Time to diagnosis of melanoma: same trend in different continents.
BACKGROUND
Patients and physicians both play an important role in the diagnosis of malignant melanoma.


OBJECTIVE
The purpose of this study was to assess important factors of delay in diagnosis at different centers and on three continents.


METHODS
Between October 2001 and October 2002, patients with histologically confirmed invasive melanoma were included in the study and given an established questionnaire. Recorded patients and tumor characteristics included age, sex, anatomic location, Breslow thickness, patients' awareness of the lesion and time with suspicion, and physicians' time (delay) before the operation.


RESULTS
The study included 985 patients (486 males, 499 females): 253 from Germany, 464 from Sweden, 58 from Brazil, and 210 from Australia. More females detected their lesions by themselves. The change to a darker color (21%) and enlargement of the area of the lesion (19%) were the major signs. The highest knowledge among patients that early detection may improve the outcome was found in Sweden and Australia. At each center, the media (newspaper, magazine, radio, and television) provided the best sources of information about melanoma. Twenty to 33% of all physicians initially consulted missed the melanoma diagnosis, independent of their specialty.


CONCLUSIONS
There are still factors for the delay in melanoma diagnosis in different countries and continents, but the differences are rather small. The results should be included in planning prevention campaigns in this specific field and in the education of medical students, physicians of all specialties, and other health professionals.
Blum
Andreas
A
Department of Dermatology, University of Tuebingen, Tuebingen, Germany. a.blum@derma.de
Ingvar
Christian
C
Avramidis
Michelle
M
von Kannen
Andreas
A
Menzies
Scott W
SW
Olsson
Håkan
H
Rezze
Gisele G
GG
Wennberg
Ann-Marie
AM
Westerhoff
Karin
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis*; D008875:Middle Aged; D012878:Skin Neoplasms / Q000175:diagnosis*; D013997:Time Factors