Skin Self-examination Research Articles

Familial Melanoma: Diagnostic and Management Implications

BackgroundAn estimated 5%–10% of all cutaneous melanoma cases occur in families. This review describes susceptibility genes currently known to be involved in melanoma predisposition, genetic testing of familial melanoma patients, and management implications.ResultsCDKN2A is the major high-penetrance susceptibility gene with germline mutations identified in 20%–40% of melanoma families. A positive CDKN2A mutation status has been associated with a high number of affected family members, multiple primary melanomas, pancreatic cancer, and early age at melanoma onset. Mutations in the other melanoma predisposition genes—CDK4, BAP1, TERT, POT1, ACD, TERF2IP, and MITF—are rare, overall contributing to explain a further 10% of familial clustering of melanoma. The underlying genetic susceptibility remains indeed unexplained for half of melanoma families. Genetic testing for melanoma is currently recommended only for CDKN2A and CDK4, and, at this time, the role of multigene panel testing remains under debate. Individuals from melanoma families must receive genetic counseling to be informed about the inclusion criteria for genetic testing, the probability of an inconclusive result, the genetic risk for melanoma and other cancers, and the debatable role of medical management. They should be counseled focusing primarily on recommendations on appropriate lifestyle, encouraging skin self-examination, and regular dermatological screening.ConclusionsGenetic testing for high-penetrance melanoma susceptibility genes is recommended in melanoma families after selection of the appropriate candidates and adequate counseling of the patient. All patients and relatives from melanoma kindreds, irrespective of their mutation status, should be encouraged to adhere to a correct ultraviolet exposure, skin self-examination, and surveillance by physicians.

Sun Protection Habits and Sunburn in Elite Aquatics Athletes: Surfers, Windsurfers and Olympic Sailors.

The objective of this study was to analyse the sun exposure habits of elite aquatics athletes, together with their sunburn history and skin examination habits, taking into account differences by sex and between sports. A cross-sectional health survey was conducted at world championship events during which elite surfers, windsurfers and Olympic sailors from 30 different countries were invited to participate. The athletes were asked to complete a self-administered questionnaire focused on sun protection habits, sun exposure and sports practices. The survey was completed by 240 athletes, 171 men (71.3%) and 69 women (28.8%), with a mean age of 22years (SD 5.86) and skin phototypes I (6.3%), II (3.3%), III (22.0%), IV (32.5%), V (9.2%) and VI (1.7%). There were significant differences between male and female athletes in skin self-examination (p< 0.001) and in the use of sunglasses (p< 0.001). In sunburn history during the last season, there were significant differences (p< 0.001) among the three sports analysed, in both sexes. The mean rate of sunburn during the previous season was 76.7%, and 27.5% of participants reported having experienced three or more sunburns that lasted at least 1day. This type of athlete is at high risk of sunburn and hence of future skin cancer. However, there is a general lack of awareness of this risk. This study highlights the need to inform such athletes and to raise awareness of the dangers, through educational interventions on the importance of protecting against sunburn in order to reduce the future incidence of skin cancer.

Consumer Acceptance and Expectations of a Mobile Health Application to Photograph Skin Lesions for Early Detection of Melanoma

Background: Mobile teledermoscopy may facilitate skin self-examinations (SSEs) and further improve monitoring and detection of melanoma. Objective: To assess consumer acceptability and expectations of a mobile health app used to: (i) instruct SSE and (ii) conduct consumer-performed mobile teledermoscopy. Methods: People aged 18 years and above were invited to participate in either (i) an online survey or (ii) focus group in Brisbane, Australia. Participants were asked about their SSE practices, mobile teledermoscopy acceptance, and app design and functionality. The online survey responses and focus group discussions were coded by two researchers who conducted thematic analysis. Results: Four focus groups were held with a total of 28 participants; 88 participants completed the online survey. The mean ages of participants in the focus group and online survey were 46 and 38 years, respectively. There were more males in the focus groups (61%, 17/28) compared to the online survey (19%, 17/88). Regular SSEs were conducted by 56 (64%) of the online survey participants. Barriers to SSE were forgetfulness (44%), low self-perceived risk of melanoma (25%) and low confidence in conducting SSEs (25%). The large majority of online survey participants (95%) would consider sending photos of their skin lesions to a medical practitioner via an app. Focus group participants reported that they would accept using mobile teledermoscopy; however, they would prefer to use it to monitor lesions between face-to-face consultations. Conclusions: Overall, participants had positive views on using mobile teledermoscopy to send images of skin lesions to a dermatologist or other medical practitioner.

