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Biopsy for Adults with Suspected Skin Cancer: A Rapid Qualitative Review

Last updated: November 21, 2019
Project Number: RC1215-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. How do people with suspected skin cancer view skin biopsy? What are their perspectives on, expectations of, and preferences for skin biopsy and the diagnostic process for suspected skin cancer?
  2. How do health care providers who care for people with suspected skin cancer view skin biopsy? What are their perspectives on, expectations of, and preferences for with skin biopsy and the diagnostic process for suspected skin cancer?

Key Message

This review used thematic synthesis to synthesize the results of 12 included publications and described how people with suspected skin cancer and their health care providers experienced the process of diagnosis. People who were diagnosed with skin cancer were often the ones who noticed a suspicious looking lesion or mole that triggered their diagnosis. They described experiencing delays in being diagnosed because they did not immediately present to a health care provider for a variety of reasons, including being busy or not thinking it was serious. Other times people experienced a delay in being diagnosed because their physician did not order further testing or offered them reassurances that their lesions were non-cancerous. People with a concerning lesion or mole were not always reassured by their health care providers words and instead persisted in getting diagnosed by seeking a second opinion or by continuing to bring their concerns forward to their health care provider. Health care providers raised worries about the impact of referring people who turn out to not have skin cancer on the health care system. Once diagnosed, people with skin cancer described how skin cancer was an emotionally destabilizing and shocking experience. Being diagnosed with skin cancer raised fears of death and about the future. People had to at once navigate their treatment while coping with their feelings. With clear information and adequate time for consultation, communication with health care providers left people diagnosed with skin cancer felt supported and informed and able to navigate their treatment. The importance of communication with health care providers in the experiences of those diagnosed with skin cancer highlights the emotional and physical needs of skin cancer patients.After treatment, people who had been diagnosed found themselves continuing to watch their bodies and coping with feelings of uncertainty and anxiety about their future. People who had been treated described how waiting for test results was particularly fraught with anxiety during the follow-up period.