Abstract
BackgroundThe rising incidence of melanoma – Switzerland has the highest incidence in Europe - is a major public health challenge. Swiss dermatologist introduced the “Swiss Skin Cancer Day” (SSCD) in 2006, which provides skin cancer screening at no costs. The aim of the study was to describe the participating subjects and their motivation and investigate factors influencing the probability of a clinical diagnosis of skin malignancy.Methods150 dermatologists were involved in the SSCD in May 2012. Dermatologists were not remunerated. Participants had the opportunity to show a single skin lesion to a dermatologist at no cost. A questionnaire for each participating subject collected data about subjects’ age, sex, risk factors and reason for encounter; furthermore the dermatologist noted down clinical diagnosis and further management. We used descriptive statistics to report characteristics of participants and skin lesions. We built two multiple logistic regression models, one regarding the clinical diagnosis of skin malignancy and one regarding the further management.Results5266 subjects (55.6% female) were assessed; in 308 (5.8%) participants a clinical diagnosis of skin malignancy was found. In 1732 participants (32.9%) a clinical follow up or an excision was recommended. In the multiple logistic regression model age, sex, skin phototype and the reason for participation at the SSCD were found as significant risk factors regarding the clinical diagnosis of skin malignancy. Participants with skin cancer risk factors were more likely to get a clinical follow up recommended even if the clinical diagnosis was benign.ConclusionA self-perceived suspicious lesion was the strongest predictor for a clinical diagnosis of skin malignancy at the SSCD. This suggests that skin self-examination might also work in general population. Future research should focus on better access to a specialist in case a suspicious skin lesion was discovered. Safety and quality of the SSCD should be further investigated, especially concerning the discrepancy between the low number of malignant lesions and the high quantity of participants where further clinical examinations or interventions were recommended.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-014-0581-6) contains supplementary material, which is available to authorized users.
Highlights
The rising incidence of melanoma – Switzerland has the highest incidence in Europe - is a major public health challenge
The majority of 3178 subjects (60.4%) declared that they wanted to use the possibility of a free check-up of the skin. 1530 (29.1%) were using the possibility to show a self-perceived suspicious skin lesion, 87 (1.7%) had skin cancer cases in their entourage, 276 (5.25%) were sent by their partners, 188 (3.6%) stated different or no reasons
We investigated possible reasons for this discrepancy in our multiple regression model; participants with risk factors were more likely to get a recommendation for further workup, which could be explained by the context of the Swiss Skin Cancer Day” (SSCD), since participants were only allowed to show one skin lesion
Summary
The rising incidence of melanoma – Switzerland has the highest incidence in Europe - is a major public health challenge. The rising incidence of melanoma over the past decades is a major public health challenge [1,2]. Clinical examination of skin does not require expensive technical equipment and early detection of melanoma has a huge impact on prognosis [4], cutaneous melanoma seems to be prone to studies showed that SSE reduces tumor thickness and melanoma incidence in high-risk patients [15,16,17,18]. A suspicious lesion in SSE might have unnecessary barriers with a contact to a primary care physician and a possible secondary referral to a dermatologist, since many primary care physicians feel rather insecure concerning the diagnosis of melanoma [19]
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