Examination of the ability of people to identify early changes of melanoma in computer-altered pigmented skin lesions

Hanrahan, P. F.

doi:10.1001/archderm.133.3.301

Cited by 16 publications

(13 citation statements)

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“…The most prominent finding in our data was that elderly patients present with significantly thicker melanomas, a phenomenon described in both Europe and Australia (Hersey et al , 1991; Melia et al , 1995; Hanrahan et al , 1997; Kelly, 1998; Chang et al , 2003; Testori et al , 2009; Criscione and Weinstock, 2010). …”

Section: Discussionsupporting

confidence: 65%

“…Despite physical deterioration, it has been demonstrated that older people should be very well able to detect skin changes associated with early melanoma (Hanrahan et al , 1997). This finding does suggest that public education campaigns and increased alertness in the context of elderly care might be useful to encourage the detection of skin changes.…”

Section: Discussionmentioning

confidence: 99%

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Breslow thickness in the Netherlands: a population-based study of 40 880 patients comparing young and elderly patients

et al. 2012

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Background: Melanoma incidence has increased rapidly in the last decades, and predictions show a continuing increase in the years to come. The aim of this study was to assess trends in melanoma incidence, Breslow thickness (BT), and melanoma survival among young and elderly patients in the Netherlands. Methods: Patients diagnosed with invasive melanoma between 1994 and 2008 were selected from the Netherlands Cancer Registry. Incidence (per 100 000) over time was calculated for young (<65 years) and elderly patients (⩾65 years). Distribution of BT for young and elderly males and females was assessed. Regression analysis of the log-transformed BT was used to assess changes over time. Relative survival was calculated as the ratio of observed survival to expected survival. Results: Overall, 40 880 patients were included (42.3% male and 57.7% female). Melanoma incidence increased more rapidly among the elderly (5.4% estimated annual percentage change (EAPC), P <0.0001) than among younger patients (3.9% EAPC, P <0.0001). The overall BT declined significantly over time ( P <0.001). Among younger patients, BT decreased for almost all locations. Among elderly males, BT decreased for melanomas in the head and neck region ( P =0.001) and trunk ( P <0.001), but did not decrease significantly for the other regions. Among elderly females, BT only decreased for melanomas at the trunk ( P =0.01). The relative survival of elderly patients was worse compared with that of younger patients ( P <0.001). Conclusion: Melanoma incidence increases more rapidly for elderly than for younger patients and the decline in BT is less prominent among elderly patients than among young patients. Campaigns in the Netherlands should focus more on early melanoma detection in the elderly.

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Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Breslow thickness in the Netherlands: a population-based study of 40 880 patients comparing young and elderly patients

et al. 2012

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“…A 1997 randomized controlled trial examined the ability of older (>45 years) vs. younger (<30 years) people to identify early changes of melanoma in photographs of computer‐altered pigmented skin lesions 37 . The intervention consisted of an educational brochure highlighting the changes that should be recognized, including shape, color, size, and the appearance of a new lesion.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of skin self‐examination for the early detection of melanoma

Hamidi

Peng²,

Cockburn

2010

Int J Dermatology

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The National Cancer Institute's "Melanoma Action Plan" calls for reduction of melanoma mortality through early detection. Routine skin self-examination (SSE) has the potential to increase chances of early detection and treatment and may be the key to melanoma survival. We provide a focused review of the accuracy of SSE for detecting premalignant lesions and cutaneous risk factors for melanoma, with suggestions for future directions for enhancing measurement of SSE accuracy and ways in which to improve the public's perceptions of melanoma efficacy. We examined published data on the efficacy of skin self-examination for the early detection of melanoma. We searched the MEDLINE database for publications between January 1, 1987 and June 1, 2007 using search terms for "melanoma" and "self-examination." We found that sensitivity of skin self-examination is low, ranging from 25% to 93%, while specificity is generally higher (83% to 97%). Attempts to increase improve the lay public's perceptions of the early signs of melanoma have proved effective, while those aimed at increasing accuracy of SSE with targeted interventions have been moderately successful. SSE's insensitivity for detection of pigmented lesions should prompt further investigation of educational interventions to enhance its accuracy and lead to its adoption as a cheap, simple screening tool. Assessment of the accuracy and efficacy of SSE should proceed using standardized definitions and measurements such that it is easier to pool data on the overall value of SSE as a screening modality.

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“…A study using computer-generated changes in lesions showed that people are unable to memorize their skin sufficiently well to recognize changes over long intervals. 43 This is reinforced by the observation that, compared with doctor-detected lesions, lesions detected by laypersons were 20 times more likely to be noticed incidentally than as a result of a systematic skin check. Nevertheless, there may be benefit in encouraging people to become familiar with their skin and to present any changes to a physician.…”

Section: Possible Methods To Improve Early Detectionmentioning

confidence: 99%