Level III Services: Preventive services that clinicians and care systems could provide to patients, but only after careful consideration of the costs and benefits. Providing these services is left to the judgment of individual care systems, clinicians and their patients.
| The USPSTF recommendations are fully endorsed by the ICSI Preventive Services work group. |
Grade of Recommendation and Level of Certainty as Evaluated by USPSTF |
|
Grade of Recommendation:
Level of Certainty:
|
| “Benefits: The evidence is insufficient (lack of studies) to determine whether early detection of skin cancer reduces mortality or morbidity from skin cancer. This is a critical gap in the evidence. Harms: The evidence is insufficient (lack of studies) to determine the magnitude of harms from screening for skin cancer. Potential harms of screening for skin cancer include misdiagnosis, over-diagnosis, and the resultant harms from biopsies and overtreatment. This is a critical gap in the evidence. Benefits-Harms Assessment: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for skin cancer by primary care clinicians or by patient skin self-examination. If this service is used, patients should be made aware of the uncertainty about the balance of benefits and harms.” |
| Relevant Resources: http://www.uspreventiveservicestaskforce.org/uspstf09/skincancer/skincanrs.htm |
| ICSI Preventive Services Work Group Supplement: There is some data to suggest that whole body skin exam (WBSE) is associated with thinner melanomas at the time of detection, but there remains a lack of randomized controlled trials examining WBSE, as well as uncertainty about the effect on morbidity and mortality. |