The effectiveness of skin cancer screening and continuing medical education programs toward increasing the survival of patients with malignant melanoma.
The 5-year survival rate for malignant melanoma has increased 40% over the last 50 years. During this same time period, the treatment for the disease has not changed significantly, and consists of wide excision of the primary tumour and perhaps regional node dissection. The purpose of this study was to investigate the possible impact of screening/education programs on melanoma survival. In 1987, a multimodality University-based Melanoma Treatment Center was established and programs were instituted for skin cancer screening and Continuing Medical Education (CME) of health care providers. During the last 5 years, 594 patients with newly diagnosed melanoma have been registered at the clinic. The number of patients with localized (stage 1 or 2, negative regional nodes) disease was 516 (85%). For all stages of disease, the 3-year actuarial survival for this screened population was 85%. From the National Cancer Database of 9879 patients registered with melanoma for 1988, 75% had localized disease and the 3-year survival was 76%. There were significant differences noted between the screened Florida population and the nationwide database using an odds ratio statistic. This involved a higher frequency of patients diagnosed with localized disease (odds ratio = 1.89 (1.49-2.40)) and a better survival (odds ratio = 1.79 (1.41-2.27)) in the screened population served by CME-educated community physicians.
Reintgen
D
D
Department of Surgery, University of South Florida, Tampa 33682-0179.
Cruse
C W
CW
Wells
K
K
Stankard
C
C
Saba
H
H
Schroer
K
K
Cox
C
C
Berman
C
C
Glass
F
F
Alvarez
L
L
D000206:Actuarial Analysis; D005431:Florida / Q000453:epidemiology; D006266:Health Education / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008403:Mass Screening / Q000706:statistics & numerical data; D008545:Melanoma / Q000401:mortality* / Q000517:prevention & control* / Q000601:surgery; D016017:Odds Ratio; D012307:Risk Factors; D012878:Skin Neoplasms / Q000401:mortality* / Q000517:prevention & control* / Q000601:surgery; D016019:Survival Analysis