title: Dermatologist detection and skin self-examination are associated with thinner melanomas: results from a survey of the Italian Multidisciplinary Group on Melanoma.
abstract: OBJECTIVE
  To investigate patterns of detection and variables associated with early diagnosis of melanoma in a population at intermediate melanoma risk.
  
  
  METHODS
  Survey.
  
  
  METHODS
  Hospital and university centers belonging to the Italian Multidisciplinary Group on Melanoma.
  
  
  METHODS
  Eight hundred sixteen patients who were consecutively diagnosed as having melanoma and treated at 11 participating centers.
  
  
  METHODS
  Relationship between patterns of detection and patient's and physician's delay with melanoma thickness, assessed by multivariate analysis.
  
  
  RESULTS
  A statistically significant association with early diagnosis was found for female sex (odds ratio [OR] for a lesion >1 mm in thickness, 0.70; 95% confidence interval [CI], 0.50-0.97), higher educational level (OR, 0.44; 95% CI, 0.24-0.79), residence in northern and central Italy (compared with southern Italy) (OR, 0.44; 95% CI, 0.30-0.65 and OR, 0.24; 95% CI, 0.15-0.37, respectively), and the habit of performing a skin self-examination (OR, 0.65; 95% CI, 0.45-0.93). When adjusted for all the previously mentioned variables, only melanoma detection made by a dermatologist, maybe incidentally, was associated with a statistically significant additional effect on early diagnosis (OR, 0.45; 95% CI, 0.28-0.73). No significant effect of anatomical site (trunk compared with other sites: OR, 0.83; 95% CI, 0.59-1.17), presence of atypical nevi (OR, 0.78; 95% CI, 0.52-1.17), and patient's delay (>3 months compared with < or =3 months: OR, 1.12; 95% CI, 0.78-1.60) was found.
  
  
  CONCLUSIONS
  Future melanoma early diagnosis strategies should adequately stress the role of skin self-examination among the adult population, and should recommend that dermatologists perform a total skin examination to identify suspect lesions (such an examination should also be performed during consultations for other reasons).
authors.affiliation: Department of Dermatology, University of Florence, Via degli Alfani 31, 501221 Florence, Italy. CARLI@unifi.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Carli
authors.forename: Vincenzo
authors.initials: V
authors.lastname: De Giorgi
authors.forename: Domenico
authors.initials: D
authors.lastname: Palli
authors.forename: Andrea
authors.initials: A
authors.lastname: Maurichi
authors.forename: Patrizio
authors.initials: P
authors.lastname: Mulas
authors.forename: Catiuscia
authors.initials: C
authors.lastname: Orlandi
authors.forename: Gian Lorenzo
authors.initials: GL
authors.lastname: Imberti
authors.forename: Ignazio
authors.initials: I
authors.lastname: Stanganelli
authors.forename: Pierfranco
authors.initials: P
authors.lastname: Soma
authors.forename: Domenico
authors.initials: D
authors.lastname: Dioguardi
authors.forename: Caterina
authors.initials: C
authors.lastname: Catricalá
authors.forename: Roberto
authors.initials: R
authors.lastname: Betti
authors.forename: Roberto
authors.initials: R
authors.lastname: Cecchi
authors.forename: Ugo
authors.initials: U
authors.lastname: Bottoni
authors.forename: Angela
authors.initials: A
authors.lastname: Bonci
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Scalvenzi
authors.forename: Benvenuto
authors.initials: B
authors.lastname: Giannotti
mesh_terms: D000328:Adult; D000368:Aged; D003880:Dermatology / Q000706:statistics & numerical data*; D003937:Diagnosis, Differential; D005260:Female; D019538:Health Care Surveys / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012307:Risk Factors; D016353:Self-Examination / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D013997:Time Factors