Patients’ Views About Skin Self-examination After Treatment for Localized Melanoma

Abstract

IMPORTANCE Skin self-examination (SSE) is a key factor in the early detection of melanoma, and many new and recurrent melanomas are first detected by patients themselves or their family members. OBJECTIVE To explore the views of patients with melanoma regarding SSE in general, as well as their attitudes toward using novel digital technologies to support their own SSE. DESIGN, SETTING, AND PARTICIPANTS Qualitative study with semistructured interviews that were conducted from June 20 to December 12, 2016, with 37 individuals in Sydney, Australia, who were previously treated for a first primary localized melanoma during 2014 and had not had a recurrence or new primary melanoma in the time since treatment. MAIN OUTCOMES AND MEASURES Patients' views and experiences, analyzed thematically. RESULTS A total of 37 patients (11 women and 26 men; median age, 67 years [interquartile range, 59.5-72 years]) were interviewed. Participants perceived SSE as important for the early identification of local recurrence or new primary melanomas. Despite this belief, participants did not report undertaking full-body SSE on a regular basis. Factors that influenced their low engagement in thorough SSE included lack of self-efficacy, reliance on clinician consultations as the primary means of melanoma detection, and fear of cancer recurrence. Regarding the use of digital technology to assist with SSE, the key motivating factors in favor of such tools were the ability to track changes in lesions over time and the use of automated reminders to undertake SSE. Deterrents included a lack of confidence in undertaking SSE and in using new technology. CONCLUSIONS AND RELEVANCE Patients with melanoma are aware of the importance of thorough skin examinations. However, a lack of confidence in their ability to undertake SSE and reliance on clinicians as the primary means of melanoma detection may inhibit patients from undertaking regular and thorough SSE. Patients may benefit from new digital technologies that assist them in undertaking SSE, provided they have appropriate education and technical support.

Patient Perspectives on the Use of Artificial Intelligence for Skin Cancer Screening

“…Contextualizing our results within the medical literature is limited by the paucity of data on how patients perceive AI for skin cancer screening. Dieng et al 16 found that patients lack confidence in their ability to undertake skin self-examination after treatment for localized melanoma and that some patients are receptive to assistance from new digital technologies. In line with the symbiosis theme in our study, Tran et al 17 found that most patients were ready to accept the use of AI for skin cancer screening after reading a vignette but only under human control.…”

Review of educational tools for skin self‐examination: A qualitative analysis of laypeople’s preferences

“…Other qualitative analysis among melanoma patients also found a lack of confidence to perform SSE and a preferred reliance on skin checks by health professionals. 46 This is of concern when studies show that self-efficacy is a key facilitator of SSE. 43,44 Low self-efficacy may be due to the complexity of the task to be performed, which highlights the need for an easy and clear tool.…”

Co-Design of a Trustworthy AI System in Healthcare: Deep Learning Based Skin Lesion Classifier

“…Any AI system intended as a prevention tool to support lay people in self-screening could represent a significant step towards fostering patients' active involvement in prevention efforts, especially given the shift towards telemedicine since the beginning of the COVID-19 pandemic. Research also suggests that patients are open to using new digital solutions for performing skin selfexaminations, as long as they receive adequate technical support for using these tools (Dieng et al, 2019) and don't feel that they compromise the doctor-patient relationship (Nelson et al, 2020). However, there are also certain challenges to the introduction of these new tools from the patient's point of view.…”