BACKGROUND Accurate self-reporting of keratinocyte carcinoma (KC) informs clinical decision-making, but real-world performance in dermatology clinics is understudied. OBJECTIVE To evaluate the sensitivity, specificity, and accuracy of patient-reported facial or scalp KC, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC) during routine dermatology encounters. PATIENTS AND METHODS In this multicenter cohort study, 338 adults with Fitzpatrick phototypes I–III and visible actinic damage were prospectively enrolled at 6 academic centers. Participants self-reported their history of KC, BCC, and SCC within the prior 2 years. Chart review served as the reference standard. Diagnostic accuracy metrics were calculated, including worst-case sensitivity analyses. RESULTS Self-reported KC showed high accuracy (92.2%), sensitivity (93.8%), and specificity (91.2%). SCC sensitivity was lower (78.3%) despite high specificity (95.9%). In worst-case analyses, SCC sensitivity declined to 64.3%. Negative predictive values exceeded positive predictive values across all cancer types. CONCLUSION Patient self-reporting of KC is generally reliable, particularly for excluding disease. However, SCC is more likely to be underreported, underscoring the need to verify cancer history in high-risk patients or those at risk for poor recall.
Riddle et al. (2026) studied this question.