Which symptoms are linked to a delayed presentation among melanoma patients? A retrospective study

Abstract

BackgroundThe incidence of melanoma is rising. Early detection is associated with a more favourable outcome. The factors that influence the timing of a patient’s presentation for medical assessment are not fully understood.The aims of the study were to measure the nature and duration of melanoma symptoms in a group of patients diagnosed with melanoma within the preceding 18 months and to identify the symptoms and barriers associated with a delay in presentation.MethodsA questionnaire was distributed to a random sample of 200 of the 963 melanoma patients who had participated in the Cancer Patient Experience Survey 2010 and were known to be alive 1 year later. Data were collected on symptoms, duration of symptoms prior to presentation and the reasons for not attending a doctor sooner.ResultsA total of 159 patients responded to the questionnaire; 74 (47%) were men; mean age was 62 (range 24–90) years. Of the 149 patients who reported a symptom, 40 (27%) had a delayed presentation (i.e. >3 months). A mole growing bigger was the most common symptom and reporting this symptom was significantly associated with a delayed presentation (odds ratio (OR) 2.04, 95% confidence interval (95% CI) 1.14–5.08). Patients aged ≥65 years were less likely to report a barrier to presentation and were less likely to delay than those under 40, although this was of borderline statistical significance (OR 0.28, 95% CI 0.08–1.00).ConclusionsThis study highlights that an enlarging mole is a significant symptom influencing the timing of presentation. Increasing public awareness of the signs of melanoma and of the importance of early presentation is desirable. Health professionals should take advantage of the opportunity to educate patients on such symptoms and signs where feasible. Further exploration of the barriers to presentation in younger people should be considered.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2978-6) contains supplementary material, which is available to authorized users.

A systematic review of the frequency of features of the seven‐point checklist in proven cutaneous melanoma: The importance of change

“…1494 were females (mean: 249, median: 74.5) and 874 males (mean: 124.86, median: 49). Four studies collated ethnicity 16,26–28 of these, participants were white or Caucasian, which is consistent with typical epidemiology of melanoma 29 . Only one study provided skin type data 27 .…”

Incidence Trends and Survival Prediction of Malignant Skin Cancer: A SEER-Based Study

“…It was reported that white ethnicity was a risk factor of survival, which reflects that the melanoma occurred more frequently in people with paler skin. 36 This may be caused by fair-skinned individuals having the highest risk of sunburn and skin cancer. In the present analysis, other ethnicities had the longest OS, whereas the white group had the shortest OS.…”

Delay in Seeking Medical Attention and Diagnosis in Chinese Melanoma Patients: A Cross-Sectional Study

“…Of the 112 melanoma patients in this study, 67 (59.8%) experienced a delay in presentation (DSMA longer than three months [ 7 ]), and the DSMA of these 67 patients ranged from 4 months to 361 months. The longer the DSMA, the longer the progression of the disease and the delay in treatment.…”

“…Melanoma has a poor prognosis. In western studies, the 5-year survival rate of different stages of melanoma decreased from 91.4% (stage I) to 24.6% (stage IV), and non-ulcerative and Breslow thickness <1 mm melanoma have the best prognosis [ 7 , 8 ]. In China, the melanoma patients’ 5-year survival rate and median survival time were 41.6% and 43 months, and the 5-year disease-free survival (DFS) rate and median DFS time were 12.3% and 20 months, respectively [ 9 ].…”