Skin assessment in primary care: skin cancer & people of color
Date
2022
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Publisher
University of Delaware
Abstract
Problem and Purpose: This project examined the risk for people of color to have increased morbidity and mortality secondary to skin cancer despite its lower incidence in this population, how that correlates to late detection, and what implications exist. Skin assessment is a quick, easy and feasible examination that can lead to the early detection of skin lesions suspicious for cancer and has the potential to improve clinical outcomes. Despite being the key to early detection of skin cancer, comprehensive skin examination remains an extremely overlooked aspect of primary care. This practice change project aimed to increase the rate of total body skin assessment in primary care and promote referral to dermatology when indicated to improve early detection. ☐ Methods: Participants (n= 114) received total body skin examinations, as part of their annual wellness visit, by a nurse practitioner at a robust primary care office in Wilmington, Delaware. By way of chart reviews, the findings of these assessments were collected and analyzed to determine patient demographics, whether there was a patient-reported skin concern, whether suspicious lesions were detected, and if a referral to dermatology was made when indicated. ☐ Results: As a result of this practice change project there was an 83% increase in skin assessment. Additional results found that two patients required further treatment and/or referral, and 66% of the patients with positive skin assessments did not report a skin abnormality in their chief complaints, and thus, would not have received the skin assessment that led to a diagnosis that required treatment, per usual practice. There was also a 100% increase in the delivery of culturally sensitive patient education regarding skin cancer prevention and detection. ☐ Conclusion: This project has identified a gap in care that can easily be addressed. While lesions suspicious for skin cancer were not found as a result of this project, it remains clear that comprehensive skin assessment is, often, a missed opportunity to provide preventive care. ☐ Keywords: “total body skin exam,” “skin cancer,” “primary care,” “early detection"
Description
Keywords
Early detection, Primary care, Skin cancer, Total body skin exam