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Melanoma: HELP
Articles by Michael P. Pignone
Based on 2 articles published since 2010
(Why 2 articles?)

Between 2010 and 2020, Michael P. Pignone wrote the following 2 articles about Melanoma.
+ Citations + Abstracts
1 Guideline Screening for Skin Cancer: US Preventive Services Task Force Recommendation Statement. 2016

Anonymous721152 / Bibbins-Domingo, Kirsten / Grossman, David C / Curry, Susan J / Davidson, Karina W / Ebell, Mark / Epling, John W / GarcĂ­a, Francisco A R / Gillman, Matthew W / Kemper, Alex R / Krist, Alex H / Kurth, Ann E / Landefeld, C Seth / Mangione, Carol M / Phillips, William R / Phipps, Maureen G / Pignone, Michael P / Siu, Albert L. ·University of California, San Francisco. · Group Health Research Institute, Seattle, Washington. · University of Iowa, Iowa City. · Columbia University, New York, New York. · University of Georgia, Athens. · State University of New York Upstate Medical University, Syracuse. · Pima County Department of Health, Tucson, Arizona. · Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts. · Duke University, Durham, North Carolina. · Fairfax Family Practice Residency, Fairfax, Virginia11Virginia Commonwealth University, Richmond. · Yale University, New Haven, Connecticut. · University of Alabama at Birmingham. · University of California, Los Angeles. · University of Washington, Seattle. · Brown University, Providence, Rhode Island. · University of Texas at Austin. · Mount Sinai School of Medicine, New York, New York19James J. Peters Veterans Affairs Medical Center, Bronx, New York. ·JAMA · Pubmed #27458948.

ABSTRACT: IMPORTANCE: Basal and squamous cell carcinoma are the most common types of cancer in the United States and represent the vast majority of all cases of skin cancer; however, they rarely result in death or substantial morbidity, whereas melanoma skin cancer has notably higher mortality rates. In 2016, an estimated 76,400 US men and women will develop melanoma and 10,100 will die from the disease. OBJECTIVE: To update the 2009 US Preventive Services Task Force (USPSTF) recommendation on screening for skin cancer. EVIDENCE REVIEW: The USPSTF reviewed the evidence on the effectiveness of screening for skin cancer with a clinical visual skin examination in reducing skin cancer morbidity and mortality and death from any cause; its potential harms, including any harms resulting from associated diagnostic follow-up; its test characteristics when performed by a primary care clinician vs a dermatologist; and whether its use leads to earlier detection of skin cancer compared with usual care. FINDINGS: Evidence to assess the net benefit of screening for skin cancer with a clinical visual skin examination is limited. Direct evidence on the effectiveness of screening in reducing melanoma morbidity and mortality is limited to a single fair-quality ecologic study with important methodological limitations. Information on harms is similarly sparse. The potential for harm clearly exists, including a high rate of unnecessary biopsies, possibly resulting in cosmetic or, more rarely, functional adverse effects, and the risk of overdiagnosis and overtreatment. CONCLUSIONS AND RECOMMENDATION: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in adults (I statement).

2 Article Screening for Melanoma in Men: a Cost-Effectiveness Analysis. 2020

Adamson, Adewole S / Jarmul, Jamie A / Pignone, Michael P. ·Department of Internal Medicine, Dell Medical School, University of Texas at Austin, Austin, TX, USA. adewole.adamson@austin.utexas.edu. · LIVESTRONG Cancer Institutes, The University of Texas at Austin, Austin, TX, USA. adewole.adamson@austin.utexas.edu. · University of North Carolina at Chapel Hill Department of Medicine, Chapel Hill, NC, USA. · University of North Carolina-Chapel Hill Gillings School of Public Health, Chapel Hill, NC, USA. · Department of Internal Medicine, Dell Medical School, University of Texas at Austin, Austin, TX, USA. · LIVESTRONG Cancer Institutes, The University of Texas at Austin, Austin, TX, USA. ·J Gen Intern Med · Pubmed #31705474.

ABSTRACT: BACKGROUND: Systematic screening skin examination has been proposed to reduce melanoma-related mortality. OBJECTIVE: To assess the potential effectiveness of screening, in a demographic at high risk of melanoma mortality. DESIGN: A cohort Markov state-transition model was developed comparing systematic screening versus usual care (no systematic screening). In the base case, we evaluated a sensitivity and specificity of 20% and 85%, respectively, for usual care (incidental detection) and 50% sensitivity and 85% specificity from systematic screening. We examined a wide range of values in sensitivity analyses. PARTICIPANTS: Potential screening strategies applied to a hypothetical population of 10,000 white men from ages 50-75. MAIN MEASURES: Incremental cost-effectiveness ratio, measured in cost per quality adjusted life year (QALY). KEY RESULTS: Using base case assumptions, screening every 2 years beginning at age 60 reduced melanoma mortality by 20% with a cost-utility of $26,503 per QALY gained. Screening every 2 years beginning at age 50 reduced mortality by 30% with an incremental cost-utility of $67,970 per QALY. Results were sensitive to differences in accuracy of systematic screening versus usual care, and costs of screening, but were generally insensitive to costs of biopsy or treatment. CONCLUSIONS: Assuming moderate differences in accuracy with systematic screening versus usual care, screening for melanoma every 2 years starting at age 50 or 60 may be cost-effective in white men. Results are sensitive to degree of difference in sensitivity with screening compared to usual care. Better studies of the accuracy of systematic screening exams compared with usual care are required to determine whether a trial of screening should be undertaken.