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<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE" /><meta name="citation_inbook_title" content="PDQ Cancer Information Summaries [Internet]" /><meta name="citation_title" content="Skin Cancer Screening (PDQ®)" /><meta name="citation_publisher" content="National Cancer Institute (US)" /><meta name="citation_date" content="2017/03/10" /><meta name="citation_author" content="PDQ Screening and Prevention Editorial Board" /><meta name="citation_pmid" content="26389300" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK65861/" /><meta name="citation_keywords" content="skin cancer" /><meta name="citation_keywords" content="disease screening" /><meta name="citation_keywords" content="skin cancer" /><meta name="citation_keywords" content="disease screening" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Skin Cancer Screening (PDQ®)" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="National Cancer Institute (US)" /><meta name="DC.Contributor" content="PDQ Screening and Prevention Editorial Board" /><meta name="DC.Date" content="2017/03/10" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK65861/" /><meta name="description" content="Expert-reviewed information summary about tests used to detect or screen for skin cancer." /><meta name="og:title" content="Skin Cancer Screening (PDQ®)" /><meta name="og:type" content="book" /><meta name="og:description" content="Expert-reviewed information summary about tests used to detect or screen for skin cancer." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK65861/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/pdqcis/CDR0000062750/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK65861/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" media="print" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} .body-content h2, .body-content .h2 {border-bottom: 1px solid #97B0C8} .body-content h2.inline {border-bottom: none} a.page-toc-label , .jig-ncbismoothscroll a {text-decoration:none;border:0 !important} .temp-labeled-list .graphic {display:inline-block !important} .temp-labeled-list img{width:100%}</style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript" src="/corehtml/pmc/js/large-obj-scrollbars.min.js"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script><meta name="book-collection" content="NONE" />
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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK65861_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK65861_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK65861_"><span class="title" itemprop="name">Skin Cancer Screening (PDQ®)</span></h1><div class="subtitle whole_rhythm">Health Professional Version</div><p class="contrib-group"><span itemprop="author">PDQ Screening and Prevention Editorial Board</span>.</p><p class="small">Published online: March 10, 2017.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000062750__111">This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about skin cancer screening. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.</p><p id="CDR0000062750__112">This summary is reviewed regularly and updated as necessary by the PDQ Screening and Prevention Editorial Board, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH).</p></div><div id="CDR0000062750__1"><h2 id="_CDR0000062750__1_"> Overview</h2><p id="CDR0000062750__2">Note: Separate PDQ summaries on <a href="/books/n/pdqcis/CDR0000062764/">Skin Cancer Prevention</a>, <a href="/books/n/pdqcis/CDR0000062909/">Skin Cancer
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Treatment</a>, <a href="/books/n/pdqcis/CDR0000552637/">Genetics of Skin Cancer</a>, and <a href="/books/n/pdqcis/CDR0000304747/">Levels of Evidence for Cancer Screening and Prevention Studies</a> are also available.</p><div id="CDR0000062750__22"><h3>Interventions</h3><p id="CDR0000062750__23">The only widely proposed screening procedure for skin cancer is visual examination of the skin, including both self-examination and clinical examination.</p></div><div id="CDR0000062750__24"><h3>Benefits</h3><p id="CDR0000062750__25">The evidence is inadequate to determine whether visual examination of the skin in asymptomatic individuals leads to a reduction in mortality from melanomatous skin cancer. Further, in asymptomatic populations, the effect of visual skin examination on mortality from nonmelanomatous skin cancers is unknown.</p><p id="CDR0000062750__90"><b>Magnitude of Effect: Unknown.</b></p><ul id="CDR0000062750__46" class="simple-list"><li class="half_rhythm"><div>Study Design: Direct evidence limited to a single ecologic study.</div></li><li class="half_rhythm"><div>Internal Validity: Poor.</div></li><li class="half_rhythm"><div>Consistency: N/A.</div></li><li class="half_rhythm"><div>External Validity: Poor.