Serial screening for XXXX : measures and strategies that have consistently achieved early detection and cure.

@entity1 @entity92 @entity204 @entity320
OBJECTIVE: To determine the effectiveness of a serial screening program in achieving early detection and preventing @entity204 in @entity1 at increased risk for @entity320 . DESIGN: Retrospective study. SETTING: Private dermatology practice. @entity1 : The study included all @entity1 at increased risk for @entity320 who were screened in the program during the 17-year period, July 1, 1992-June 30, 2009 (=1108 @entity1 per year). MAIN OUTCOME MEASURES: Survival and indicators of early detection. RESULTS: All @entity320 that developed in program @entity1 during the 17-year period were detected early and there were no deaths, metastases, recurrences, nor need for sentinel node biopsies. An analysis of @entity320 cases seen in five recent years revealed additional evidence of consistent early detection: 80 percent of the lesions were in situ, no lesions were greater than 0.15 mm in @entity92 , and all lesions were in the radial growth phase, a stage almost always associated with cure. Four measures, often absent in mass screening programs, contributed to very early detection and cure: thorough serial examinations, biopsying suspicious lesions (particularly pigmented lesions that were highly irregular and/or approaching black in color), recalling @entity1 every six months to detect all @entity320 in the radial growth phase, and educating @entity1 on the need to return. CONCLUSION: An office-based surveillance program that includes serial full skin examinations and ongoing recalls appears capable of detecting @entity320 at a very early stage when cures can be realized in almost every case. Therefore, when @entity1 present with recognized risk factors for @entity320 , dermatologists should seriously consider recommending and performing such serial screening procedures.
