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Arch Dermatol. 2009 Apr;145(4):409-14. doi: 10.1001/archdermatol.2009.8.

Factors associated with physician discovery of early melanoma in middle-aged and older men.

Author information

  • 1Department of Dermatology, Boston University School of Medicine, 720 Harrison Ave, DOB 801A, Boston, MA 02118, USA. ageller@bu.edu

Abstract

OBJECTIVE:

To determine factors associated with physician discovery of early melanoma in middle-aged and older men.

DESIGN:

Survey.

SETTING:

Three institutional melanoma clinics.

PARTICIPANTS:

A total of 227 male participants (aged > or =40 years) with invasive melanoma who completed surveys within 3 months of diagnosis. Intervention Survey.

MAIN OUTCOME MEASURES:

Factors associated with physician-detected thin melanoma.

RESULTS:

Patients with physician-detected melanoma were older, 57% were 65 years or older compared with 34% for other-detected (odds ratio [OR], 2.57; 95% confidence interval [CI], 1.19-5.55) and 42% for patient-detected melanoma (P = .07). Physician-detected melanoma in the oldest patients (aged > or =65 years) had tumor thickness equal to that of self-detected melanoma or melanoma detected by other means in younger patients. Back lesions composed 46% of all physician-detected melanoma, 57% of those detected by other means, and 16% of self-detected lesions (physician- vs self-detected: OR, 4.25; 95% CI, 1.96-9.23). Ninety-two percent of all physician-detected back-of-the-body melanomas were smaller than 2 mm compared with 63% of self-detected lesions (P = .004) and 76% of lesions detected by other means (P = .07).

CONCLUSIONS:

Skin screenings of at-risk middle-aged and older American men can be integrated into the routine physical examination, with particular emphasis on hard-to-see areas, such as the back of the body. "Watch your back" professional education campaigns should be promoted by skin cancer advocacy organizations.

PMID:
19380662
DOI:
10.1001/archdermatol.2009.8
[PubMed - indexed for MEDLINE]
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