Sensitivity, predictive values, pretest–posttest probabilities, and likelihood ratios of presurgery clinical diagnosis of nonmelanoma skin cancers

Abstract

Background: The precision of clinical diagnosis of skin tumors is not commonly measured and, therefore, very little is known about the diagnostic ability of clinicians.

Objective: This study aimed to compare clinical and histopathologic diagnoses of nonmelanoma skin cancers with regard to sensitivity, predictive values, pretest–posttest probabilities, and likelihood ratios.

Methods: Two hundred nineteen patients with 241 nonmelanoma skin cancers were enrolled in this study. Of these patients, 49.4% were female and 50.6% were male. The mean age ± standard deviation (SD) was 63.66 ± 16.44 years for the female patients and 64.77 ± 14.88 years for the male patients. The mean duration of the lesions was 20.90 ± 32.95 months. One hundred forty-eight (61.5%) of the lesions were diagnosed as basal cell carcinoma (BCC) and 93 (38.5%) were diagnosed as squamous cell carcinoma (SCC) histopathologically.

Results: Sensitivity, positive predictive value, and posttest probability were calculated as 75.96%, 87.77%, and 87.78% for BCC and 70.37%, 37.25%, and 37.20% for SCC, respectively. The correlation between clinical and histopathologic diagnoses was found to be higher in BCC.

Conclusion: Knowledge of sensitivity, predictive values, likelihood ratios, and posttest probabilities may have implications for the management of skin cancers. To prevent unnecessary surgeries and achieve high diagnostic accuracies, multidisciplinary approaches are recommended.

Keywords::

• Skin
• cancer
• nonmelanoma
• clinicopathological correlation
• diagnostic accuracy