Risk factors for development of new skin neoplasms in patients with past history of skin cancer: A survival analysis

We conducted a retrospective study aiming to assess the risk, and associated risk factors, of developing subsequent skin cancers after having a first diagnosis of skin cancer. We included all patients with biopsy-proven skin cancer attending a dermatology clinic between July 2007 and July 2017. We assessed the frequency of new skin cancers, as well as potential demographic and clinical factors significantly associated with occurrence of such neoplasms, that were identified by means of a survival analysis. We analyzed 969 patients with a total of 1584 skin neoplasms (1122 basal cell carcinomas (BCC), 310 squamous cell carcinomas (SCC), 143 melanomas and 9 other neoplasms). 165 patients (17.0%) developed subsequent skin neoplasms. Factors identified in multivariable models to be significantly associated with development of new skin cancers included older age (adjusted HR = 1.04 per year; 95%CI = 1.02–1.05; p < 0.001), and presence of synchronous neoplasms (adjusted HR = 2.25; 95%CI = 1.61–3.14; p < 0.001). Having a history of a BCC was significantly associated with development of new BCC (adjusted HR = 1.63; 95%CI = 1.05–2.54; p = 0.030), while having a previous SCC was associated with occurrence of subsequent SCC (adjusted HR = 3.60; 95%CI = 1.93–6.72; p < 0.001). These findings point to the importance of careful follow-up (e.g., skin self-examination and full body examination) of skin cancer patients.

Direct-to-consumer mobile teledermoscopy for skin cancer screening: Preliminary results demonstrating willingness-to-pay in Australia

Introduction Internationally, teledermoscopy has been found to have clinical and economic efficacy. This study aims to identify the attributes of a mobile teledermoscopy service that consumers prefer. This preliminary study was set within a broader randomised control trial (RCT) investigating the effectiveness of direct to consumer mobile teledermoscopy. Methods We undertook a discrete choice experiment (DCE). The DCE comprised 24 choice sets, divided into in two blocks of 12. For each choice set, respondents were asked to make discrete choices between two opt-out choices and two skin cancer screening service options described by seven attributes. A mixed logit model was used to estimate preferences for skin cancer screening services. Consumer preferences weights were used to calculate marginal willingness-to-pay (WTP) for skin cancer screening services. Results The DCE was completed by 113 consumer respondents. Consumers’ preference for dermatologist involvement in their diagnosis, increased accuracy, and reduced excisions were all statistically significant in driving choice between service models. Consumers preferred having a professional involved in their skin cancer screening, rather than performing a self-examination. Consumers were only WTP $1.18 to change from a GP visit to mobile teledermoscopy (diagnosis using a phone camera). However, they were WTP $43 to have their results reviewed by a dermatologist rather than a GP, and $117 to increase the chance of detecting a melanoma if it was present from 65-75% to 95%. Conclusion Skin cancer screening services which are delivered by health professionals, rather than skin self-examination, are preferred by consumers. Consumers were willing to pay for their preferred skin cancer screening method, especially if a dermatologist was involved.

Knowledge and practices of primary care providers on skin cancer and skin self-examination.

To determine the knowledge and practices related to skin cancer and skin self-examination of primary care providers. This cross-sectional descriptive study was conducted in Turkey. The study was carried out in primary health centers such as family health centers, community health centers, early cancer detection centers and family planning centers in 2016-2017. Participants' socio-demographic characteristics, their knowledge and practices related to skin cancer, skin cancer risk factors and skin self-examination were determined. The study population included 94 primary care providers. The symptoms of which the participants were most aware were changes in the color of moles or skin spots (95.71%), and of which participants were the least aware was the itching of a mole (71.43%). Among participants, the most recognized risk factor was having fair skin (97.14%), whereas the least known was the presence of birthmarks (24.29%). The mean scores the participants obtained from the questionnaire were as follows: 5.39±1.61 for skin cancer risk factors and 10.47±2.73 for skin cancer symptoms. Of the participants, 14.29% received training on skin self-examination, 38.57% knew how to perform skin self-examination, and 67.14% did not perform skin self-examination. Of the participants, 61.7% did not perform skin self-examination because they did not know what to look for. Of the participants, 85.71% did not have continuing education/workshop about skin self-examination after graduation. Although the primary care providers' knowledge of skin cancer symptoms was adequate, their knowledge of skin cancer risk factors was not sufficient. Primary care providers' knowledge of skin self-examination was good, but they did not perform skin self-examination adequately.

