Melanoma Detection by Non-Specialists: An Untapped Potential for Triage?

Abstract

Introduction: The incidence of melanoma increased considerably in recent decades, representing a significant public health problem. We aimed to evaluate the ability of non-specialists for the preliminary screening of skin lesions to identify melanoma-suspect lesions. Materials and Methods: A medical student and a dermatologist specialist examined the total body scans of 50 patients. Results: The agreement between the expert and the non-specialist was 87.75% (κ = 0.65) regarding the assessment of clinical significance. The four parameters of the ABCD rule were evaluated on the 129 lesions rated as clinically significant by both observers. Asymmetry was evaluated similarly in 79.9% (κ = 0.59), irregular borders in 74.4% (κ = 0.50), color in 81.4% (κ = 0.57), and diameter in 89.9% (κ = 0.77) of the cases. The concordance of the two groups was 96.9% (κ = 0.83) in the case of the detection of the Ugly Duckling Sign. Conclusions: Although the involvement of GPs is part of routine care worldwide, emphasizing the importance of educating medical students and general practitioners is crucial, as many European countries lack structured melanoma screening training programs targeting non-dermatologists.

Advances in Early Detection of Melanoma and the Future of At-Home Testing

“…Another method available for individuals to use is to look for "ugly duckling signs"moles which appear different from other moles on the same individual [44]. Generally benign nevi in an individual's skin share common visual characteristics [45], and comparing all of a patient's nevi has the potential to reduce the number of biopsies by a factor of seven as opposed to analyzing each nevi on an individual basis [46].…”

MicroRNA-155 and Disease-Related Immunohistochemical Parameters in Cutaneous Melanoma

“…Nevertheless, the most effective way to improve the survival of cancer patients lies in early diagnosis and targeted treatment [ 7 ]. Therefore, many researchers are devoted to discovering novel biomarkers to predict the diagnosis or prognosis of melanoma and guide precise clinical treatments [ 8 , 9 ].…”

Evaluation of primary care physicians' competence in selective skin tumour triage after short versus long dermoscopy training: a randomized non‐inferiority trial

“…Specific educational training programs, 11–14 including dermoscopy training, have demonstrated to enhance PCPs' diagnostic accuracy and management of skin cancer 15–18 . Nevertheless, dermoscopy is currently used very little by PCPs 19–21 probably due to lack of adequate training opportunities and to the long training duration required to become competent 22–25 …”

“…[15][16][17][18] Nevertheless, dermoscopy is currently used very little by PCPs [19][20][21] probably due to lack of adequate training opportunities and to the long training duration required to become competent. [22][23][24][25] In 2016, the Triage Amalgamated Dermoscopic Algorithm (TADA) was specifically created for non-experts to triage skin lesions suspicious of malignancy using dermoscopy. 26,27 In a 3-h workshop, participants first learned to identify the dermoscopic features of three common types of benign lesions and then to recognize a panel of dermoscopic criteria that raise suspicion of malignancy.…”