OBJECTIVE: Melanoma incidence and mortality are increasing among United States (U.S.) adults. Currently, routine skin cancer screening total body skin examinations (TBSEs) by a physician are not recommended by the United States Preventive Services Task Force (USPSTF); while organizations such as the American Cancer Society recommend screening. Currently, there are limited data on the prevalence, correlates, and trends of TBSE among U.S. adults. METHODS: We analyzed data by race/ethnicity, age, and skin cancer risk level, among other characteristics from three different National Health Interview Survey (NHIS) cancer control supplements conducted every five years since 2000 in random U.S. households. High-risk status and middle-risk status were defined based on the USPSTF criteria (age, race, sunburn, and family history). RESULTS: Prevalence of having at least one TBSE increased from 14.5 in 2000 to 16.5 in 2005 to 19.8 in 2010 (P<0.0001). In 2010, screening rates were higher among the elderly, the fair-skinned, those reporting sunburn(s), and individuals with a family history of skin cancer. Approximately 104.7million (51.1%) U.S. adults are at high-risk for developing melanoma, of which 24.0% had at least one TBSE. CONCLUSIONS: TBSE rates have been increasing since 2000 both overall and among higher-risk groups. Data on screening trends could help tailor future prevention strategies.

In 2006, melanoma affected 53,919 persons and resulted in 8441 deaths.1 Periodic total-body skin examination (TBSE) may increase the detection of earlier-stage melanomas.2 However, skin cancer screening guidelines vary, with one organization citing insufficient evidence to recommend for or against routine TBSEs3 and another recommending skin cancer examination for individuals 20 years and older during a periodic health examination.4 | Using data from the National Health Interview Survey, an annual household survey, we examined the prevalence and correlates of having a TBSE by a physician. In 2000 and 2005, respondents were asked, “Have you ever had all of your skin from head to toe checked for cancer either by a dermatologist or some other kind of doctor?” Respondents who answered positively were also asked the date of their most recent skin examination. Sample sizes for adults (aged ≥18 years) were 30,119 in 2000 and 28,551 in 2005. TBSE percentages were age standardized using the direct method. Adjusted TBSE percentages were calculated as predictive margins from a multivariable logistic regression model. The predictive margin for a given group represents the average predicted response had everyone in the sample been in that group (Table I).