Skin cancer screening by dermatologists, family practitioners, and internists: barriers and facilitating factors

Abstract

Objective: To determine barriers and facilitating factors to skin cancer screening practices among US primary care physicians and dermatologists.

Design: Survey.

Setting: Physicians randomly selected from the American Medical Association's Medical Marketing Services database from April 1 through November 30, 2005.

Participants: A total of 2999 US dermatologists, family practitioners, and internists.

Main outcome measures: Results based on 1669 surveys returned regarding practice characteristics, skin cancer screening behaviors, and barriers and facilitating factors to performing full-body skin examinations for patients.

Results: The overall response rate was 59.2%. More dermatologists (552 [81.3%]) reported performing full-body skin examinations on patients than did family practitioners (333 [59.6%]) (P < .05) or internists (243 [56.4%]) (P < .05). Among all physicians, time constraints, competing comorbidities, and patient embarrassment were reported as the top 3 barriers to performing full-body skin examinations, and these barriers were different among medical specialties. Among all physicians, having patients at high risk for skin cancer, patient demand for complete examination/mole check, and the influence of medical training were reported as facilitating factors to performing full-body skin examinations.

Conclusion: Becoming more knowledgeable about physician barriers to skin cancer screening could help improve primary and secondary practices in both the primary care and dermatology settings.