</div></li></ul></div><div id="CDR0000062750__29"><h3>Harms</h3><p id="CDR0000062750__30">Based on fair, though unquantified evidence, visual examination of the skin in asymptomatic individuals may lead to adverse consequences. These include complications of diagnostic or treatment interventions (such as poor cosmetic or functional outcomes) and the psychological effects of being labeled with a potentially fatal disease. Other harmful consequences are overdiagnosis, leading to the detection of biologically benign disease that would otherwise go undetected, and the possibility of misdiagnosis of a benign lesion as malignant.</p><p id="CDR0000062750__91"><b>Magnitude of Effect: Unknown.</b></p><ul id="CDR0000062750__41" class="simple-list"><li class="half_rhythm"><div>Study Design: Case series, ecologic studies.</div></li><li class="half_rhythm"><div>Internal Validity: Fair.</div></li><li class="half_rhythm"><div>Consistency: Fair.</div></li><li class="half_rhythm"><div>External Validity: Fair.</div></li></ul></div></div><div id="CDR0000062750__6"><h2 id="_CDR0000062750__6_"> Description of the Evidence</h2><div id="CDR0000062750__87"><h3>Background</h3><div id="CDR0000062750__88"><h4>Incidence and mortality</h4><p id="CDR0000062750__71">There are three main types of skin cancer:</p><ul id="CDR0000062750__95"><li class="half_rhythm"><div>Basal cell carcinoma.</div></li><li class="half_rhythm"><div>Squamous cell carcinoma (together with basal cell carcinoma, this is referred to as nonmelanoma skin cancer).</div></li><li class="half_rhythm"><div>Melanoma.</div></li></ul><p id="CDR0000062750__96">Basal cell carcinoma and squamous cell carcinoma are the most common forms of skin cancer but have substantially better prognoses than the less common, generally more aggressive melanoma.</p><p id="CDR0000062750__72">Nonmelanoma skin cancer is the most commonly occurring cancer in the United States. Its incidence appears to be increasing in some [<a class="bk_pop" href="#CDR0000062750_rl_6_1">1</a>] but not all [<a class="bk_pop" href="#CDR0000062750_rl_6_2">2</a>] areas of the United States. Overall U.S. incidence rates have likely been increasing for a number of years.[<a class="bk_pop" href="#CDR0000062750_rl_6_3">3</a>] At least some of this increase may be attributable to increasing skin cancer awareness and resulting increasing investigation and biopsy of skin lesions. A precise estimate of the total number and incidence rate of nonmelanoma skin cancer is not possible, because reporting to cancer registries is not required. However, based on Medicare fee-for-service data extrapolated to the U.S. population, it has been estimated that the total number of persons treated for nonmelanoma skin cancers in 2012 was about 3,000,000.[<a class="bk_pop" href="#CDR0000062750_rl_6_4">4</a>,<a class="bk_pop" href="#CDR0000062750_rl_6_5">5</a>] That number would exceed all other cases of cancer estimated by the American Cancer Society for that year, which was about 1.6 million.[<a class="bk_pop" href="#CDR0000062750_rl_6_6">6</a>]</p><p id="CDR0000062750__73">Melanoma is a reportable cancer in U.S. cancer registries, so there are more reliable estimates of incidence than is the case with nonmelanoma skin cancers. In 2017, it is estimated that 87,110 individuals in the United States will be diagnosed with melanoma and approximately 9,730 will die of it. The incidence of melanoma has been increasing for at least 30 years. Among adults aged 50 years and older, the incidence rate has increased by 2% to 5% per year, however, data from 2004 to 2013 indicate that rates stabilized
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among individuals younger than 50 years.[<a class="bk_pop" href="#CDR0000062750_rl_6_5">5</a>] From 2005 to 2014, mortality rates stabilized among individuals 50 years and older and declined by 2.6%
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per year in individuals younger than 50 years.[<a class="bk_pop" href="#CDR0000062750_rl_6_5">5</a>]</p><p id="CDR0000062750__74">A study of skin biopsy rates in relation to melanoma incidence rates obtained from the Surveillance, Epidemiology, and End Results Program (SEER) of the National Cancer Institute indicated that much of the observed increase in incidence between 1986 and 2001 was confined to local disease and was most likely caused by overdiagnosis as a result of increased skin biopsy rates during this period.[<a class="bk_pop" href="#CDR0000062750_rl_6_7">7</a>] Between 1998 and 2007, a 2.5% relative yearly incidence increase in melanoma among children and adolescents was observed in SEER databases.[<a class="bk_pop" href="#CDR0000062750_rl_6_8">8</a>] During that time, the average annual incidence in this group was exceptionally low (5.4 per 1 million), which may have resulted in spurious trends. Nevertheless, similar trends have been seen in Sweden.