The Value of Total Body Photography for the Early Detection of Melanoma: A Systematic Review.

Annkathrin Hornung,Theresa Steeb,Titus J Brinker,Thomas Breakell,Anja Wessely,Carola Berking,Michael Erdmann,Markus V Heppt

doi:10.3390/ijerph18041726

Abstract

Early detection of melanoma is critical to reduce the mortality and morbidity rates of this tumor. Total body photography (TBP) may aid in the early detection of melanoma. To summarize the current evidence on TBP for the early detection of melanoma, we performed a systematic literature search in Medline, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for eligible records up to 6th August 2020. Outcomes of interest included melanoma incidence, incisional and excisional biopsy rates, as well as the Breslow’s index of detected tumors. Results from individual studies were described qualitatively. The risks of bias and applicability of the included studies was assessed using the QUADAS-2 checklist. In total, 14 studies published between 1997 and 2020 with an overall sample size of n = 12082 (range 100–4692) were included in the qualitative analysis. Individuals undergoing TBP showed a trend towards a lower Breslow’s thickness and a higher proportion of in situ melanomas compared to those without TBP. The number needed to excise one melanoma varied from 3:1 to 14.3:1 and was better for lesions that arose de novo than for tracked ones. The included studies were judged to be of unclear methodological concern with specific deficiencies in the domains “flow and timing” and “reference standard”. The use of TBP can improve the early detection of melanoma in high-risk populations. Future studies are warranted to reduce the heterogeneity of phenotypic risk factor definition and the technical implementation of TBP. Artificial intelligence-assisted analysis of images derived from 3-D TBP systems and digital dermoscopy may further improve the early detection of melanoma.

Highlights

Early detection of cutaneous lesions remains of paramount importance to significantly reduce the morbidity and mortality caused by melanoma, as thinner primary tumors are associated with an improved survival rate [7,8,9]
We aimed to investigate the value of Total body photography (TBP) in the early detection of melanoma
We have identified 14 studies with an overall sample size of n = 12,082 highlighting that individuals undergoing TBP showed a trend towards a lower Breslow’s thickness and a higher proportion of in situ melanomas compared to those without TBP

Summary

Introduction

The incidence of cutaneous melanoma continues to rise steadily in Western countries with Caucasian populations each year [1,2]. Surgical treatment is usually curative following early detection of the disease [3,4]. Melanoma quickly becomes life-threatening once it metastasizes [3], considerable progress has been made following novel therapeutic interventions including BRAF and MEK inhibitors and immunotherapies [5,6]. Early detection of cutaneous lesions remains of paramount importance to significantly reduce the morbidity and mortality caused by melanoma, as thinner primary tumors are associated with an improved survival rate [7,8,9]. Strategies to improve early detection are critical in patients at high risk for melanoma

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Conclusion