Although total-body examination in screening for skin cancer may be able to detect a higher absolute number of cancers, lesion-directed screening is comparably effective and may be less time consuming, according to a recent study published online ahead of print in JAMA Dermatology.

Isabelle Hoorens, MD, of the University Hospital Ghent in Belgium looked at 1,982 patients as part of a population-based cross-sectional screening by a team of six dermatologists in two sociodemographically similar regions who were screened with either total-body examination or lesion-directed screening. They focused on participation rate, detection rate, anxiety and cost.

The researchers found that the skin cancer detection rate per 100 participants did not differ significantly between the two groups, with 2.3% in the total-body examination group and 3.2% in the lesion-directed screening group. Operational effectiveness was found to be 0.4% in the total-body group compared to 0.1% in the lesion-directed group.

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In addition, lesion-directed screening was 5.6 times less time consuming than total-body examination, although patients in the former group had a higher baseline anxiety.

“When performed by dermatologists, lesion-directed screening is an acceptable alternative screening method in health care systems with limited budgets or long waiting lists,” the authors concluded.


1. Hoorens I, Vossaert K, Pil L, et al. Total-Body Examination vs Lesion-Directed Skin Cancer Screening [published online ahead of print October 14, 2015]. JAMA Dermatology. doi:10.1001/jamadermatol.2015.2680.