[<a class="bk_pop" href="#CDR0000062750_rl_6_8">8</a>] In the U.S. study of pediatric melanoma, nearly one-half of the patients had local disease (22% of patients had <i>in situ</i> disease and 25% of patients had superficial spreading), and nearly one-half of the patients had disease with a thickness of less than one millimeter. Given that mortality from pediatric melanoma had been fairly stable during those years,[<a class="bk_pop" href="#CDR0000062750_rl_6_9">9</a>] it is likely that the increase in incidence could be explained, at least in part, by overdiagnosis.</p></div></div><div id="CDR0000062750__9"><h3>Risk Factors</h3><p id="CDR0000062750__75">Epidemiologic evidence suggests that exposure to UV radiation and the sensitivity of an individual’s skin to UV radiation are risk factors for skin cancer, although the type of exposure (high-intensity and short-duration vs. chronic exposure) and pattern of exposure (continuous vs. intermittent) may differ among the three main types of skin cancer.[<a class="bk_pop" href="#CDR0000062750_rl_6_10">10</a>-<a class="bk_pop" href="#CDR0000062750_rl_6_12">12</a>] In addition, the immune system may play a role in pathogenesis of skin cancers. Organ-transplant recipients receiving immunosuppressive drugs are at elevated risk of skin cancers, particularly squamous cell cancers (SCC). Arsenic exposure also increases the risk of cutaneous SCC.[<a class="bk_pop" href="#CDR0000062750_rl_6_13">13</a>,<a class="bk_pop" href="#CDR0000062750_rl_6_14">14</a>]</p><p id="CDR0000062750__10">The incidence of melanoma rises rapidly in Caucasians after age 20 years. Fair-skinned individuals exposed to the sun are at higher risk. Individuals with certain types of pigmented lesions
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(dysplastic or atypical nevi), with several large nondysplastic nevi, with
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many small nevi, or with moderate freckling have a twofold to threefold increased risk of
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developing melanoma.[<a class="bk_pop" href="#CDR0000062750_rl_6_15">15</a>] Individuals with familial dysplastic nevus syndrome
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or with several dysplastic or atypical nevi are at high (>fivefold) risk of
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developing melanoma.[<a class="bk_pop" href="#CDR0000062750_rl_6_15">15</a>]
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</p></div><div id="CDR0000062750__86"><h3>Accuracy of Making a Clinical Diagnosis of Melanoma</h3><p id="CDR0000062750__78">A systematic review of 32 studies that compared the accuracy of dermatologists and primary care physicians in making a clinical diagnosis of melanoma concluded that there was no statistically significant difference in accuracy. However, the results were inconclusive, owing to small sample sizes and study design weaknesses.[<a class="bk_pop" href="#CDR0000062750_rl_6_16">16</a>] In addition, differentiating between benign and malignant melanocytic tumors during histologic examination of biopsy specimens has been shown to be inconsistent even in the hands of experienced dermatopathologists.[<a class="bk_pop" href="#CDR0000062750_rl_6_17">17</a>,<a class="bk_pop" href="#CDR0000062750_rl_6_18">18</a>] This fact undermines results of studies examining screening effectiveness and also may undermine the effectiveness of any screening intervention. Furthermore, this suggests that requesting a second opinion regarding the pathology of biopsy specimens may be important.[<a class="bk_pop" href="#CDR0000062750_rl_6_17">17</a>,<a class="bk_pop" href="#CDR0000062750_rl_6_18">18</a>]</p></div><div id="CDR0000062750__81"><h3>Evidence of Benefit Associated With Screening</h3><p id="CDR0000062750__82">More than 90% of melanomas that arise in the skin can be recognized with the naked
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eye. Very often there is a prolonged horizontal growth phase during which
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time the tumor expands centrifugally beneath the epidermis but does not invade
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the underlying dermis. This horizontal growth phase may provide lead time for
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early detection. Melanoma is more easily cured if treated before the onset of the
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vertical growth phase with its metastatic potential.[<a class="bk_pop" href="#CDR0000062750_rl_6_19">19</a>]</p><p id="CDR0000062750__83">The probability of tumor recurrence within 10 years after curative resection is less than 10% with tumors
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less than 1.4 mm in thickness. For patients with tumors less than 0.76 mm in