PMD28 - Consumer Willingness-To-Pay and Preference for Skin Cancer Screening Services in Australia

To determine consumer preferences and willingness-to-pay for skin cancer screening services in Australia. During 2016-2017, 113 participants in a randomised controlled trial comparing self-skin examination and mobile teledermoscopy completed a discrete choice experiment (DCE) question set about skin cancer screening services. The DCE question set was comprised of 24 questions, divided into in two blocks. For each question, respondents were asked to make discrete choices between mutually exclusive skin cancer screening services options described by 7 attributes with 2-3 levels. Each question also had 2 opt-out choices; ‘skin self-examination’ and ‘do nothing’. This DCE was designed using the principle of d-efficiency and analysed using a mixed logit model. All variables except cost were effects coded. The model was used to estimate preferences for skin cancer screening services, and measures of interest such as marginal willingness to pay, and uptake of new services. Diagnostic accuracy was the most important factor for consumers when choosing a skin cancer screening option, closely followed by the number of benign lesions removed to find one melanoma. Consumers preferred having a professional involved in their skin cancer screening, rather than performing a self-examination. Additionally, the model indicated a preference for services that offered shorter waiting time for diagnosis, and minimal time away from usual activities. When selecting a mobile teledermoscopy screening service, consumers were willing to pay an extra AU$43 to have the images reviewed by a dermatologist instead of a general practitioner. Consumers were also willing to pay AU$64 to reduce this time away from usual activities from 3-4 hours down to 1-2 hours. Skin cancer screening services which were delivered by health professionals and offered optimal diagnostic accuracy were preferred by consumers. They were willing to pay for their preferred skin cancer screening method, especially if a dermatologist was involved.

Piloting the Use of Smartphones, Reminders, and Accountability Partners to Promote Skin Self-Examinations in Patients with Total Body Photography: A Randomized Controlled Trial.

The aim of this study was to evaluate the use of a mobile application (app) in patients already using total body photography (TBP) to increase skin self-examination (SSE) rates and pilot the effectiveness of examination reminders and accountability partners. Randomized controlled trial with computer generated randomization table to allocate interventions. University of Pennsylvania pigmented lesion clinic. 69 patients aged 18years or older with an iPhone/iPad, who were already in possession of TBP photographs. A mobile app loaded with digital TBP photos for all participants, and either (1) the mobile app only, (2) skin examination reminders, (3) an accountability partner, or (4) reminders and an accountability partner. Change in SSE rates as assessed by enrollment and end-of-study surveys 6months later. Eighty one patients completed informed consent, however 12 patients did not complete trial enrollment procedures due to device incompatibility, leaving 69 patients who were randomized and analyzed [mean age 54.3years, standard deviation 13.9). SSE rates increased significantly from 58% at baseline to 83% at 6months (odds ratio 2.64, 95% confidence interval 1.20-4.09), with no difference among the intervention groups. The group with examination reminders alone had the highest (94%) overall satisfaction, and the group with accountability partners alone accounted for the lowest (71%). A mobile app alone, or with reminders and/or accountability partners, was found to be an effective tool that can help to increase SSE rates. Skin examination reminders may help provide a better overall experience for a subset of patients. ClinicalTrials.gov Identifier: NCT02520622.

