Dermatologist detection and skin self-examination are associated with thinner melanomas: results from a survey of the Italian Multidisciplinary Group on Melanoma.
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).
Carli
Paolo
P
Department of Dermatology, University of Florence, Via degli Alfani 31, 501221 Florence, Italy. CARLI@unifi.it
De Giorgi
Vincenzo
V
Palli
Domenico
D
Maurichi
Andrea
A
Mulas
Patrizio
P
Orlandi
Catiuscia
C
Imberti
Gian Lorenzo
GL
Stanganelli
Ignazio
I
Soma
Pierfranco
P
Dioguardi
Domenico
D
Catricalá
Caterina
C
Betti
Roberto
R
Cecchi
Roberto
R
Bottoni
Ugo
U
Bonci
Angela
A
Scalvenzi
Massimiliano
M
Giannotti
Benvenuto
B
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