Assessing the role of community pharmacists in early skin cancer detection: a real-world study

Identification of at-risk population is essential for skin cancer screening. Community pharmacists (CPs) play an important role in the healthcare system by participating in disease screening strategies in Spain. However, their role in skin cancer screening, in collaboration with general physicians and dermatologists, has not been addressed. To assess the role of CPs in identification of population with risk factors for early skin cancer detection. 184 CPs from 104 pharmacies (4.34% of the total number of pharmacies in the province of Barcelona), 49 primary care physicians (PCPs), and referral dermatologists across basic healthcare areas (BHAs) of the province of Barcelona. Volunteers attending community pharmacies were recruited by CPs. A skin cancer risk factor questionnaire was administered to each participant. Upper limbs were examined and pigmented lesions larger than 2 mm were noted. Participants were classified as at risk if at least one skin cancer risk factor was present. All participants were referred to PCPs for a Total Body Skin Examination (TBSE) and a skin cancer risk factor questionnaire re-administered, to the concordance with the pharmaceutical one. Finally, patients with suspected skin cancer or risk factors that required a dermatological evaluation were referred to dermatology specialists. 340 participants were prospectively recruited in the study, 240 were assessed by PCPs, and 74 of them were finally referred to dermatologists for diagnostic confirmation. Among referred patients, 15 malignant lesions were confirmed: one malignant melanoma, one squamous cell carcinoma, and 13 basal cell carcinomas. Additionally, seven actinic keratosis were confirmed. CPs can be involved in skin cancer screening programmes, in coordination with PCPs and dermatologists. They were able to identify skin cancer risk factors that enabled the diagnosis of a significant number of occult skin cancers.