Awareness and early detection of cutaneous melanoma: an analysis of factors related to delay in treatment

Abstract

Factors associated with the detection of cutaneous melanomas and reasons for delay in diagnosis were investigated in 429 patients with histologically proven melanoma operated on between January 1993 and June 1996. Patients were interviewed using a standardized questionnaire. In 25% of patients, treatment was delayed for more than 1 year from the time they first noticed a suspicious pigmented lesion. Melanoma was detected by the patients themselves in 67% of women and 45% of men. The three predominant clinical symptoms of melanoma were change in colour (darker), increase in size and increase in elevation of a pigmented lesion. The role of sun exposure and of naevi as risk factors for melanoma, as well as the potential benefit of early treatment, were known by 87%, 66% and 82% of the patients, respectively. However, melanoma awareness had no impact on the time period between first observation of skin changes and treatment. Among the factors associated with delay in melanoma diagnosis, an initial incorrect diagnosis as a benign lesion by the physician first visited (in 18% of all cases) had the highest significance. Patients detecting their lesions themselves were treated significantly later than patients in whom others had remarked on changes in a naevus. Furthermore, melanomas of the head and neck were treated later than melanomas at other body sites. Further efforts to educate both the public and the medical profession are essential to ensure earlier treatment for cutaneous melanomas.

Cutaneous melanoma in Asian‐Americans

“…Cutaneous malignant melanoma has been well-described in highrisk populations with fair skin and light hair [2][3][4]. Incidence of cutaneous melanoma in these populations has increased over the past several decades [30][31][32].…”

Skin Cancer Knowledge and Preventive Behaviors among Patients with a Recent History of Cutaneous Squamous Cell Carcinoma

“…Due to the nature of the subject matter, it is particularly complicated to perform studies using objective evaluations. Thus, the vast majority of studies in this field rely on patient [5, 15, 18, 21] or physician reports [19, 24]. The few studies on similar topics which evaluated the reliability of self-reported information found a high reproducibility [10].…”

“…), knowledge on skin tumors, skin characteristics and sun exposure behaviors, past skin tumors and medical recommendations received after SCC diagnosis. The questionnaire was specifically developed for this study, based on a literature review [14,15,16,17] and adapting the questions to our specific objectives and context.…”

Effect of Health Care Delivery Models on Melanoma Thickness and Stage in a University-Based Referral Center

“…Most studies have shown a weak positive correlation 18 or no association (including ours) between patient delay and tumor thickness. 10,12,13,17,23,34,35 However, increased patient knowledge and awareness of cutaneous melanoma has been associated with reduction in delay time to seek medical attention 36 and with thinner lesions at diagnosis. 10,12,13,37 The effect of medical delay on melanoma stage or prognosis has been less controversial, with most studies (including ours) suggesting that physician delay has little or no effect on melanoma thickness or outcome.…”