Nurse-Led Models of Service Delivery for Skin Cancer Detection: A Systematic Review.
Leila Kattach, Heidi Singleton, Steven Ersser and 3 others
PMID 40170176WHAT IT FOUND
Nurse-led skin cancer clinics provided assessment, treatment and education, and one nurse-led eyelid service achieved accuracy similar to physician-led care.
Evidence was limited, so use local governance and clear role explanations.
Key findings
01Six studies involving 3325 patients described nurse-led skin cancer assessment, treatment or education, but the review could not combine them statistically.
02In a nurse-led versus physician-led eyelid lesion service, overall diagnostic accuracy was 80.4% for nurses and 79.6% for physicians, with missed malignancy rates of 1.1% for nurses and 1.5% for physicians.
03A nurse-led photobook teaching intervention increased reported self-skin examination by 51% compared with 17.6% for a nurse-led teaching intervention without a photobook.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only six studies met the strict inclusion criteria, so conclusions are narrow. The included studies varied widely in design, setting and outcomes, preventing meta-analysis. Most studies did not directly compare nurse-led care with physician-led care. Several studies had small samples, short follow-up or incomplete reporting. Cost-effectiveness claims were often not supported by detailed financial analyses. Multidisciplinary pathways made it difficult to separate the contribution of nurses from physicians or other clinicians. Physicians were first authors on several included studies, which may have under-described nurse-specific components. Patient and public involvement was not reported in the included studies.
The easy way to misread this
Do not conclude nurse-led skin cancer care is proven equivalent to physician-led care across all settings. Most included studies did not directly compare nurses with physicians, and the review had too few heterogeneous studies for meta-analysis.