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thickness, the likelihood of recurrence is less than 1% in 10 years.[<a class="bk_pop" href="#CDR0000062750_rl_6_20">20</a>]</p><p id="CDR0000062750__76">A systematic review of skin cancer screening examined evidence available through mid-2005 and concluded that direct evidence of improved health outcomes associated with skin cancer screening is lacking.[<a class="bk_pop" href="#CDR0000062750_rl_6_21">21</a>] An updated review published in 2016 found limited evidence that skin cancer screening reduces melanoma mortality.[<a class="bk_pop" href="#CDR0000062750_rl_6_22">22</a>,<a class="bk_pop" href="#CDR0000062750_rl_6_23">23</a>]</p><p id="CDR0000062750__85">No randomized trials evaluating the efficacy of skin cancer screening on mortality have been completed. A population-based trial (using cluster randomization) to determine the effect of skin cancer screening on melanoma mortality was initiated in Queensland, Australia, but lost its funding after the initial pilot phase, and no health outcomes were ever reported.[<a class="bk_pop" href="#CDR0000062750_rl_6_24">24</a>]
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</p><p id="CDR0000062750__116">The highest level of direct evidence available is an ecologic study comparing melanoma mortality rates across different regions of northern Germany (the SCREEN study). One region that conducted a population-based skin cancer awareness campaign, clinician education and training, and one-time clinical visual screening exams was compared with four nearby regions that did not have similar interventions available.[<a class="bk_pop" href="#CDR0000062750_rl_6_25">25</a>,<a class="bk_pop" href="#CDR0000062750_rl_6_26">26</a>] The two-stage skin cancer screening program began with a total-body visual examination of the skin by a general practitioner; if skin cancer was suspected, the patient was re-examined by a dermatologist. Nineteen percent of all those eligible were screened. The melanoma mortality rates were decreased in the years after the screening program in the screened region (1.7 per 100,000 in 1998–1999 to 0.9 per 100,000 in 2008–2009, or about one fewer melanoma death per 100,000 screened participants), whereas the melanoma mortality rates either stayed the same or increased in the comparison regions. This study has important methodological limitations such as the lack of randomization, lack of an internal control group, and lack of individual-level data to assess outcomes, as well as a low participation rate (19%) and high loss to follow-up rate (37%). Further, an independent analysis of the SCREEN study population found that the observed modest mortality reduction did not persist with longer-term follow-up; after 5 additional years, death rates from melanoma returned to baseline rates observed before the screening intervention was initiated.[<a class="bk_pop" href="#CDR0000062750_rl_6_27">27</a>]</p></div><div id="CDR0000062750__92"><h3>Evidence of Harms Associated With Screening</h3><p id="CDR0000062750__93">Harms have not been well studied or reported in quantitative terms, but the potential for adverse consequences from skin cancer screening exists. In the SCREEN study, 4.4% of all screened participants underwent a skin excision for a suspicious lesion, but the majority of biopsies did not result in a cancer diagnosis. The detection rate was especially affected by age. One case of melanoma was detected per 28 excisions overall (for both men and women), while 52 skin excisions were required to detect one melanoma in men aged 20 to 34 years.[<a class="bk_pop" href="#CDR0000062750_rl_6_28">28</a>]</p><p id="CDR0000062750__117">Visual examination of the skin in asymptomatic individuals may lead to cosmetic or functional complications of diagnostic or treatment interventions and the psychological effects of being labeled with a potentially fatal disease, although robust data on the frequency of such events are lacking. Other harmful consequences are overdiagnosis, leading to the detection of biologically benign disease that would otherwise go undetected,[<a class="bk_pop" href="#CDR0000062750_rl_6_7">7</a>] and the possibility of misdiagnosis of a benign lesion as malignant. (Refer to the <a href="#CDR0000062750__86">Accuracy of Making a Clinical Diagnosis of Melanoma</a> section of this summary for more information.)</p></div><div id="CDR0000062750_rl_6"><h3>References</h3><ol><li><div class="bk_ref" id="CDR0000062750_rl_6_1">Athas WF, Hunt WC, Key CR: Changes in nonmelanoma skin cancer incidence between 1977-1978 and 1998-1999 in Northcentral New Mexico. Cancer Epidemiol Biomarkers Prev 12 (10): 1105-8, 2003. [<a href="https://pubmed.ncbi.nlm.nih.gov/14578151" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 14578151</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_2">Harris RB, Griffith K, Moon TE: Trends in the incidence of nonmelanoma skin cancers in southeastern Arizona, 1985-1996. J Am Acad Dermatol 45 (4): 528-36, 2001. [<a href="https://pubmed.ncbi.nlm.nih.gov/11568742" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11568742</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_3">Rogers HW, Weinstock MA, Harris AR, et al.: Incidence estimate of nonmelanoma skin cancer in the United States, 2006. Arch