[Impact of French consensus conference concerning the follow-up of patients surgically treated for stage I melanoma among French dermatologists and oncologists].
BACKGROUND
Our aim was to assess the impact of the 1995 French Consensus Conference (CC) on the follow up of patients surgically treated for WHO stage I (AJCC/UICC stages IA to IIB) melanoma, two years after the recommendations had been provided to French dermatologists and oncologists by direct mailing and literature. Prior to this CC, a study of French dematologists' intentions of practice and dermatologists and oncologists effective practices had revealed a lack of homogeneity and the prescription of many paraclinical tests.


METHODS
In 1997, we sent a questionnaire similar to 1995's one to French dermatologists (3585 practitioners) and oncologists (686), with a pre-paid envelop for the response. The statistical analysis compared these results with those of 1995 for dermatologists, and the results for dermatologists and oncologists using chi(2) test.


RESULTS
The response rate was 29 p. 100 for dermatologists, 15 p. 100 for oncologists. Only the number of dermatologists following patients in private practice was increased. Prescriptions of paraclinical tests by dermatologists during initial investigation as well as during follow up dramatically decreased (-30 p. 100 to -50 p. 100), mainly for thoracoabdominal and brain computerized tomography scans and biological tests, to a lesser extent for chest X-rays and abdominal ultrasonographies. Prescriptions of paraclinical tests were higher among oncologists. The frequency of clinical surveillance in 1997 was more often as recommended. Detection of a second melanoma in the patients and their family had improved. However, oncologists' intentions of practice complied less to the CC as compared to dermatologists.


CONCLUSIONS
This study clearly showed an impact of the CC in French dermatologists' intentions of practice leading to both an improvement of patient follow up and a reduction in its cost. This impact was not as great among oncologists.
Bafounta
M L
ML
Service de dermatologie, Centre Hospitalier Universitaire Ambroise-Paré, 9, avenue Charles-de-Gaulle, 92104 Boulogne, France.
Beauchet
A
A
Poisson-Salomon
A S
AS
Saiag
P
P
D003245:Consensus Statements as Topic; D003880:Dermatology; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D008495:Medical Oncology; D008545:Melanoma / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D010818:Practice Patterns, Physicians'; D012878:Skin Neoplasms / Q000473:pathology / Q000628:therapy*; D011795:Surveys and Questionnaires