Identification of Incidental Skin Cancers Among Adults Referred to Dermatologists for Suspicious Skin Lesions

Key Points Question What is the rate of incidental skin cancer detection in urgent skin cancer clinics, and are incidental cancers more likely to be detected in patients with a clinically suspicious index lesion than in those without? Findings In a cohort study including 4726 patients, 1117 malignant lesions were detected, 22% of which were identified incidentally by total body skin examinations corresponding to an incidental lesion detection rate of 5.1%. Detection of a malignant incidental lesion by total body skin examinations was significantly more likely in patients presenting with an index lesion suspicious for malignancy, compared with patients who presented with index lesions judged to be clinically benign. Meaning The findings of this study suggest that total body skin examinations may be useful for detecting incidental skin cancers and that patients with suspicious index lesions should be prioritized.