Reliability of assessment and circumstances of performance of thorough skin self-examination for the early detection of melanoma in the Check-It-Out Project.
BACKGROUND
Thorough skin self-examination (TSSE) has substantial potential to reduce melanoma mortality by early detection.


METHODS
We interviewed 2,126 patients before a scheduled routine visit with a primary care physician, at which participation in a randomized trial was offered as part of the Check-It-Out Project. We asked about skin examination behavior and related issues.


RESULTS
By our a priori definition of TSSE, 18% of participants performed this activity, but other definitions led to widely varying estimates of 12% to 38%. Using a partner to assist in the examination was strongly associated with TSSE. That partner was generally the spouse, and wives were more likely to assist their husbands in these examinations than the reverse. The availability of a wall mirror was a particularly important predictor of TSSE performance. Visual impairment also affected performance.


CONCLUSIONS
Estimates of TSSE performance vary substantially with the questions used to elicit this information. Partners, particularly spouses, appear to play a critical role in the conduct of TSSE, and wives appear more often and more effectively engaged in this process. Appropriate circumstances, such as availability of a wall mirror, are also important factors. These findings can be used to design interventions to increase TSSE performance with the ultimate aim of reducing melanoma mortality.
Weinstock
Martin A
MA
Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA. maw@brown.edu
Risica
Patricia M
PM
Martin
Rosemarie A
RA
Rakowski
William
W
Smith
Kevin J
KJ
Berwick
Marianne
M
Goldstein
Michael G
MG
Upegui
David
D
Lasater
Thomas
T
D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis*; D008875:Middle Aged; D015203:Reproducibility of Results; D016353:Self-Examination / Q000379:methods*