Self-detected cutaneous melanomas in Italian patients

Abstract

Self-detection of suspicious pigmented skin lesion combined with rapid referral to dermatologic centres is the key strategy in the fight against melanoma. The investigation of factors associated with pattern of detection of melanoma (self- vs. nonself-detection) may be useful to refine educational strategies for the future. We investigated the frequency of melanoma self-detection in a Mediterranean population at intermediate melanoma risk. A multicentric survey identified 816 consecutive cases of cutaneous melanoma in the period January to December 2001 in 11 Italian clinical centres belonging to the Italian Multidisciplinary Group on Melanoma. All patients filled a standardized questionnaire and were clinically examined by expert dermatologists. Self-detected melanomas were 40.6%, while the remaining lesions were detected by a dermatologist (18.5%), the family physician (15.2%), other specialists (5%), the spouse (12.5%), a friend or someone else (8.2%). Variables associated with self-detected melanomas were female sex, young age, absence of atypical nevi, knowledge of the ABCD rule, habit of performing skin self-examination. Self-detected melanomas did not differ from nonself-detected tumours in term of lesion thickness; however, patients with self-detected melanomas waited a longer period before having a diagnostic confirmation (patient's delay) (> 3 months: odds ratio, 3.89; 95% confidence interval, 2.74-5.53). In order to reduce the patients' delays, educational messages should adequately stress the need for a prompt referral to a physician once a suspicious pigmented lesion is self-detected.

Analysis of prognostic factors for melanoma patients

“…Poorer survival among men compared to women could be due to late stages of melanoma at the time of diagnosis. Women more often perform self-examination or tend to contact dermatologists for screening than men (13). It is reported that melanoma is rare before puberty, it tends to be more invasive during pregnancy, and decreases during post-menopausal years.…”

“…Since elderly people often have one or more chronic diseases (heart diseases, diabetes, and others) beside melanoma, they have weakened immune systems and lower survival rates of melanoma. Additionally, elderly people rarely perform self-examination or visit dermatologists for screening (13). As a consequence, melanoma is diagnosed at a late stage and greater depth, which impacts the prognosis of the disease.…”

Associations between ocular melanoma and other primary cancers: An international population‐based study

“…Promotion of surveillance of skin pigmented lesions started in the 1980s and 1990s, and became popular mainly among young women. [20][21][22][23][24] It is commonly believed that ocular melanoma could also be associated with sun exposure, and thus, ocular melanoma patients and their doctors might have devoted greater attention to surveillance of skin pigmented lesions than other people. As a consequence, risk of subsequent cutaneous melanoma among ocular melanoma patients displayed epidemiological patterns similar to those observed for early detection of cutaneous melanoma in the general population.…”

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

“…Substantial knowledge gaps were previously reported in studies on Italian melanoma patients [21], on persons at higher risk for developing melanoma in the UK [22] and also on transplant recipients [23]. A survey on awareness and knowledge about NMSC conducted on the general population in 7 countries [5] showed that 42% of Italians rarely or never applied a sunscreen when outside, with only Spain (47%) and the USA (49%) reporting a more frequent lack of sunscreen use.…”