title: Time to diagnosis of melanoma: same trend in different continents.
abstract: 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.
authors.affiliation: Department of Dermatology, University of Tuebingen, Tuebingen, Germany. a.blum@derma.de
authors.forename: Andreas
authors.initials: A
authors.lastname: Blum
authors.forename: Christian
authors.initials: C
authors.lastname: Ingvar
authors.forename: Michelle
authors.initials: M
authors.lastname: Avramidis
authors.forename: Andreas
authors.initials: A
authors.lastname: von Kannen
authors.forename: Scott W
authors.initials: SW
authors.lastname: Menzies
authors.forename: Håkan
authors.initials: H
authors.lastname: Olsson
authors.forename: Gisele G
authors.initials: GG
authors.lastname: Rezze
authors.forename: Ann-Marie
authors.initials: AM
authors.lastname: Wennberg
authors.forename: Karin
authors.initials: K
authors.lastname: Westerhoff
mesh_terms: 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