Promoting sunscreen use and skin self-examination to improve early detection and prevent skin cancer: quasi-experimental trial of an adolescent psycho-educational intervention

BackgroundSkin cancer rates are increasing. Interventions to increase adolescent sunscreen use and skin self-examination (SSE) are required.MethodsQuasi-experimental design; 1 control and 4 intervention group schools in Scotland, UK. Participants were 15–16 year old students on the school register. The intervention was a theoretically-informed (Common-Sense Model and Health Action Process Approach) 50-min presentation, delivered by a skin cancer specialist nurse and young adult skin cancer survivor, to students in a classroom, supplemented by a home-based assignment. Outcome variables were sunscreen use intention, SSE intention/behaviour, planning, illness perceptions and skin cancer communication behaviour, measured 2 weeks pre- and 4 weeks post- intervention using self-completed pen and paper survey. School attendance records were used to record intervention up-take; students self-reported completion of the home-based assignment. Pearson’s chi-square test, analysis of variance, and non-parametric Wilcoxon Signed Ranks Test were used to measure outcomes and associations between variables. Focus groups elicited students’ (n = 29) views on the intervention. Qualitative data were analysed thematically.ResultsFive of 37 invited schools participated. 639 (81%) students in intervention schools received the intervention; 33.8% completed the home-based assignment. 627 (69.6%) of students on the school register in intervention and control schools completed a questionnaire at baseline; data for 455 (72.6%) students were available at baseline and follow-up. Focus groups identified four themes – personal experiences of skin cancer, distaste for sunscreen, relevance of SSE in adolescence, and skin cancer conversations. Statistically significant (p < 0.05) changes were observed for sunscreen use, SSE, planning, and talk about skin cancer in intervention schools but not the control. Significant associations were found between sunscreen use, planning and 2 illness perceptions (identity and consequence) and between SSE, planning and 3 illness perceptions (timeline, causes, control).ConclusionsIt is feasible to promote sunscreen use and SSE in the context of an adolescent school-based psychoeducation intention. Further research is required to improve study uptake, intervention adherence and effectiveness.Trial registrationISRCTN11141528

Association of Skin Examination Behaviors and Thinner Nodular vs Superficial Spreading Melanoma at Diagnosis

Early melanoma detection strategies include skin self-examination (SSE), physician skin examination (PSE), and promotion of patient knowledge about skin cancer. To investigate the association of SSE, PSE, and patient attitudes with the detection of thinner superficial spreading melanoma (SSM) and nodular melanoma (NM), the latter of which tends to elude early detection. This cross-sectional, questionnaire-based, multicenter study identified patients with newly diagnosed cutaneous melanoma at 4 referral hospital centers in the United States, Greece, and Hungary. Among 920 patients with a primary invasive melanoma, 685 patients with SSM or NM subtype were included. A standardized questionnaire was used to record sociodemographic information, SSE and PSE practices, and patient perceptions in the year prior to diagnosis. Data were analyzed according to histologic thickness, with a 2-mm cutoff for thinner SSM and NM. Of 685 participants (mean [SD] age, 55.6 [15.1] years; 318 [46%] female), thinner melanoma was detected in 437 of 538 SSM (81%) and in 40 of 147 NM (27%). Patients who routinely performed SSE were more likely to be diagnosed with thinner SSM (odds ratio [OR], 2.61; 95% CI, 1.14-5.40) but not thinner NM (OR, 2.39; 95% CI, 0.84-6.80). Self-detected clinical warning signs (eg, elevation and onset of pain) were markers of thicker SSM and NM. Whole-body PSE was associated with a 2-fold increase in detection of thinner SSM (OR, 2.25; 95% CI, 1.16-4.35) and thinner NM (OR, 2.67; 95% CI, 1.05-6.82). Patient attitudes and perceptions focusing on increased interest in skin cancer were associated with the detection of thinner NM. Our findings underscore the importance of complementary practices by patients and physicians for the early detection of melanoma, including regular whole-body PSE, SSE, and increased patient awareness.

Psychosocial consequences of skin cancer screening.

