Time-trend of melanoma screening practice by primary care physicians: a meta-regression analysis

Abstract

Objective: To assess whether the proportion of primary care physicians implementing full body skin examination (FBSE) to screen for melanoma changed over time.

Methods: Meta-regression analyses of available data.

Data sources: MEDLINE, ISI, Cochrane Central Register of Controlled Trials.

Results: Fifteen studies surveying 10,336 physicians were included in the analyses. Overall, 15%-82% of them reported to perform FBSE to screen for melanoma. The proportion of physicians using FBSE screening tended to decrease by 1.72% per year (P =0.086). Corresponding annual changes in European, North American, and Australian settings were -0.68% (P =0.494), -2.02% (P =0.044), and +2.59% (P =0.010), respectively. Changes were not influenced by national guide-lines.

Conclusions: Considering the increasing incidence of melanoma and other skin malignancies, as well as their relative potential consequences, the FBSE implementation time-trend we retrieved should be considered a worrisome phenomenon.

Figure 1.

Flow chart of the study selection.

Figure 2.

Proportion of primary care physicians who declare to perform full body skin examination over time. A: Overall (all eligible studies included). B: Analysis by continent. C: Analyses by presence of guide-lines. (A-NZ = Australia–New Zealand; Yes = national authorities suggest to implement melanoma screening practice among the overall population; NO = national authorities do not advocate implementation of screening practice for melanoma; NA = not assessable (national guide-lines absent or conflicting)).