Dermatol 146 (3): 283-7, 2010. [<a href="https://pubmed.ncbi.nlm.nih.gov/20231499" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20231499</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_4">Rogers HW, Weinstock MA, Feldman SR, et al.: Incidence Estimate of Nonmelanoma Skin Cancer (Keratinocyte Carcinomas) in the U.S. Population, 2012. JAMA Dermatol 151 (10): 1081-6, 2015. [<a href="https://pubmed.ncbi.nlm.nih.gov/25928283" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25928283</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_5">American Cancer Society: Cancer Facts and Figures 2017. Atlanta, Ga: American Cancer Society, 2017. <a href="https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2017/cancer-facts-and-figures-2017.pdf" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">Available online</a>. Last accessed July 13, 2017.</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_6">American Cancer Society: Cancer Facts and Figures 2012. Atlanta, Ga: American Cancer Society, 2012. <a href="https://old.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-031941.pdf" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">Available online</a>. Last accessed July 10, 2017.</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_7">Welch HG, Woloshin S, Schwartz LM: Skin biopsy rates and incidence of melanoma: population based ecological study. BMJ 331 (7515): 481, 2005. [<a href="/pmc/articles/PMC1199022/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1199022</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/16081427" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16081427</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_8">Austin MT, Xing Y, Hayes-Jordan AA, et al.: Melanoma incidence rises for children and adolescents: an epidemiologic review of pediatric melanoma in the United States. J Pediatr Surg 48 (11): 2207-13, 2013. [<a href="https://pubmed.ncbi.nlm.nih.gov/24210187" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24210187</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_9">Lewis KG: Trends in pediatric melanoma mortality in the United States, 1968 through 2004. Dermatol Surg 34 (2): 152-9, 2008. [<a href="https://pubmed.ncbi.nlm.nih.gov/18093205" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18093205</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_10">Koh HK: Cutaneous melanoma. N Engl J Med 325 (3): 171-82, 1991. [<a href="https://pubmed.ncbi.nlm.nih.gov/1805813" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1805813</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_11">Preston DS, Stern RS: Nonmelanoma cancers of the skin. N Engl J Med 327 (23): 1649-62, 1992. [<a href="https://pubmed.ncbi.nlm.nih.gov/1435901" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1435901</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_12">English DR, Armstrong BK, Kricker A, et al.: Case-control study of sun exposure and squamous cell carcinoma of the skin. Int J Cancer 77 (3): 347-53, 1998. [<a href="https://pubmed.ncbi.nlm.nih.gov/9663594" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9663594</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_13">Thomas VD, Aasi SZ, Wilson LD, et al.: Cancer of the skin. In: DeVita VT Jr, Hellman S, Rosenberg SA, eds.: Cancer: Principles and Practice of Oncology. Vols. 1 & 2. 8th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2008, pp 1863-87.</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_14">Le Mire L, Hollowood K, Gray D, et al.: Melanomas in renal transplant recipients. Br J Dermatol 154 (3): 472-7, 2006. [<a href="https://pubmed.ncbi.nlm.nih.gov/16445778" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16445778</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_15">Gandini S, Sera F, Cattaruzza MS, et al.: Meta-analysis of risk factors for cutaneous melanoma: I. Common and atypical naevi. Eur J Cancer 41 (1): 28-44, 2005. [<a href="https://pubmed.ncbi.nlm.nih.gov/15617989" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15617989</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_16">Chen SC, Bravata DM, Weil E, et al.: A comparison of dermatologists' and primary care physicians' accuracy in diagnosing melanoma: a systematic review. Arch Dermatol 137 (12): 1627-34, 2001. [<a href="https://pubmed.ncbi.nlm.nih.gov/11735713" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11735713</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_17">Farmer ER, Gonin R, Hanna MP: Discordance in the histopathologic diagnosis of melanoma and melanocytic nevi between expert pathologists. Hum Pathol 27 (6): 528-31, 1996. [<a href="https://pubmed.ncbi.nlm.nih.gov/8666360" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8666360</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_18">Lott JP, Elmore JG, Zhao GA, et al.: Evaluation of the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) classification scheme for diagnosis of cutaneous melanocytic