The US Preventive Services Task Force (USPSTF) has issued an updated recommendation statement for screening for skin cancer that concludes that the current evidence is insufficient to assess the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in adults. In this update to the 2009 recommendation statement, USPSTF decided to no longer include a statement about patient skin self-examination in the current recommendation. This intervention will be addressed in the USPSTF’s update of its recommendation statement on counseling to prevent skin cancer. Other findings and conclusions included:

• Direct evidence on the effectiveness of screening in reducing melanoma morbidity and mortality is limited to a single, fair-quality ecologic study.

• Information on harms is sparse.

• The potential for harm clearly exists, including a high rate of unnecessary biopsies, possibility resulting in cosmetic or, more rarely, functional adverse effects, and the risk of overdiagnosis and overtreatment.

Citation: US Preventive Services Task Force. Screening for Skin Cancer. US Preventive Services Task Force Recommendation Statement. JAMA. 2016;316(4):429-435. doi:10.1001/jama.2016.8465.

Commentary: Screening for skin cancer, particularly melanoma, is attractive because it would seem to fit many of the criteria for a good screening test: the condition has an asymptomatic phase during which diagnosis can yield a better outcome than waiting until the disease is manifest; the disease is common; and the screening test is acceptable to patients. Of the skin cancers, melanoma is by far the most dangerous and is the one that would be most important to catch early, as it is estimated that over 775,000 US men and women will develop melanoma and 10,100 will die from the disease. The potential benefits of screening are clear, while the potential harms include an increase in the number of skin biopsies. Simply put, there is not sufficient evidence at this point to make skin screening a routine part of practice. —Neil Skolnik, MD