Impact of physician screening on melanoma detection
Thursday December 15, 2011
Results of a historical cohort study of patients at a pigmented lesion clinic suggest that physician screening leads to higher rates of physician-detected melanoma and detection of thinner melanoma, according to a study published in the Archives of Dermatology. The findings also suggest that high-risk individuals may benefit from a PLC setting.
The study’s objective was to compare melanoma characteristics and detection patterns in new vs. established patients in a pigmented lesion clinic at Memorial Sloan-Kettering Cancer Center (MSKCC) during a 10-year period. The setting was an academic practice of 2 dermatologists with expertise in the management of pigmented skin lesions. The study population was from the PLC that serves as a tertiary referral centre for patients at high risk for developing melanoma.
As outlined in the study abstract, “the established patients had more in situ disease and thinner invasive melanomas and were less likely to present with negative prognostic attributes such as ulceration and dermal mitoses compared with new patients. In new patients, 63% of melanomas were physician detected vs. 82% in established patients; 18% of all melanomas were patient detected. Dermatologist-detected melanomas were thinner compared with self-detected melanomas. The majority of self-detected melanomas were noted by patients because of change (64%). The overall benign to malignant biopsy ratio over the 10-year period was 5.4:1.”
The authors conclude that “physician-based screening leads to higher rates of physician-detected melanoma and detection of thinner melanoma”. As such, the study “suggests that physician screening leads to higher rates of physician-detected melanoma and detection of thinner melanoma”. Also, “high-risk individuals may benefit from PLC setting”. The authors also identify the need for prospective studies to assess the survival benefit of screening.
Source:
Kovalyshyn I, Dusza SW, Siamas K, et al. The Impact of Physician Screening on Melanoma Detection. Arch Dermatol. 2011;147(11):1269-1275. doi:10.1001/archdermatol.2011.181
http://archderm.ama-assn.org/cgi/content/abstract/147/11/1269