neoplasms: Results from the International Melanoma Pathology Study Group. J Am Acad Dermatol 75 (2): 356-63, 2016. [<a href="/pmc/articles/PMC4958559/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4958559</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27189823" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27189823</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_19">Friedman RJ, Rigel DS, Kopf AW: Early detection of malignant melanoma: the role of physician examination and self-examination of the skin. CA Cancer J Clin 35 (3): 130-51, 1985 May-Jun. [<a href="https://pubmed.ncbi.nlm.nih.gov/3921200" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3921200</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_20">Blois MS, Sagebiel RW, Abarbanel RM, et al.: Malignant melanoma of the skin. I. The association of tumor depth and type, and patient sex, age, and site with survival. Cancer 52 (7): 1330-41, 1983. [<a href="https://pubmed.ncbi.nlm.nih.gov/6883293" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 6883293</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_21">Wolff T, Tai E, Miller T: Screening for skin cancer: an update of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 150 (3): 194-8, 2009. [<a href="https://pubmed.ncbi.nlm.nih.gov/19189909" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19189909</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_22">Wernli KJ, Henrikson NB, Morrison CC, et al.: Screening for Skin Cancer in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 316 (4): 436-47, 2016. [<a href="https://pubmed.ncbi.nlm.nih.gov/27458949" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27458949</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_23">Bibbins-Domingo K, Grossman DC, Curry SJ, et al.: Screening for Skin Cancer: US Preventive Services Task Force Recommendation Statement. JAMA 316 (4): 429-35, 2016. [<a href="https://pubmed.ncbi.nlm.nih.gov/27458948" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27458948</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_24">Aitken JF, Elwood JM, Lowe JB, et al.: A randomised trial of population screening for melanoma. J Med Screen 9 (1): 33-7, 2002. [<a href="https://pubmed.ncbi.nlm.nih.gov/11943795" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11943795</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_25">Katalinic A, Waldmann A, Weinstock MA, et al.: Does skin cancer screening save lives? An observational study comparing trends in melanoma mortality in regions with and without screening. Cancer 118 (21): 5395-402, 2012. [<a href="https://pubmed.ncbi.nlm.nih.gov/22517033" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22517033</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_26">Breitbart EW, Waldmann A, Nolte S, et al.: Systematic skin cancer screening in Northern Germany. J Am Acad Dermatol 66 (2): 201-11, 2012. [<a href="https://pubmed.ncbi.nlm.nih.gov/22074699" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22074699</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_27">Boniol M, Autier P, Gandini S: Melanoma mortality following skin cancer screening in Germany. BMJ Open 5 (9): e008158, 2015. [<a href="/pmc/articles/PMC4577929/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4577929</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26373399" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26373399</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062750_rl_6_28">Waldmann A, Nolte S, Geller AC, et al.: Frequency of excisions and yields of malignant skin tumors in a population-based screening intervention of 360,288 whole-body examinations. Arch Dermatol 148 (8): 903-10, 2012. [<a href="https://pubmed.ncbi.nlm.nih.gov/22911184" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22911184</span></a>]</div></li></ol></div></div><div id="CDR0000062750__19"><h2 id="_CDR0000062750__19_">Changes to This Summary (03/10/2017)</h2><p id="CDR0000062750__21">The PDQ cancer information summaries are reviewed regularly and updated as
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new information becomes available. This section describes the latest
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changes made to this summary as of the date above.</p><p id="CDR0000062750__113"><b><a href="#CDR0000062750__6">Description of the Evidence</a></b></p><p id="CDR0000062750__128">Added American Cancer Society as <a href="#CDR0000062750__72">reference 5</a>.</p><p id="CDR0000062750__129">Updated <a href="#CDR0000062750__73">statistics</a> with estimated new cases and deaths for 2017. Also revised text to state that among adults aged 50 years and older, the incidence rate has increased by 2% to 5% per year, however, data from 2004 to 2013 indicate that rates stabilized among individuals younger than 50 years; from 2005 to 2014, mortality rates stabilized among individuals 50 years and older and declined by 2.6% per year in individuals younger than 50 years.</p><p id="CDR0000062750__127">Added Lott et al. as <a href="#CDR0000062750__78">reference 18</a>.</p><p id="CDR0000062750__disclaimerHP_3">This summary is written and maintained by the <a href="http://www.cancer.gov/publications/pdq/editorial-boards/screening-prevention" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Screening and Prevention Editorial Board</a>, which is
