Validity of patient self-reported history of skin cancer

Arch Dermatol. 2004 Jun;140(6):730-5. doi: 10.1001/archderm.140.6.730.


Objective: To determine the validity of patient self-report of skin cancer history.

Design: A cohort of patients was randomly selected from the case group in a prior case-control study involving skin cancer, and a second cohort was randomly selected from the controls of that study. Patient self-reported history (as determined by responses to a survey) was compared with the gold standard of chart documentation of a pathology report or a procedure note from Mohs micrographic surgery demonstrating skin cancer.

Setting: University-based outpatient dermatology clinic.

Patients: Three hundred patients were selected.

Main outcome measures: Patients were considered to have correctly classified their skin cancer history if their self-reported history was consistent with chart documentation.

Results: We obtained chart information for 258 patients.Of those patients, 183 (70.9%) had chart documentation of nonmelanoma skin cancer, and 16 (6.2%) had chart documentation of a melanoma. Using chart documentation as the gold standard, we found that patients correctly identified their basal cell carcinoma status in 84.3% of cases; their squamous cell carcinoma status in 81.5% of cases; their overall nonmelanoma skin cancer status in 91.8% of cases; their melanoma status in 94.8% of cases; and their overall skin cancer status in 92.6% of cases. Patients' self-reported history of skin cancer of any type had a positive predictive value of 95.1% and a negative predictive value of 85.9%.

Conclusions: Self-reported history of skin cancer had a high degree of sensitivity and specificity and a high positive and negative predictive value within the study population. Obtaining medical information by patient report appears to be a useful tool for determining medical history of skin cancer.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Basal Cell / epidemiology
  • Carcinoma, Basal Cell / pathology
  • Carcinoma, Basal Cell / surgery
  • Carcinoma, Squamous Cell / epidemiology
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery
  • Case-Control Studies
  • Cohort Studies
  • Databases, Factual / standards
  • Diagnosis-Related Groups
  • Female
  • Humans
  • Male
  • Medical History Taking / standards
  • Melanoma / epidemiology
  • Melanoma / pathology
  • Melanoma / surgery
  • Middle Aged
  • Mohs Surgery
  • Pennsylvania / epidemiology
  • Sensitivity and Specificity
  • Skin Neoplasms / epidemiology*
  • Skin Neoplasms / pathology
  • Skin Neoplasms / surgery*
  • Surveys and Questionnaires / standards*