Efficacy of physician and self skin-examination practices for early melanoma detection

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9037 Background: Early detection of invasive melanoma is critical for successful treatment, and most cutaneous melanomas are visible on the skin surface. Recent literature has emphasized the value of the clinical skin examination and skin self-examination (SSE) in reducing melanoma mortality. However, the efficacy of skin examination practices in early melanoma detection remains poorly understood. Methods: Individuals ≥18 years with a diagnosis of invasive primary melanoma were surveyed within 3 months of diagnosis at Stanford/VA Palo Alto and University of Michigan regarding predictors of early melanoma discovery. Data were analyzed (SAS 9.1) to determine age-adjusted associations between skin examination, sociodemographic measures, and melanoma thickness at diagnosis. Results: The 223 patients (57% male; mean age 56.4 years, SD 16.7 years) had a mean tumor depth of 2.06 mm (SD 2.19). Receiving a physician skin examination within the last year (48%) was associated with significantly thinner tumors at diagnosis (1.57 mm vs. 2.42 mm, p=0.006). Patients who examined all of their own moles most frequently (at least every six months) (34%) had slightly thinner tumors (1.76 mm vs. 2.22 mm; p=0.142) than those who did not. Individuals routinely examining their skin on 7 or more of the 13 body areas assessed (49%) had a mean tumor depth of 1.91 mm, versus 2.21 mm among those who did not (p=0.298). Use of a melanoma picture as an aid in SSE (30%) was associated with significantly thinner tumors (1.50 mm vs. 2.30 mm, p= 0.013). Conclusions: Physician skin exam was a strong predictor of earlier melanoma detection, supporting the current emphasis on physician skin examination for secondary prevention. Selected SSE practices were also associated with thinner tumors at diagnosis. Measures of frequency of mole self-examination and proportion of overall skin area examined during SSE were modest predictors of earlier melanoma diagnosis. A more specific measure of behavior during SSE (use of a melanoma picture aid) was strongly associated with thinner tumors. While thorough SSE appears to be important in early melanoma detection, more precise definitions of vigilant SSE are required. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Schering-Plough