Screening for melanoma may save lives, but may also cause patient distress. One key reason that preventative visual skin examinations for skin cancer are not currently recommended is the inadequate available evidence to assess potential harm to psychosocial wellbeing. We investigated potential psychological harms and benefits of skin examinations by conducting telephone surveys in 2015 of 187 screened participants; all were ≥35 years old. Participants had their skin examined by practitioners who had completed INFORMED, a validated web-based training for detection of skin cancers, particularly melanoma. Participants underwent the Spielberger State-Trait Anxiety Inventory (STAI), Psychological Consequences of Screening (PCQ), Hospital Anxiety and Depression (HAD) scale, and the 12-Item Short Form Health Survey (SF-12). Analyses were conducted in 2017. Of the entire study sample, 40% were thoroughly screened as determined by patient-reported level of undress and skin areas examined. Participants who were thoroughly screened: did not differ on negative psychosocial measures; scored higher on measures of positive psychosocial wellbeing (PCQ); and were more motivated to conduct monthly self-examinations and seek annual clinician skin examinations, compared to other participants (p < 0.05). Importantly, thoroughly screened patients were more likely to report skin prevention practices (skin self-examinations to identify a concerning lesion, practitioner provided skin exam), recommend skin examinations to peers, and feel satisfied with their skin cancer education than less thoroughly screened individuals (p < 0.01). Our results suggest that visual screening for skin cancer does not worsen patient psychosocial wellbeing and may be associated with improved skin cancer-related practices and attitudes.

Quality of Life, Behaviour and Attitudes towards Actinic Keratosis in Spain: The PIQA Study

ObjectiveThis study was aimed to examine patients’ knowledge, behaviours and attitudes regarding actinic keratosis (AK) lesions and the impact of the disease on patients’ quality of life (QoL). MethodsObservational study of patients with AK lesions in Spain. QoL was evaluated with the validated version of Spanish AKQoL questionnaire. Skin self-examination, sun-exposure, habits and attitudes towards AK's treatment were recorded using different questionnaires. The adherence was assessed by means of the Morisky-Green test. Among other variables, QoL and adherence to treatment were compared by using Pearson's χ2 test and one-way ANOVA tests. Inferential analysis regarding such factors and length of treatment were also performed. ResultsA total of 1240 patients (73.6 [10.5] years old) were recruited. Overall, patients that showed higher levels of concern were also showed a higher impairment on QoL. AK had greater effects on women's QoL and those who performed skin self-examination, think that AK is a disease and/or believe that moisturizers can prevent skin aging (P<.05). Adherence and length of treatment were strongly related, since patients with treatments intended for <1week were more likely to show good adherence and complete remission of AK (Odds Ratio [95%CI]: 6.25 [4.55-8.33] and 2.63 [1.96-3.45]), respectively). ConclusionsConcerns due to AK are mainly related to sex and to the consideration of AK as a disease. More concerned patients tend to have lower QoL and good adherence to treatment. Short length of treatment was associated with better adherence and complete remission of AK lesions.

Sun Protection and Skin Self-examination and the US Preventive Services Task Force Recommendation on Behavioral Counseling for Skin Cancer Prevention

Sun Protection and Skin Self-examination and the US Preventive Services Task Force Recommendation on Behavioral Counseling for Skin Cancer Prevention

Skin cancer knowledge, attitudes, beliefs, and prevention practices among medical students: A systematic search and literature review.

BackgroundAs future physicians, medical students will play an important role in the prevention of skin cancers by becoming directly involved in skin cancer prevention education and counseling patients about the hazards of ultraviolet light.ObjectiveWe assessed the skin cancer-related knowledge, attitudes, beliefs, and prevention practices reported in previous studies of medical students.MethodsThe search for relevant articles was performed in four electronic databases: PubMed (Medline), Cumulative Index to Nursing and Allied Health, ERIC, and PsycINFO. Studies were included if they met the following criteria: 1) targeted medical students; 2) assessed sun avoidance, sun protection, skin self-examination, and/or indoor tanning behaviors; 3) were published in peer-reviewed journals; and 4) complete data were available for extraction.ResultsA total of 21 studies are included in this review. Important findings include moderate-to-high levels of skin cancer knowledge and low levels of both sunscreen and ultraviolet light knowledge. The attitudes and knowledge of medical students reflect a low level of concern with regard to the perceived importance of skin cancer compared with other forms of cancer despite a high level of concern for the importance of skin cancer prevention. Furthermore, this review demonstrated that medical students fail to protect themselves routinely from the sun and have a high interest in tanning bed use.ConclusionThis review demonstrates the need to educate medical students about skin cancer and skin cancer preventive behaviors. New strategies and educational campaigns should be developed to communicate better information on skin cancer morbidity, mortality, and prevention to medical students. This will pay dividends by improving the practice of these future physicians in all specialties.

