title: Melanoma early detection with thorough skin self-examination: the "Check It Out" randomized trial.
abstract: BACKGROUND
  Monthly thorough skin self-examination (TSSE) is an important practice for early melanoma detection that is performed by a small minority of the population.
  
  
  METHODS
  A randomized trial was conducted to determine whether a multicomponent intervention can increase TSSE performance and to describe the effects on performance of skin surgeries compared with a similar control intervention focused on diet.
  
  
  METHODS
  One thousand three hundred fifty-six patients attending a routine primary care visit in southeastern New England participated in this trial.
  
  
  METHODS
  Participants received instructional materials, including cues and aids, a video, and a brief counseling session and (at 3 weeks) a brief follow-up phone call (from a health educator) and tailored feedback letters.
  
  
  METHODS
  Performance of TSSE assessed by telephone interview and having a surgical procedure performed on the skin were confirmed by examining medical records.
  
  
  RESULTS
  TSSE was performed by substantially more participants at 2, 6, and 12 months in the intervention group than in the control group (55% vs 35%, p<0.0001 at 12 months). We also noted that a substantially higher proportion in the intervention group had skin surgery in the first 6 months (8.0% vs 3.6%, p=0.0005), but there was no difference at 6 to 12 months (3.9% vs 3.3%, p=0.5).
  
  
  CONCLUSIONS
  The TSSE intervention was effective in increasing performance of TSSE, in that it resulted in increased surgery on the skin, and that increase in skin procedures only persisted for 6 months. Intervention to increase TSSE may result in long-term benefit in early detection of melanoma while causing only a short-term excess of skin surgeries.
authors.affiliation: Dermatoepidemiology Unit, VA Medical Center Providence, Brown University, 830 Chalkstone Avenue, Providence, RI 02908, USA. maw@brown.edu
authors.forename: Martin A
authors.initials: MA
authors.lastname: Weinstock
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Risica
authors.forename: Rosemarie A
authors.initials: RA
authors.lastname: Martin
authors.forename: William
authors.initials: W
authors.lastname: Rakowski
authors.forename: Catherine
authors.initials: C
authors.lastname: Dubé
authors.forename: Marianne
authors.initials: M
authors.lastname: Berwick
authors.forename: Michael G
authors.initials: MG
authors.lastname: Goldstein
authors.forename: Suddhasatta
authors.initials: S
authors.lastname: Acharyya
authors.forename: Thomas
authors.initials: T
authors.lastname: Lasater
mesh_terms: D000328:Adult; D000368:Aged; D062109:Dermatologic Surgical Procedures; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008545:Melanoma / Q000145:classification / Q000175:diagnosis*; D008875:Middle Aged; D009511:New England; D016353:Self-Examination / Q000706:statistics & numerical data*