How well do physicians recognize melanoma and other problem lesions?

Cassileth, Barrie R.; Clark, Wallace H.; Lusk, Edward J.; Frederick, Beth E.; Thompson, C. Jean; Walsh, William P.

doi:10.1016/s0190-9622(86)70068-6

Cited by 175 publications

(77 citation statements)

References 9 publications

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“…11 This is particularly important given results from previous studies that have consistently indicated that dermatologists are superior to nondermatologists in the diagnosis and management of skin disease, including skin cancer. [12][13][14][15][16] This suggests that the provision for payment of preventive services by Medicare or direct access to dermatologists within managed care systems may improve outcomes.…”

Section: Commentmentioning

confidence: 99%

The Association of Medicare Health Care Delivery Systems With Stage at Diagnosis and Survival for Patients With Melanoma

Kirsner

Wilkinson

et al. 2005

Arch Dermatol

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Section: Commentmentioning

confidence: 99%

The Association of Medicare Health Care Delivery Systems With Stage at Diagnosis and Survival for Patients With Melanoma

Kirsner

Wilkinson

et al. 2005

Arch Dermatol

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“…Stephenson et al 20 found that greater than 50% of family physicians lacked confidence in recognizing melanoma. Cassileth et al 21 showed that only 38% of nondermatologist physicians correctly identified at least four of six melanomas compared with 92% of dermatologists. Perhaps, more comprehensive training of physicians, particularly primary care physicians, at identifying early melanomas and encouraging them to perform skin examinations as part of health maintenance may increase the detection of early disease.…”

Section: Detection Patternsmentioning

confidence: 99%

Thin primary cutaneous melanomas

Schwartz

Wang

Hamilton

et al. 2002

Cancer

109

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BACKGROUNDPublic awareness and education may lead to the detection of thinner melanomas, which may result in a decrease in morbidity and mortality rates. Which detection patterns, lesion, and patient characteristics are associated with early detection?METHODSUsing the University of Michigan prospective melanoma database, the detection patterns, lesion characteristics, and patient characteristics of 1515 consecutive patients with in situ or invasive cutaneous melanomas were reviewed. Tumor thickness (measured in millimeters) was evaluated in relationship to detection patterns (patient, physician, spouse), lesion characteristics (change in color, size, shape/elevation, ulceration, bleeding, tenderness, itching), and patient characteristics (gender, skin type, number of atypical and clinically benign nevi, history of sunburn, personal and family history of melanoma).RESULTSPatient characteristics associated with early detection included female gender, at least one atypical nevus, greater than 20 clinically benign nevi, and/or a personal history of melanoma. Skin types I, II, and III, a history of sunburn, and/or a family history of melanoma were also associated with thinner lesions, but these associations were not statistically significant. Lesion characteristics associated with earlier detection included a change in color, size, shape/elevation, and/or itching. Physician‐detected melanomas were significantly thinner than patient or spouse‐detected lesions.CONCLUSIONSEducational campaigns should include increasing melanoma awareness in males and educating the public on the early signs and symptoms. Education should be directed at both high and low‐risk groups. Physicians should consider performing total skin examinations routinely on patients. Although they detect a relatively small percentage of all melanomas, physicians detect significantly thinner lesions. Cancer 2002;95:1562–8. © 2002 American Cancer Society.DOI 10.1002/cncr.10880

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“…For instance, in one study only 12% of nondermatology physicians and third-year medical students recognized melanoma lesions in photographs (Cassileth et al, 1986). In another study, upon examining a patient complaining of other symptoms, only one of 285 medical students commented on a suspicious lesion that was located prominently on the patient's neck (Robinson & McGaghie, 1996).…”

mentioning

confidence: 99%