Skin Cancer Screening By Dermatologists, Family Practitioners, And Internists Barriers And Facilitating Factors

Objective: To determine barriers and facilitating factors to skin cancer screening practices among US primary care physicians and dermatologists.Design: Survey.Setting: Physicians randomly selected from the American Medical Association's Medical Marketing Services database from April 1 through November 30, 2005.Participants: A total of 2999 US dermatologists, family practitioners, and internists.Main Outcome Measures: Results based on 1669 surveys returned regarding practice characteristics, skin cancer screening behaviors, and barriers and facilitating factors to performing full-body skin examinations for patients.Results: The overall response rate was 59.2%. More dermatologists (552 [81.3%]) reported performing full-body skin examinations on patients than did family practitioners (333 [59.6%]) (P<.05) or internists (243 [56.4%]) (P<.05). Among all physicians, time constraints, competing comorbidities, and patient embarrassment were reported as the top 3 barriers to performing full-body skin examinations, and these barriers were different among medical specialties. Among all physicians, having patients at high risk for skin cancer, patient demand for complete examination/mole check, and the influence of medical training were reported as facilitating factors to performing full-body skin examinations.Conclusion: Becoming more knowledgeable about physician barriers to skin cancer screening could help improve primary and secondary practices in both the primary care and dermatology settings.