Efficacy of Skin Self-Examination Practices for Early Melanoma Detection

Abstract

Although skin self-examination (SSE) may increase rates of early melanoma detection, the efficacy of different SSE practices has not been thoroughly studied. We examined associations between SSE practices and tumor thickness in patients with recently diagnosed melanoma. Methods: 321 melanoma patients at three hospitals completed questionnaires on demographics and SSE practices. Patient-reported SSE was measured by routine examination of 13 specific body areas, frequency of mole examination, and use of a melanoma picture aid to assist with SSE. Histologic diagnoses and Breslow depth were confirmed by dermatopathologists. Regression analyses were used to calculate ratios of geometric mean tumor thickness and odds ratios for having thicker versus thinner tumors for different SSE behaviors. Results: Rates of SSE varied considerably by SSE item. Patients routinely examining at least some of their skin had thinner melanomas [adjusted geometric mean tumor ratio, 0.73; 95% confidence interval (95% CI), 0.50-0.94]. Frequency of mole examination did not predict tumor thickness. Using a melanoma picture as a SSE aid was strongly associated with reduced tumor thickness (adjusted ratio, 0.75; 95% CI, 0.66-0.85 for ever versus never use). A composite measure of thoroughness of SSE was the best predictor of thickness (adjusted ratio, 0.58; 95% CI, 0.36-0.75) for high versus low thoroughness. Conclusions: SSE was associated with decreased tumor thickness by most measures. However, the diverse rates of SSE practices and the distinct associations between these practices and melanoma thickness suggest a complexity in SSE that should be addressed in future studies. SSE should be evaluated by more than one measure.

Profile of Skin Biopsies and Patterns of Skin Cancer in a Tertiary Care Center of Western Nepal

“…Because of poor dermatologist patient ratio and outpatient nature, skin examination almost always occurs in shorter time. Furthermore, the guidelines for frequency of dermatologists' cutaneous examinations, particularly in <30 1 0 0 1 30-39 0 2 5 7 40-49 3 2 5 10 50-59 3 0 8 11 60-69 1 0 11 12 70-79 4 0 8 12 >80 0 0 2 2 asymptomatic color skin are a topic of debate due to the lack of high quality evidence for this practice (Pollitt et al, 2009). Patients who are immunocompromised have higher risk of non melanoma skin cancer.…”

A melanoma malignum korai felismerését befolyásoló tényezők

“…A melanoma korai felfedezését befolyásoló tényezők vizsgálatát illetően számos adat áll rendelkezésre a szakirodalomban [6][7][8][9][10][11][12][13][14][15] Pontos tanácsot kapott, hogy mit és hogyan kell figyelnie a bőrén (%, fő) 8% (11) megszerkesztett kérdőívvel vizsgálatunkon kívül két tanulmány készült [19,20]. Az Amerikai Egyesült Álla-mokban a kérdőívet kitöltők 61%-a férfi volt, a medián tumorvastagság 1,25 mm-nek adódott, és az esetek 57%-ában 1 mm-nél vastagabb tumort diagnosztizáltak.…”

“…Korábbi kérdőíves vizsgálatok a melanoma korai felismerését befolyásoló tényezőként azonosították a női nemet, a fiatalabb életkort, a magasabb iskolai végzett-séget, a kedvezőbb társadalmi-gazdasági helyzetet, a speciális egészségügyi ellátáshoz való hozzáférést, a rendszeres orvosi és önvizsgálatot, a folyamatosan fejlő-dő diagnosztikai eszközök használatát és a nagyszámú, atípusos anyajegy jelenlétét a bőrön [6][7][8][9][10][11][12][13][14][15].…”

The Evolution of Melanoma Diagnosis: 25 Years Beyond the ABCDs

“…31,32 Persons undergoing skin self-examination were found to be more aware of melanoma and to have the lesions they detected be thinner when biopsied versus persons who did not practice this approach. 33 The main predictors of thorough skin self-examination performance are having been advised to do so by a physician, availability of a partner to help, and availability of a wall and hand-held mirror. The use of photographic examples of lesions with the ABCDE characteristics enhances the effectiveness of the procedure.…”