Abstract
Objective. To assess whether the proportion of primary care physicians implementing full body skin examination (FBSE) to screen for melanoma changed over time.Methods. Meta-regression analyses of available data. Data Sources: MEDLINE, ISI, Cochrane Central Register of Controlled Trials.Results. Fifteen studies surveying 10,336 physicians were included in the analyses. Overall, 15%–82% of them reported to perform FBSE to screen for melanoma. The proportion of physicians using FBSE screening tended to decrease by 1.72% per year (P =0.086). Corresponding annual changes in European, North American, and Australian settings were −0.68% (P =0.494), −2.02% (P =0.044), and +2.59% (P =0.010), respectively. Changes were not influenced by national guide-lines.Conclusions. Considering the increasing incidence of melanoma and other skin malignancies, as well as their relative potential consequences, the FBSE implementation time-trend we retrieved should be considered a worrisome phenomenon.
Highlights
The incidence rate of melanoma has increased dramatically and persistently throughout the developed and industrialized world over the past 20 years, reaching the proportion of an epidemic disease [1,2]
We did not consider information pertaining to beliefs or personal views of physicians regarding the role of full body skin examination, as these may be different from actual practice
We aim to evaluate 1) the proportion of primary care physicians who declare to perform full body skin examination to screen for skin malignancy and its changes over time; 2) the regional distribution of the phenomenon (Australia versus Europe versus North America); and 3) the relative impact of the presence of national guide-lines
Summary
The incidence rate of melanoma has increased dramatically and persistently throughout the developed and industrialized world over the past 20 years, reaching the proportion of an epidemic disease [1,2]. Overall melanoma mortality is rising, mainly in older men, while rates are decreasing or stabilizing for younger adults [4]. Mortality from melanoma is mainly dependent on the thickness of the lesions at diagnosis [5]. An accurate and timely detection of melanoma is extremely important since early-stage disease is often curable with simple surgical excision; early detection offers the opportunity to improve survival [6]. More than 80% of melanomas are diagnosed at a localized stage, when the cure rate is high [7]
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