Patient Preferences for Follow-up After Recent Excision of a Localized Melanoma

The standard model of follow-up posttreatment of localized melanoma relies on clinician detection of recurrent or new melanoma, through routinely scheduled clinics (clinician-led surveillance). An alternative model is to increase reliance on patient detection of melanoma, with fewer scheduled visits and increased support for patients' skin self-examination (SSE) (eg, using smartphone apps to instruct, prompt and record SSE, and facilitate teledermatology; patient-led surveillance). To determine the proportion of adults treated for localized melanoma who prefer the standard scheduled visit frequency (as per Australian guideline recommendations) or fewer scheduled visits (adapted from the Melanoma Follow-up [MELFO] study of reduced follow-up). This survey study used a telephone interview for surveillance following excision of localized melanoma at an Australian specialist center. We invited a random sample of 400 patients who had completed treatment for localized melanoma in 2014 to participate. They were asked about their preferences for scheduled follow-up, and experience of follow-up in the past 12 months. Those with a recurrent or new primary melanoma diagnosed by the time of interview (0.8-1.7 years since first diagnosis) were asked about how it was first detected and treated. SSE practices were also assessed. Proportion preferring standard vs fewer scheduled clinic visits, median delay between detection and treatment of recurrent or new primary melanoma, and SSE practices. Of the 262 people who agreed to be interviewed, the mean (SD) age was 64.3 (14.3) years, and 93 (36%) were women. Among the 230 people who did not have a recurrent or new primary melanoma, 149 vs 81 preferred the standard vs fewer scheduled clinic visits option (70% vs 30% after adjusting for sampling frame). Factors independently associated with preferring fewer visits were a higher disease stage, melanoma on a limb, living with others, not having private health insurance, and seeing a specialist for another chronic condition. The median delay between first detection and treatment of recurrent or new primary melanoma was 7 and 3 weeks, respectively. Only 8% missed a scheduled visit, while 40% did not perform SSE or did so at greater than 3-month intervals. Some patients with melanoma may prefer fewer scheduled visits, if they are supported to do SSE and there is rapid clinical review of anything causing concern (patient-led surveillance).

Calidad de vida, comportamiento y actitudes hacia la queratosis actínica en España: estudio PIQA

ObjectiveThis study was aimed to examine patients’ knowledge, behaviours and attitudes regarding actinic keratosis (AK) lesions and the impact of the disease on patients’ quality of life (QoL). MethodsObservational study of patients with AK lesions in Spain. QoL was evaluated with the validated version of Spanish AKQoL questionnaire. Skin self-examination, sun-exposure, habits and attitudes towards AK's treatment were recorded using different questionnaires. The adherence was assessed by means of the Morisky-Green test. Among other variables, QoL and adherence to treatment were compared by using Pearson's χ2 test and one-way ANOVA tests. Inferential analysis regarding such factors and length of treatment were also performed. ResultsA total of 1240 patients (73.6 [10.5] years old) were recruited. Overall, patients that showed higher levels of concern were also showed a higher impairment on QoL. AK had greater effects on women's QoL and those who performed skin self-examination, think that AK is a disease and/or believe that moisturizers can prevent skin aging (P<.05). Adherence and length of treatment were strongly related, since patients with treatments intended for <1week were more likely to show good adherence and complete remission of AK (Odds Ratio [95%CI]: 6.25 [4.55-8.33] and 2.63 [1.96-3.45]), respectively). ConclusionsConcerns due to AK are mainly related to sex and to the consideration of AK as a disease. More concerned patients tend to have lower QoL and good adherence to treatment. Short length of treatment was associated with better adherence and complete remission of AK lesions.

