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JAMA. 1999 Feb 17;281(7):640-3.

Is physician detection associated with thinner melanomas?

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  • 1Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, MD, USA.

Abstract

CONTEXT:

In cutaneous melanoma, tumor depth remains the best biologic predictor of patient survival. Detection of prognostically favorable lesions may be associated with improved survival in patients with melanoma.

OBJECTIVE:

To determine melanoma detection patterns and relate them to tumor thickness.

DESIGN:

Interview survey.

SETTING AND PATIENTS:

All patients with newly detected primary cutaneous melanoma at the Melanoma Center, Johns Hopkins Medical Institutions, between June 1995 and June 1997.

MAIN OUTCOME MEASURE:

Tumor thickness grouped according to detection source.

RESULTS:

Of the 102 patients (47 men, 55 women) in the study, the majority of melanomas were self-detected (55%), followed by detection by physician (24%), spouse (12%), and others (10%). Physicians were more likely to detect thinner lesions than were patients who detected their own melanomas (median thickness, 0.23 mm vs 0.9 mm; P<.001). When grouped according to thickness, 11 (46%) of 24 physician-detected melanomas were in situ, vs only 8 (14%) of 56 patient-detected melanomas. Physician detection was associated with an increase in the probability of detecting thinner (< or =0.75 mm) melanomas (relative risk, 4.2; 95% confidence interval, 1.4-11.1; P=.01).

CONCLUSIONS:

Thinner melanomas are more likely to have been detected by physicians. Increased awareness by all physicians may result in greater detection of early melanomas.

PMID:
10029126
[PubMed - indexed for MEDLINE]
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