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Public Health. 2008 Dec;122(12):1433-9. doi: 10.1016/j.puhe.2008.04.012. Epub 2008 Aug 26.

Assessing melanoma risk factors: how closely do patients and doctors agree?

Author information

  • 1Department of Dermatology, Medical University of Graz, 8036 Graz, Austria. erika.richtig@med-uni.graz.at

Abstract

OBJECTIVES:

Self-examination of the skin has been associated with a reduced risk of advanced melanoma, but self-assessment has corresponded imperfectly with clinical examination by a dermatologist, and shown only moderate accuracy in identifying individuals at risk.

STUDY DESIGN:

Population-based screening campaign in Styria, Austria.

METHODS:

One thousand two hundred and twenty-three Caucasians volunteered for a free skin assessment by a dermatologist. First, they answered a questionnaire in which they assessed their own melanoma risk factors, and they were subsequently examined by a dermatologist. Kappa agreements between the two assessments were calculated.

RESULTS:

The overall kappa agreements on the estimated number of naevi, the assessment of skin phototype and the perception of increased melanoma risk were 0.34 [95% confidence interval (CI) 0.30-0.37], 0.28 (95%CI 0.24-0.32) and 0.24 (95% CI 0.18-0.30), respectively. Kappa agreements below 0.40 are considered poor. Stratification by age and gender revealed slightly higher scores for subgroups on single items.

CONCLUSIONS:

Screening for melanoma should be population based and should not be limited to self-referrals since self-assessment for melanoma risk factors is inaccurate. Educational programmes must be developed to improve self-assessment and to target populations at risk.

PMID:
18752818
[PubMed - indexed for MEDLINE]
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