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首页> 外文期刊>Preventive Medicine: An International Journal Devoted to Practice and Theory >Increased effectiveness of targeted skin cancer screening in the Veterans Affairs population of Northern California.
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Increased effectiveness of targeted skin cancer screening in the Veterans Affairs population of Northern California.

机译：在北加州退伍军人事务人口中，针对性皮肤癌筛查的有效性提高。

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Skin cancer screening in populations at increased risk may be more useful than mass screening. We assessed the effectiveness of screening a targeted population in the Veterans Affairs Palo Alto Health Care System (VAPAHCS) for skin cancer/precancer detection and follow-up.We studied the demographics, presumptive diagnoses, and outcome of 374 participants in free screening clinics conducted over a 3-year period in multiple northern California sites. The number of attendees with presumptive actinic keratosis (AK), basal cell carcinoma (BCC), squamous cell carcinoma (SCC), dysplastic nevus (DN), and melanoma was noted.Three hundred sixty-two males and 12 females were screened (mean age 63.4 years); 74% were Caucasian. Two hundred three individuals (54%) had a positive screen including 139 (52%) with presumptive AK, 41 (11%) with BCC, 9 (2%) with SCC, and 14 (4%) with DN versus potential melanoma. One hundred one (50%) of referred individuals were subsequently evaluated by VAPAHCS dermatologists. Biopsy was performed in 34/36 cases (94%), with a positive predictive value of 62% in patients with suspected BCC, 43% for SCC, 37.5% for DN and 12.5% for melanoma.Targeting a predominantly elderly Caucasian population with minimal to no prior dermatologic care yielded high rates of detection for precancers, skin cancer, and atypical nevi, and resulted in an increased percentage of pathologically confirmed nonmelanoma skin cancer, particularly BCC, compared to prior screening studies and population-based cancer registries.
机译：在高风险人群中进行皮肤癌筛查可能比大规模筛查更有用。我们评估了在退伍军人事务部帕洛阿尔托医疗保健系统（VAPAHCS）中对目标人群进行皮肤癌/癌症前期检测和随访的筛查效果，并研究了374名参与者在免费筛查诊所中的人口统计学，推定诊断和结果在3年的时间里在北加州的多个地点工作。记录有推测性光化性角化病（AK），基底细胞癌（BCC），鳞状细胞癌（SCC），增生性痣（DN）和黑色素瘤的与会人数，其中362例为男性，12例为女性（平均年龄63.4岁）; 74％是白人。与潜在的黑色素瘤相比，有203名个体（54％）筛查为阳性，包括139名（52％）假定性AK，41名（11％）的BCC，9名（2％）的SCC和14名（4％）的DN。随后由VAPAHCS皮肤科医生评估了一百零一（50％）的被推荐人。在34/36例患者中进行了活检（94％），对怀疑为BCC，SCC为43％，DN为37.5％，黑素瘤为12.5％的患者的阳性预测值为62％。与先前的筛查研究和基于人群的癌症登记资料相比，在没有以前的皮肤病护理的情况下，癌症前期，皮肤癌和非典型痣的检出率很高，并且导致病理证实的非黑色素瘤皮肤癌（尤其是BCC）的百分比增加。

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