Family physician visits and early recognition of melanoma.
BACKGROUND
Malignant melanoma is a deadly skin cancer with a rapidly-increasing incidence, mortality and public health burden. Thin melanomas are easily treated with good prognosis, while the thicker lesions have relatively poor survival. To broaden strategies for early recognition of melanoma, we investigated the relationship between primary care service and melanoma thickness at diagnosis.


METHODS
All 714 patients diagnosed with a primary malignant melanoma between January 1995 and December 1999 in Nova Scotia were included in the present study and linked to provincial physician billing databases to reveal the patients' use of family physician services prior to the diagnosis of melanoma. We examined the importance of physician use of services for tumour thickness using logistic regression while adjusting for potential confounders. Tumour thickness was dichotomized to thin and thick using 0.75 mm as a cutoff.


RESULTS
Patients who regularly visited their family physician (2 to 5 times during a two-year interval prior to diagnosis) were 66% (95% CI, 31-84) less likely to be diagnosed with thick melanoma as compared to patients who consulted their family physician less or not at all. Progression to thick tumours could have been reduced by 11.70% (95% CI, -1.33-25.77) if all patients had consulted their family physician at least once a year.


CONCLUSIONS
Increased awareness of the need for regular medical check-ups could reduce the public health burden of melanoma.
Di Quinzio
Melanie L
ML
Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS.
Dewar
Ron A
RA
Burge
Frederick I
FI
Veugelers
Paul J
PJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005194:Family Practice; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D008875:Middle Aged; D009674:Nova Scotia / Q000453:epidemiology; D011634:Public Health; D012042:Registries; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology