preventive Services Task Force, Grossman DC, Curry SJ, Owens DK, et al. Behavioral counseling to prevent skin cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2018;319(11):1134-1142.