Early Detection Strategies for Melanoma Compared
In this study, the investigators aimed to reduce melanoma mortality by improving understanding of modifiable factors related to early detection. To meet this aim, the investigators surveyed 566 adults with invasive melanoma on demographics, health care access, SSE, and PSE practices during the year before diagnosis. “SSE was measured by use of a melanoma picture aid and routine examination of some/all body sites vs none; patient-reported partial or full-body PSE also was assessed,” they wrote. “Melanoma thickness was dichotomized at 1 mm.”
Demographically, this study enrolled patients aged 18 to 99 years, (61% male). From this population, measured median tumor thickness was 1.25 mm; 321 tumors (57%) were >1 mm thick. “Thinner tumors (≤1 mm) were associated with age ≤60 years (P=.0002), women (P=.0127), higher education level (P=.0122), and physician discovery (P≤.0001),” they reported. Patients who performed routine SSE were more likely to have thinner tumors than those who did not (odds ratio [OR], 2.66; 95% CI, 1.48–4.80), whereas full-body PSE was associated with thinner tumors (OR, 2.51; 95% CI, 1.62–3.87), largely because of the effect of PSE in men aged >60 years (OR, 4.09 95% CI, 1.88–8.89).
The investigators concluded that SSE and PSE are complementary early detection strategies, particularly in men aged >60 years. “Also, given the high rates of physician access, PSE may be a more practical approach for successful early detection in this subgroup with highest mortality.”