Experienced dermatologists using dermoscopy may be 13.3 times more accurate compared with primary care physicians in diagnosing melanoma, according to a recent review.

In the systematic review and meta-analysis, published in JAMA Dermatology, investigators examined skin cancer diagnostic accuracy across 100 studies and uncovered substantial differences based on physician specialty, experience, and examination method. The findings indicated that dermatologists, especially those trained in dermoscopy, demonstrated superior diagnostic accuracy for melanoma and keratinocytic carcinoma compared with primary care physicians (PCPs).

Among experienced dermatologists, dermoscopy yielded a sensitivity of 85.7% and specificity of 81.3% for melanoma compared with a sensitivity of 49.5% and specificity of 91.3% for PCPs using the same method. In clinical examination alone, sensitivity and specificity for melanoma diagnosis were 76.9% and 89.1%, respectively, among experienced dermatologists; whereas inexperienced dermatologists reported 78.3% sensitivity and 66.2% specificity. For keratinocytic carcinoma, experienced dermatologists using dermoscopy demonstrated 83.7% sensitivity and 87.4% specificity, while PCPs recorded 81.4% sensitivity and 80.1% specificity.

Dermoscopy markedly enhanced diagnostic precision, showing a 5.7-fold increase in the rate of accurate melanoma diagnoses for experienced dermatologists compared with clinical examination alone. Additionally, experienced dermatologists were 13.3 times more likely than PCPs to diagnose melanoma accurately when using dermoscopy.

The findings indicated that dermoscopy improved diagnostic accuracy for dermatologists and suggested that PCPs may see similar diagnostic benefits with dermoscopy training.

Full disclosures can be found in the published review.