"Your Skin Tells You" Campaign for keratinocyte cancers: when individuals' selection makes the difference

Background: Prevention campaigns for skin cancers have focused primarily on melanoma, and over time there has been increasing awareness of the need to select the population to be screened to maximize program effectiveness.Objectives: To report the results of a free dermatological initiative, as part of an awareness campaign dedicated to keratinocyte cancers, targeting individuals pre-selected through a short questionnaire.Methods: One day of dermatological consultations was held at 15 dermato-oncology referral centers during May 22-June 30, 2021. For selection, individuals answered a telephone interview consisting of 7 yes/no questions on risk factors. Demographics, clinical characteristics of suspicious tumors and histopathologic diagnosis of excised lesions were collected. Suspicion rate, detection rate and positive predictive values (PPV) for any skin cancer, basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (cSCC) and melanoma, were calculated. Results: A total of 320 individuals (56.9% males; 43.1% females) with a median age of 69.6 (range 21-91) years qualified for the screening initiative. Overall, skin cancers and precancerous lesions were diagnosed in 65.9% of the patients. Suspicion rate was 28.7% for any skin cancer (92/320), 22.8% for BCC (73/320), 4.7% for cSCC (15/320) and 1.2% for melanoma (4/320). Detection rate was 23.4% for any skin cancer (PPV 93.7%), 18.1% for BCC (PPV 95.1%), 4.4% for cSCC (PPV 93.3%) and 0.9% for melanoma (PPV 75%). Conclusions: Selection of individuals at high-risk is a cost-effective approach for early detection campaigns for keratinocyte cancers.