Melanoma Early Detection With Thorough Skin Self-ExaminationThe “Check It Out” Randomized Trial

Weinstock, Martin A.; Risica, Patricia Markham; Martin, Rosemarie A.; Rakowski, William; Dubé, Catherine; Berwick, Marianne; Goldstein, Michael G.; Acharyya, Suddhasatta; Lasater, Thomas M.

doi:10.1016/j.amepre.2007.02.024

Cited by 86 publications

(121 citation statements)

References 26 publications

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“…8 It has been previously shown that the Check-It-Out intervention produced a sustained increase in the performance of skin self-examinations with only a transient increase in skin surgieries. 4 The goal of this study was to examine the use and perceived helpfulness of the Check-It-Out intervention components and their associations with adopting the practice of TSSE.…”

Section: Discussionmentioning

confidence: 99%

“…3 A successful intervention was conducted (The Check-It-Out Project), which included instructional materials, cues and aids, health educator counseling, and follow up letters, to effectively increase the performance of TSSE. 4 This report explores the use of the various components of the Check-It-Out intervention and their associations with subsequently performing successful TSSE in patients who were not previously performing TSSE.…”

Section: Introductionmentioning

confidence: 99%

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Components of a successful intervention for monthly skin self-examination for early detection of melanoma: The “Check It Out” Trial

Lee

Weinstock

Risica

2008

Journal of the American Academy of Dermatology

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Components of a successful intervention for monthly skin self-examination for early detection of melanoma: The “Check It Out” Trial

Lee

Weinstock

Risica

2008

Journal of the American Academy of Dermatology

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“…A minority of individuals practice regular SSE, with estimates of ∼20% to 25% in the United States and Australia (9,10). The efficacy of SSE in detecting thinner melanomas and reducing morbidity and mortality has not been extensively studied (1,11).…”

Section: Introductionmentioning

confidence: 99%

“…Melanomas are most commonly detected by patients themselves (5,6); therefore, considerable effort has been directed to develop interventions to increase the proficiency and practice of skin self-examination (SSE; refs. [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Skin Self-Examination Practices for Early Melanoma Detection

Pollitt

Geller

Brooks

et al. 2009

Cancer Epidemiology, Biomarkers &Amp; Prevention

101

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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.

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“…Furthermore, it would mean patients and clinicians would be trained to see (recognize) when a warning sign for possible malignancy exists so they can appropriately deal with the suspect lesion. The existing evidence regarding early detection of melanoma is limited but suggestive of a potentially potent effect on mortality (9); we need to rigorously assess our efforts to qualify their effects, including possible negative consequences (10). Efforts at early detection seem to be responsible for most of our progress to date in melanoma, limited as it may be, and to have the potential to substantially reduce melanoma mortality in the future.…”

Section: Cancer Epidemiol Biomarkers Prev 2008;17(3) March 2008mentioning

confidence: 99%

Are We Overemphasizing Sun Avoidance in Protection from Melanoma?

Wartman

Weinstock

2008

Cancer Epidemiology, Biomarkers &Amp; Prevention

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The public health effect of melanoma in the United States is undeniable as f60,000 diagnoses of invasive melanoma and 8,000 deaths from melanoma are expected in 2007. Due to the poor outcomes associated with treating advanced cases of melanoma, substantial public health resources have been devoted to prevention efforts. Of the various factors involved in the pathogenesis of melanoma, including genetic predisposition, immunosuppression, and UV radiation, decreasing UV exposure has attracted the most attention for decreasing the public health effect of melanoma. Although sun avoidance may be an important measure for reducing the public health effect of melanocytic and keratinocytic malignancies, educational and media campaigns to encourage sun avoidance have failed to achieve the desired behavior changes in young people, have had limited effect on elderly patients who have already experienced decades of damaging sun exposure, and most importantly have failed to decrease the incidence of melanoma. We believe the best method to reduce deaths from melanoma is to emphasize early detection and treatment of suspicious lesions through combined efforts of both patients and providers. The public health effect of melanoma is undeniable as f60,000 diagnoses of invasive melanoma and 8,000 deaths from melanoma are expected in 2007 (1). Due to the poor outcomes associated with treating advanced cases of melanoma, substantial public health resources have been devoted to prevention efforts. Of the various factors involved in the pathogenesis of melanoma, including genetic predisposition, immunosuppression, and UV radiation, decreasing UV exposure has attracted the most attention for decreasing the public health effect of melanoma.Although sun avoidance may be an important measure for reducing the public health effect of melanocytic and keratinocytic malignancies, educational and media campaigns to reduce sun exposure have failed to achieve the desired behavior changes in young people, have had limited effect on elderly patients who have already experienced decades of damaging sun exposure, and most importantly have failed to decrease the incidence of melanoma. In examining the recent trends in and attitudes toward sun exposure and sun protection in U.S. adolescents, Cokkinides et al. (2) found that between 1998 and 2004, despite widespread sun protection campaigns, there was only a small nonsignificant reduction in the high baseline sunburn frequency and at best modest changes in sun protection practices. Furthermore, a recent analysis of the Behavioral Risk Factor Surveillance System has documented an increased prevalence of sunburns in the United States in adults (3). This does not suggest that we are about to see a major decrease in melanoma incidence. Even in places such as Australia, where primary prevention through sun avoidance has been widely embraced for many years, and sophisticated campaigns mounted, sunburn rates and melanoma incidence are still increasing (4). Furthermore, success in reducing UV exposure, we...

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Melanoma Early Detection With Thorough Skin Self-ExaminationThe “Check It Out” Randomized Trial

Cited by 86 publications

References 26 publications

Components of a successful intervention for monthly skin self-examination for early detection of melanoma: The “Check It Out” Trial

Components of a successful intervention for monthly skin self-examination for early detection of melanoma: The “Check It Out” Trial

Efficacy of Skin Self-Examination Practices for Early Melanoma Detection

Are We Overemphasizing Sun Avoidance in Protection from Melanoma?

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