Impact of a smartphone application on skin self-examination rates in patients who are new to total body photography: A randomized controlled trial

Impact of a smartphone application on skin self-examination rates in patients who are new to total body photography: A randomized controlled trial

Euromelanoma in Portugal 2010-2016

Introdução: A incidência dos cancros da pele tem vindo a aumentar nos últimos anos em todo o mundo. O alerta das populações para a prevenção primária, promovendo o conhecimento sobre factores de risco e incentivando melhores comportamentos de proteção solar, bem como a prevenção secundária fomentando o auto-exame de pele e rastreios, são estratégias fundamentais da luta contra o cancro da pele. A Sociedade Portuguesa de Dermatologia e Venereologia e a Associação Portuguesa de Cancro Cutâneo, têm colaborado com o Euromelanoma, uma iniciativa pan-Europeia de informação e rastreio de cancro da pele, desde o ano 2000.Material e Métodos: Este estudo transversal consistiu na avaliação dos dados do formulário do Euromelanoma preenchido aquando do rastreio no dia do Euromelanoma, em Portugal Continental e Ilhas, nas instituições públicas e privadas, de 2010 a 2016.Resultados: Foram incluídos 9862 indivíduos, 63% mulheres e 37% homens, com uma média de idades de 48 anos. O número de lesões clinicamente suspeitas de malignidade, ou de risco de malignidade, foi relativamente baixo mas consistente com outros estudos publicados do Euromelanoma: 3% carcinoma basocelular, 0,4% carcinoma espinocelular, 1% melanoma e 6% de queratoses actínicas.Conclusão: A iniciativa do Euromelanoma suscitou a nível nacional e internacional uma maior sensibilização das populações para a temática do cancro da pele, com amplificação das mensagens pela comunicação social, assumindo-se como um importante tema de saúde pública, reconhecido pelas autoridades políticas e sanitárias.

Follow-Up Recommendations after Diagnosis of Primary Cutaneous Melanoma: A Population-Based Study in New South Wales, Australia.

Follow-up practices after diagnosis and treatment of primary cutaneous melanoma vary considerably. We aimed to determine factors associated with recommendations for follow-up setting, frequency, skin surveillance, and concordance with clinical guidelines. The population-based Melanoma Patterns of Care study documented clinicians' recommendations for follow-up for 2148 patients diagnosed with primary cutaneous melanoma over a 12-month period (2006/2007) in New South Wales, Australia. Multivariate log binomial regression models adjusted for patient and lesion characteristics were used to examine factors associated with follow-up practices. Of 2158 melanomas, Breslow thickness was<1mm for 57% and≥1mm for 30%, while in situ melanomas accounted for 13%. Follow-up was recommended for 2063 patients (96%). On multivariate analysis, factors associated with a recommendation for follow-up at a specialist center were Breslow thickness≥1mm [prevalence ratio (PR) 1.05, 95% confidence interval (CI) 1.01-1.09] and initial treatment at a specialist center (PR 1.12, 95% CI 1.08-1.16). Longer follow-up intervals of>3months were more likely to be recommended for females, less likely for people living in rural compared with urban areas, and less likely for thicker (≥1mm) melanomas compared with in situ melanomas. Skin self-examination was encouraged in 84% of consultations and was less likely to be recommended for patients≥70years (PR 0.88, 95% CI 0.84-0.93) and for those with thicker (≥1mm) melanomas (PR 0.92, 95% CI 0.86-0.99). Only 1% of patients were referred for psychological care. Follow-up recommendations were generally consistent with Australian national guidelines for management of melanoma, however some variations could be targeted to improve patient outcomes.

Melanoma Awareness and Self-Examination Practices in Saudi Arabia

Background: Althoughmelanoma rationalizes less than 1% of cases with skin cancer, it accounts for the greater number of skin cancer deaths. Objectives: The objective of this study was to investigate the current knowledge and self-examination practices in Saudi Arabia. Subjects and methods: A cross-control study was conducted using an anonymous web-based survey. A total of 203subjects from Saudi Arabia took part in this survey during the period from 11 December 2017 to 23 December 2017.Participants were asked to fill an anonymous survey about their demographic characteristics, knowledge, attitudes, and practices regarding early detection of melanoma. Results: The majority of the subjects were males (55%), university/post graduates (78%), single (83%) and have no children (89%).Around 76% of our population was aware of melanoma, about 65% were aware of its risk factor, and about 55% could identify its early symptoms. The greater number of subjects 196(96.6%) reported that they did not conduct self-examination. Conclusion: Despite the fact that the majority of our population was aware of melanoma, our study suggests designing and implementing awareness campaigns and programs to highlight the importance of early detection of melanoma and skin self-examination (SSE).