Background & objective: Skin cancer is a very common malignancy that occurs more frequently in fair skin and older individuals. Raman spectroscopy is a non-invasive optical technique that can be used as an adjunct for skin cancer diagnosis. The objective of this study is to evaluate whether incorporating patient demographics can improve skin cancer diagnosis based on Raman spectroscopy. Patients & Methods: Raman spectra of 731 lesions and their respective adjacent normal skin were measured in vivo using a real-time Raman spectrometer. The lesions were divided into skin cancers (including malignant melanoma, basal cell carcinoma, squamous cell carcinoma and precancerous lesion - actinic keratosis, n = 340) and benign skin lesions (including pigmented nevi and seborrheic keratosis, n = 391). Patient age, gender, skin type and location of the lesion were incorporated into the analysis. Multivariate statistical analysis including principal component and general discriminant analysis (PC-GDA) and partial least squares (PLS) are used for skin cancer discrimination based on leave-one-out cross-validation. Results: The posterior probability of being a cancer is significantly dependent on gender, age and location of the lesion (p<0.05) but independent of skin type (p>0.05). The area under the receiver operating characteristic curve (ROC) is increased from 0.905 (95%CI: 0.884-0.927) to 0.932 (95%CI: 0.919-0.945) after taking into account demographics. Correspondingly, the specificity is increased from 43.2% to 50.1% at sensitivity of 99%; and from 73.4% to 77.5% at sensitivity of 90%. Conclusions: The specificity is increased after incorporating demographics into the algorithm for skin cancer diagnosis based on Raman spectroscopy.
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