Melanoma Surveillance and Earlier Diagnosis

Schneider, J.; Sagebiel, RichardW.; Moore, DanH.; Lawton, G.

doi:10.1016/s0140-6736(87)90625-8

Cited by 12 publications

(3 citation statements)

References 4 publications

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“…The effects of the campaigns in reducing the depth distribution of cutaneous malignant melanomas at diagnosis have sometimes been encoura'ging, but in other instances have shown little effect (Mackie & Doherty, 1988;Cristofolini et al, 1986;Schneider et al, 1987;Smith, 1979;Southampton Melanoma CIroup, 1986 (Mackie, 1986). This gave a seven point checklist of the danger points to look for in a pigmented lesion; itch, size greater than 5mm, increase in size, irregular shape, colour variation, inflammation and crusting or bleeding, and recommended that patients presenting with pigmented lesions displaying three or more of the seven points should be referred for specialist opinion.…”

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confidence: 99%

Effects of a health education campaign for the earlier diagnosis of melanoma

Whitehead

Wroughton²,

Elwood³

et al. 1989

Br J Cancer

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Summary As part of a national campaign to combat the rising incidence of and mortality from cutaneous malignant melanoma, a programme of improved clinical services and professional and public education was set up in Nottingham in January to July 1987. The public education campaign in July led to an immediate increase in the weekly number of referrals to the pigmented lesion clinic from 10 to 54. The effect on general practitioner workload was less dramatic, the weekly number of consultations for discrete pigmented lesions rising from 0.5 to 3. In materials sent to GPs, we recommended that patients with three or more of seven specified signs should be referred for specialist opinion. Only 40% of the patients referred to the pigmented lesion clinic fulfilled this criterion, but 6% of these patients had a melanoma, compared to only 0.4% of those who did not meet the criterion. In the 6 months following the campaign, 64% of melanomas diagnosed in Nottingham residents had a Breslow thickness of <1.5mm whereas only four (16%) were >3.5mm. However, this distribution was not significantly different from that seen in the three and a half years before the campaign. These results suggest that attempts to improve early diagnosis of the disease by health education are justified, but, in view of the service implications, full evaluation of such campaigns by large scale and long-term studies is essential. Future campaigns should give greater stress to referral criteria.The incidence and mortality of cutaneous malignant melanoma in white populations is rapidly rising; mortality from the disease in England and Wales has more than doubled since 1950 (Osmond et al., 1983). Several large epidemiological studies show that melanoma is associated with exposure to ultraviolet light (Gallagher et al., 1986;Holman et al., 1986). However, the relationship is complicated, so as yet simple and effective primary preventive measures have not been developed.The best prognostic indicator for malignant melanoma is the Breslow thickness of the tumour, tumours with a depth of less than 0.76mm having a virtual 100% 5-year survival rate whereas tumours with a depth greater than 3.5mm have a 5-year survival rate of less than 40% (Breslow, 1970). The

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confidence: 99%

Effects of a health education campaign for the earlier diagnosis of melanoma

Whitehead

Wroughton²,

Elwood³

et al. 1989

Br J Cancer

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“…Even before the program began, workforce awareness and early diagnosis may have surpassed the levels in the surrounding community 25,26,27 . At the outset of the study, which was accompanied by massive local publicity in 1984, 96% of LLNL employees reported having some knowledge regarding melanoma.…”

Section: Discussionmentioning

confidence: 99%

Screening program reduced melanoma mortality at the Lawrence Livermore National Laboratory, 1984 to 1996

Schneider

Moore

Mendelsohn

2008

Journal of the American Academy of Dermatology

117

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“…Their report proposed the actuarial probability ofmelanoma developing in family members with DN as 56.0% (±IO.I) from age 20 to age 59 (2). The sporadic form of DN has been estimated by other groups to occur in around 5% of white Americans with no familial history of melanoma (3)(4)(5). The prevalence of DN, which was surveyed retrospectively in the cases of sporadic (non-familial) melanoma, was 39% (41/105 cases examined), according to the recent report by Department of Dermatology, KobeUniversity Schoolof Medicine, Kobe,Japan.…”

Section: Introductionmentioning

confidence: 99%

Dysplastic Nevus Syndrome: Melanoma‐prone Disease

Tsukamoto

Hayashibe

Ichihashi

1992

The Journal of Dermatology

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Regardless of subsequent clinical courses of patients with dysplastic nevi (DN), substantial evidence supporting DN as one of the melanoma-prone diseases is not yet available, especially in sporadic DN, due to the lack of genetic information other than retrospective studies in clinical observation. This study aimed at the immunohistological characterization of sporadic DN distinct from common nevi (CN) and at the evaluation of the potentially of sporadic DN for malignant transformation. We considered our results together with previous immunological and epidemiological reports. We noted the following three immunohistological characteristics. 1) Proliferating cell nuclear antigen (PCNA), one of the markers for active cell division, could be detected on DN cells in junctional nests of only one among ten DN examined but not on CN cells at all. 2) The altered expression of alpha-smooth muscle actin (alpha-Sma), often observed in melanoma cells, could not be detected in DN cells. However, anti-alpha-Sma monoclonal antibody (MoAb) clearly demonstrated distinctive hypervascularity in the stroma surrounding DN when compared with CN. 3) ME491 antigen, which is known to be expressed mainly in the radial growth phase of melanoma, was detected with similar intensity on both DN and CN. These data indicate that DN has a somewhat higher potentiality than CN for cell division and secretion of some cytokines which can induce hypervascularity in the surrounding stroma, but that DN has not yet undergone the significant phenotypic changes observed in melanoma cells. Further advancements in understanding molecular events in DN cells will be of great benefit in setting DN in the multiple oncogenic spectrum from pigment cells to melanoma.

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Melanoma Surveillance and Earlier Diagnosis

Cited by 12 publications

References 4 publications

Effects of a health education campaign for the earlier diagnosis of melanoma

Effects of a health education campaign for the earlier diagnosis of melanoma

Screening program reduced melanoma mortality at the Lawrence Livermore National Laboratory, 1984 to 1996

Dysplastic Nevus Syndrome: Melanoma‐prone Disease

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