Abstract
ᅟ
The purpose of the current study was to determine the accuracy of the clinical diagnosis in non-melanoma skin malignancy as confirmed by histopathological examination of the specimen. Positive predictive value (PPV) was selected as a reliable measure of diagnostic accuracy.
Methods
Clinical diagnosis was made in the outpatient clinic by a consultant oral and maxillofacial surgeon. We reviewed the electronic charts of 210 patients with non-melanoma skin malignant tumours and calculated the positive predictive value of the initial clinical diagnosis. Histological confirmation for each lesion was compared with the provisional clinical diagnosis made in the clinic.
Results
Of the 147 lesions provisionally diagnosed as basal cell carcinomas, 133 lesions were histologically confirmed to be basal cell carcinomas (BCC) (PPV 90.4 %). Of the 63 lesions provisionally thought to be squamous cell carcinomas, 47 lesions were histologically confirmed as squamous cell carcinomas (SCC) (PPV 74.6 %). The difference between the PPVs for the two types of malignancy in our study was not significant (p = 0.39). Statistics between our results for BCC and SCC and those reported from two other cancer institutes revealed no significant difference (p = 0.58 and 0.07).
Conclusions
The present study supports that relying on clinical diagnosis with the purpose to formalise a treatment plan for head and neck non-melanoma skin cancer is safe and efficient. This is more reliable in cases of basal cell carcinoma in comparison to suspected squamous cell carcinomas. Although positive predictive value represents a reliable measure of diagnostic accuracy, it is increased when populations with higher prevalence of the disease are studied.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ek E, Giorlando F, Su S, Dieu T (2005) Clinical diagnosis of skin tumours: how good are we? Anz J Surg 75:415–420
Telfer NR, Colver GB, Morton CA (2008) British Association of Dermatologists. Guidelines for the management of basal cell carcinoma. Br JDermatol 159:35–48
Motley R, Kersey P, Lawrence C (2002) Multi-professional guidelines for the management of the patient with primary cutaneous squamous cell carcinoma. Br J Dermatol 146:18–25
Schwartzberg JB, Elgart GW, Romanelli P, Fangchao M, Federman DG, Kirsner RS (2005) Accuracy and predictors of basal cell carcinoma diagnosis. Dermatol Surg 31(5):534–537
Leiter U, Garbe C (2008) Epidemiology of melanoma and non-melanoma skin cancer-the role of sunlight. Adv Exp Med Biol 624:89–103
Presser SE, Taylor JR (1987) Clinical diagnostic accuracy of basal cell carcinoma. J Am Acad Dermatol 16:988–990
Lightstone AC, Kopf AW, Garfinkel L (1965) Diagnostic accuracy a new approach to its evaluation. Results in basal cell epitheliomas. Arch Dermatol 91:497–502
McKechnie AJ (2014) See-and-treat surgery for facial skin cancer. Br J Oral Maxillofac Surg 52(7):598–602
Conflict of interest
The authors of this study would like to declare no conflict of interest. Approval for the study was obtained from the audit and research department.
Compliance with ethical guidelines
No ethical approval was required for this study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Stathopoulos, P., Ghaly, G., Sisodia, B. et al. Positive predictive value of clinical diagnosis of head and neck non-melanoma skin malignancies. How accurate are we?. Oral Maxillofac Surg 19, 387–390 (2015). https://doi.org/10.1007/s10006-015-0509-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10006-015-0509-2