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editorially independent of NCI. The summary reflects an independent review of
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the literature and does not represent a policy statement of NCI or NIH. More
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information about summary policies and the role of the PDQ Editorial Boards in
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maintaining the PDQ summaries can be found on the <a href="#CDR0000062750__AboutThis_1">About This PDQ Summary</a> and <a href="http://www.cancer.gov/publications/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ® - NCI's Comprehensive Cancer Database</a> pages.
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</p></div><div id="CDR0000062750__AboutThis_1"><h2 id="_CDR0000062750__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000062750__AboutThis_2"><h3>Purpose of This Summary</h3><p id="CDR0000062750__AboutThis_3">This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about skin cancer screening. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.</p></div><div id="CDR0000062750__AboutThis_4"><h3>Reviewers and Updates</h3><p id="CDR0000062750__AboutThis_5">This summary is reviewed regularly and updated as necessary by the <a href="http://www.cancer.gov/publications/pdq/editorial-boards/screening-prevention" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Screening and Prevention Editorial Board</a>, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH).</p><p id="CDR0000062750__AboutThis_22"> Board members review recently published articles each month to determine whether an article should:</p><ul id="CDR0000062750__AboutThis_6"><li class="half_rhythm"><div>be discussed at a meeting,</div></li><li class="half_rhythm"><div>be cited with text, or</div></li><li class="half_rhythm"><div>replace or update an existing article that is already cited.</div></li></ul><p id="CDR0000062750__AboutThis_7">Changes to the summaries are made through a consensus process in which Board members evaluate the strength of the evidence in the published articles and determine how the article should be included in the summary.</p><p id="CDR0000062750__AboutThis_9">Any comments or questions about the summary content should be submitted to Cancer.gov through the NCI website's <a href="https://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Email Us</a>. Do not contact the individual Board Members with questions or comments about the summaries. Board members will not respond to individual inquiries.</p></div><div id="CDR0000062750__AboutThis_10"><h3>Levels of Evidence</h3><p id="CDR0000062750__AboutThis_11">Some of the reference citations in this summary are accompanied by a level-of-evidence designation. These designations are intended to help readers assess the strength of the evidence supporting the use of specific interventions or approaches. The PDQ Screening and Prevention Editorial Board uses a <a href="/books/n/pdqcis/CDR0000304747/">formal evidence ranking system</a> in developing its level-of-evidence designations.</p></div><div id="CDR0000062750__AboutThis_12"><h3>Permission to Use This Summary</h3><p id="CDR0000062750__AboutThis_13">PDQ is a registered trademark. Although the content of PDQ documents can be used freely as text, it cannot be identified as an NCI PDQ cancer information summary unless it is presented in its entirety and is regularly updated. However, an author would be permitted to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks succinctly: [include excerpt from the summary].”</p><p id="CDR0000062750__AboutThis_14">The preferred citation for this PDQ summary is:</p><p id="CDR0000062750__AboutThis_15">PDQ® Screening and Prevention Editorial Board. PDQ Skin Cancer Screening. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: <a href="https://www.cancer.gov/types/skin/hp/skin-screening-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.cancer.gov/types/skin/hp/skin-screening-pdq</a>. Accessed <MM/DD/YYYY>. [PMID: 26389300]</p><p id="CDR0000062750__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use within the PDQ summaries only. Permission to use images outside the context of PDQ information must be obtained from the owner(s) and cannot be granted by the National Cancer Institute. Information about using the illustrations in this summary, along with many other cancer-related images, is available in <a href="https://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>, a collection of over 2,000 scientific images.
