Factors associated with physician discovery of early melanoma in middle-aged and older men.
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.
Geller
Alan C
AC
Department of Dermatology, Boston University School of Medicine, 720 Harrison Ave, DOB 801A, Boston, MA 02118, USA. ageller@bu.edu
Johnson
Timothy M
TM
Miller
Donald R
DR
Brooks
Katie R
KR
Layton
Christle J
CJ
Swetter
Susan M
SM
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