Melanoma Screening Advised for High-Risk Patients

Most patients younger than 50 with no medical or family history detect their own skin cancer

WEDNESDAY, June 22 (HealthDay News) -- Screening for early melanoma detection should be focused on the at-risk population, according to a study published in the June issue of the Archives of Dermatology.

Sean T. McGuire, from the University of Pittsburgh School of Medicine, and colleagues assessed which groups of patients were most likely to detect their own melanoma without evaluation by a dermatologist. A total of 167 patients with incident biopsy-confirmed melanomas were included in a retrospective analysis from 2003 to 2008. The proportion of melanomas found by a dermatologist during examination compared with those identified by the patient was the primary outcome measured. The association between those who detected the melanoma (dermatologists versus patients) and patient age, personal history of skin cancer, family history of melanoma, and the lesion depth was evaluated in a secondary analysis.

The investigators found that 60.5 percent of the melanomas were detected by patients. Detection by a dermatologist was significantly correlated with a patient age of 50 years or older, a personal history of skin cancer, and a depth of lesion of less than 0.75 mm at the time of detection. Of the patients who had a low baseline risk of melanoma at an age younger than 50 years with no personal history of skin cancer or family history of melanoma, only 3 percent were detected by a dermatologist. These patients were significantly more likely to find their own melanoma (odds ratio, 7.32).

"Screening and surveillance efforts should focus on patients 50 years or older and those with a personal history of skin cancer or a family history of melanoma," the authors write.

One of the study authors disclosed financial ties to the biotechnology and medical device industries.

Abstract
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