WEDNESDAY, Nov. 13, 2024 -- Diagnostic accuracy for skin cancer differs significantly when comparing examination methods and physician specialty and experience, according to a review published online Nov. 13 in JAMA Dermatology.

Jennifer Y. Chen, M.D., from the San Francisco Veterans Affairs Health Care System, and colleagues conducted a systematic review and meta-analysis to examine the accuracy of skin cancer diagnosis by lesion type, physician specialty and experience, and physical examination method. One hundred studies were included in the analysis.

The researchers found that the sensitivity and specificity for diagnosing keratinocytic carcinomas was 79.0 and 89.1 percent, respectively, for experienced dermatologists using clinical examination and clinical images; 83.7 and 87.4 percent, respectively, using dermoscopy and dermoscopic images; and 81.4 and 80.1 percent, respectively, for primary care physicians (PCPs). The odds of an accurate diagnosis of keratinocytic carcinomas were 2.5-fold higher for experienced dermatologists using in-person dermoscopy and dermoscopic images compared with in-person clinical examination and images. When examining for melanoma using clinical examination and images, sensitivity and specificity were 76.9 and 89.1 percent, 78.3 and 66.2 percent, and 37.5 and 84.6 percent for experienced dermatologists, inexperienced dermatologists, and PCPs, respectively; when using dermoscopy and dermoscopic images, the corresponding sensitivity and specificity were 85.7 and 81.3 percent, 78.0 and 69.5 percent, and 49.5 and 91.3 percent. The odds of accurate diagnosis of melanoma using dermoscopy versus clinical examination were 5.7-fold higher for experienced dermatologists.

"These results suggest that clinical examination combined with dermoscopy likely yields better accuracy than either method alone," the authors write.