Overscreening and underscreening for melanoma: comment on "the influence of age and sex on reasons for seeking and expected benefits of skin cancer screening".

OBJECTIVE To determine the influence of age and sex on why individuals seek skin cancer screening and their understanding of its benefits. DESIGN Voluntary survey. SETTING Academic dermatology department. PARTICIPANTS Individuals 18 years or older being seen for skin cancer screening from May to October 2009. MAIN OUTCOME MEASURES Patients' reasons for seeking and perceived benefits of skin cancer screening and understanding of screening recommendations. RESULTS Of 546 patients, 487 eligible individuals (89.2%) participated in the survey. Most (80.6%) sought screening without a particular lesion of concern. Women were more likely than men to present with a lesion they believed could be skin cancer (24.6% vs 11.9%; P < .001) or because they were concerned about previous sun exposure (34.3% vs 23.8%; P < .05). Individuals younger than 50 years were more likely than older patients to seek screening because of a family history of melanoma (30% vs 18.9%; P < .01). Men 50 years or older were more likely than other patients to seek skin cancer screening because of a previous skin cancer diagnosis (64.6% vs 40.8%; P < .001). Most patients believed that screening reduces the risk of death from skin cancer and prevents skin cancer. There was no consensus among patients regarding the frequency with which healthy adults should be screened for skin cancer. CONCLUSIONS There is a need for better educational campaigns with specific recommendation for who should be screened for skin cancer. Men 50 years or older, the group at highest risk for death from melanoma, are most likely to seek screening only after being diagnosed as having a skin cancer.