More Patients Discover Melanoma
But physicians find the cancer earlier
More than half of newly detected melanomas, the most dangerous type of skin cancer, are self-detected by patients. However, physicians are able to detect these cancers at earlier stages, according to The Journal of the American medical Association (JAMA).
Darin S. Epstein, M.D., of the Johns Hopkins School of Medicine in Baltimore, and colleagues surveyed 102 people with newly detected melanoma between June 1995 and June 1997 to determine melanoma detection patterns and relate them to the thickness of the tumors.
"Physician detection was associated with a 400 percent increase in the likelihood of discovering thinner melanomas," the authors write.
The researchers found that of the 102 patients in the study (47 men and 55 women), 55 percent of the melanomas were self-detected, followed by detection by a physician (24 percent), spouse (12 percent) and others (10 percent). 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).
When grouped according to thickness, 46 percent of physician-detected melanomas (11 out of 24) were still confined to the site of origin and had not spread to surrounding tissue vs. only 14 percent of patient-detected melanomas (8 out of 56). Only 8 percent (2 out of 24) of the physician-detected melanomas were greater than 1.50 mm in tumor thickness while 34 percent (19 out of 56) of the patient-detected melanomas were greater than 1.50 mm in thickness.
The researchers also found that patients were more likely to detect melanomas in a visible location. For example, 70 percent (48 out of 69) of the melanomas on the head, arms, legs and chest were self-detected by patients, whereas patients detected only 24 percent (8 out of 33) of the melanomas on the back or buttocks.
Patients with at least a college education were more likely to have their melanomas detected by a physician, possibly because these patients sought medical advice more often. Physician-detected melanomas also received faster treatment, according to the study. The median time to biopsy (surgical removal of the cancer) after initial detection of a suspicious lesion was three months.
Among the lesions that were detected by physicians, a biopsy had been performed within a month in 83 percent of the cases and a biopsy had not been performed within six months in only 4 percent of the cases. For patient detected lesions, a biopsy had been performed within a month in 16 percent of the cases, while a biopsy had not been performed within six months in 45 percent of the cases.