False-negative findings in skin cancer and melanoma screening

Background : Few data are available on the accuracy of visual skin examination by dermatologists as a skin cancer and melanoma screening tool. Objective : The purpose of this study was to assess the number of false-negative findings in a skin cancer-melanoma screening program. Methods : We obtained follow-up information regarding 1551 persons with a negative screening result in a skin cancer-melanoma screening program in 1990. Follow-up was established by record linkage with two different population-based registries. Results : Fifteen persons had new skin cancers. Three of their lesions had been present at the original screening and had probably been missed; 12 were genuinely new. No melanomas were among the missed cases. The calculated sensitivity of the screening was 93.3%, its specificity was 97.8%, its positive predictive value was 54.0%, and its negative predictive value was 99.8%. Conclusion : Visual examination by dermatologists as a screening tool for skin cancer and melanoma is appropriate.