Recent skin self-examination and doctor visits in relation to melanoma risk and tumour depth.
BACKGROUND
Little is known about the potential benefit of skin self-examination for melanoma prevention and early detection.


OBJECTIVE
To determine whether skin self-examination is associated with reduced melanoma risk, self-detection of tumours, and reduced risk of deeper melanomas.


METHODS
We used data from a population-based case-control study (423 cases, 678 controls) to assess recent skin self-examination in relation to self-detection, melanoma risk and tumour depth ( ≤1 mm; > 1 mm). Logistic regression was used to estimate odds ratios (ORs) and confidence intervals (CIs) for associations of interest.


RESULTS
Skin self-examination conducted 1-11 times during a recent year was associated with a possible decrease in melanoma risk (OR 0·74; 95% CI 0·54-1·02). Melanoma risk was decreased for those who conducted skin self-examination and saw a doctor (OR 0·52; 95% CI 0·30-0·90). Among cases, those who examined their skin were twice as likely to self-detect the melanoma (OR 2·23; 95% CI 1·47-3·38), but self-detection was not associated with shallower tumours. Tumour depth was reduced for those who conducted skin self-examination 1-11 times during a recent year (OR 0·39; 95% CI 0·18-0·81), but was not influenced by seeing a doctor, or by conducting skin self-examination and seeing a doctor.


CONCLUSIONS
Risk of a deeper tumour and possibly risk of melanoma were reduced by skin self-examination 1-11 times annually. Melanoma risk was markedly reduced by skin self-examination coupled with a doctor visit. We cannot, however, exclude the possibility that our findings reflect bias or confounding. Additional studies are needed to elucidate the potential benefits of skin self-examination for melanoma prevention and early detection.
Department of Community and Family Medicine, Dartmouth Medical School, Norris Cotton Cancer Center, Lebanon, NH 03756, USA. linda.titus@dartmouth.edu
L J
LJ
Titus
K
K
Clough-Gorr
T A
TA
Mackenzie
A
A
Perry
S K
SK
Spencer
J
J
Weiss
S
S
Abrahams-Gessel
M S
MS
Ernstoff
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012307:Risk Factors; D016353:Self-Examination / Q000379:methods*; D012878:Skin Neoplasms / Q000473:pathology*