The effectiveness of skin cancer screening and continuing education programs towards increasing the survival of patients with melanoma

Prevention and Early Detection of Melanoma: A Surgeon's Perspective

“…Since beginning the intensive follow-up of the melanoma patients, all the lesions diagnosed subsequently had tumor thicknesses < 1.0 rnrn and are considered curable. None of the multiple primary melanoma patients have developed metastatic disease in the local-regional distribution of the second and third primaries and no patients have died in this series of metastatic disease [27]. It makes sense to screen this high-risk population.…”

“…Once an individual is diagnosed with malignant melanoma, that person is at an increased risk of developing another melanoma compared to the normal population. Patients that present to the Moffitt/USF clinic are placed into an intensive follow-up/screening program that consists of physical examinations and liver function tests every 3 months for the first 2 years, since this is the time interval in which up to 80% of the recurrences in malignant melanoma occur [27]. They are followed every 6 months thereafter with blood work and CXRs.…”

“…Other investigators [20,24,[27][28][29] have identified risk factors for the development of malignant melanoma and have proposed mathematical models to identify the high-risk population suitable for screening. If a high-risk population can be identified, one will improve the predictive value of a skin examination in the screening setting.…”

“…Those patients with a past history of melanoma are at a 9-12.5 times risk of developing a second primary when compared to the normal population [I5). The second primary in programs that have the intensive follow-up program is always thinner than the first and curable [27] with simple excision with conservative margins. In fact, those patients who have a "thin" melanoma with the initial diagnosis have more of a chance of developing a second primary than dying of metastatic melanoma [15].…”