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</p></div><div id="CDR0000062750__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000062750__AboutThis_19">The information in these summaries should not be used as a basis for insurance reimbursement determinations. More information on insurance coverage is available on Cancer.gov on the <a href="https://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000062750__AboutThis_20"><h3>Contact Us</h3><p id="CDR0000062750__AboutThis_21">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="https://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="https://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Email Us</a>.</p></div></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65861.4/?report=reader">PubReader</a></li><li><a href="/books/NBK65861.4/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK65861" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK65861" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Screening and Prevention Editorial Board. Skin Cancer Screening (PDQ®): Health Professional Version. 2017 Mar 10. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. <span class="bk_cite_avail"></span></div></div></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Version History</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter shutter_closed" title="Show/hide content" remembercollapsed="true" pgsec_name="version_history" id="Shutter"></a></div><div class="portlet_content" style="display: none;"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><span class="bk_col_itm"><a href="/books/NBK65861.18/">NBK65861.18</a></span> May 24, 2024</li><li><span class="bk_col_itm"><a href="/books/NBK65861.17/">NBK65861.17</a></span> May 24, 2023</li><li><span class="bk_col_itm"><a href="/books/NBK65861.16/">NBK65861.16</a></span> September 2, 2022</li><li><span class="bk_col_itm"><a href="/books/NBK65861.15/">NBK65861.15</a></span> March 11, 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28, 2017</li><li><span class="bk_col_itm">NBK65861.4</span> March 10, 2017 (Displayed Version)</li><li><span class="bk_col_itm"><a href="/books/NBK65861.3/">NBK65861.3</a></span> December 1, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK65861.2/">NBK65861.2</a></span> March 4, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK65861.1/">NBK65861.1</a></span> May 14, 2015</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>In this Page</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="page-toc" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="#CDR0000062750__1" ref="log$=inpage&link_id=inpage"> Overview</a></li><li><a href="#CDR0000062750__6" ref="log$=inpage&link_id=inpage"> Description of the Evidence</a></li><li><a href="#CDR0000062750__19" ref="log$=inpage&link_id=inpage">Changes to This Summary (03/10/2017)</a></li><li><a href="#CDR0000062750__AboutThis_1" ref="log$=inpage&link_id=inpage">About This PDQ Summary</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related publications</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="document-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65739/">Patient Version</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related information</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" 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2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/28876831" ref="ordinalpos=1&linkpos=2&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Thyroid Cancer Screening (PDQ®): Health Professional Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Thyroid Cancer Screening (PDQ®): Health Professional Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Screening and Prevention Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" 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xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389241" ref="ordinalpos=1&linkpos=4&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Esophageal Cancer Screening (PDQ®): Health Professional Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Esophageal Cancer Screening (PDQ®): Health Professional Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Screening and Prevention Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389229" ref="ordinalpos=1&linkpos=5&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Endometrial Cancer Screening (PDQ®): Health Professional Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Endometrial Cancer Screening (PDQ®): Health Professional Version.<div class="brieflinkpopdesc"><em 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