title: Factors associated with physician discovery of early melanoma in middle-aged and older men.
abstract: OBJECTIVE
  To determine factors associated with physician discovery of early melanoma in middle-aged and older men.
  
  
  METHODS
  Survey.
  
  
  METHODS
  Three institutional melanoma clinics.
  
  
  METHODS
  A total of 227 male participants (aged > or =40 years) with invasive melanoma who completed surveys within 3 months of diagnosis. Intervention Survey.
  
  
  METHODS
  Factors associated with physician-detected thin melanoma.
  
  
  RESULTS
  Patients with physician-detected melanoma were older, 57% were 65 years or older compared with 34% for other-detected (odds ratio [OR], 2.57; 95% confidence interval [CI], 1.19-5.55) and 42% for patient-detected melanoma (P = .07). Physician-detected melanoma in the oldest patients (aged > or =65 years) had tumor thickness equal to that of self-detected melanoma or melanoma detected by other means in younger patients. Back lesions composed 46% of all physician-detected melanoma, 57% of those detected by other means, and 16% of self-detected lesions (physician- vs self-detected: OR, 4.25; 95% CI, 1.96-9.23). Ninety-two percent of all physician-detected back-of-the-body melanomas were smaller than 2 mm compared with 63% of self-detected lesions (P = .004) and 76% of lesions detected by other means (P = .07).
  
  
  CONCLUSIONS
  Skin screenings of at-risk middle-aged and older American men can be integrated into the routine physical examination, with particular emphasis on hard-to-see areas, such as the back of the body. "Watch your back" professional education campaigns should be promoted by skin cancer advocacy organizations.
authors.affiliation: Department of Dermatology, Boston University School of Medicine, 720 Harrison Ave, DOB 801A, Boston, MA 02118, USA. ageller@bu.edu
authors.forename: Alan C
authors.initials: AC
authors.lastname: Geller
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Johnson
authors.forename: Donald R
authors.initials: DR
authors.lastname: Miller
authors.forename: Katie R
authors.initials: KR
authors.lastname: Brooks
authors.forename: Christle J
authors.initials: CJ
authors.lastname: Layton
authors.forename: Susan M
authors.initials: SM
authors.lastname: Swetter
mesh_terms: D000368:Aged; D003880:Dermatology; D042241:Early Diagnosis; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D010353:Patient Education as Topic; D010820:Physicians; D012648:Self Care; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology