Accuracy of malignant melanoma detection in the community.
Malignant melanoma (MM) has increased profoundly in the past three-four decades in white populations worldwide. Early diagnosis is crucial for successful treatment. We aimed to assess the accuracy rate of diagnosing MM in the community by the surgeon and referring physicians. We prospectively collected data on all patients with preoperatively suspected or histologically proven MM, treated by a single plastic surgeon, between October 2001 and April 2005. Data were statistically analyzed using Excel software. Of the 50 patients with histopathologically proven MM, 74% were referred by dermatologists, 16% by primary caregivers, and 10% came independently or were under supervision of the operating plastic surgeon. Eighty percent MM lesions were early-stage, under 1 mm. Forty lesions were diagnosed clinically as MM by the plastic surgeon prior to surgery. Dermatologists diagnosed MM in only 30% of cases; the other 70% were referred for removal of suspect lesions. Dermatologists referred most MM cases. The high number of patients diagnosed with early stage MM (80%) reflects the efficiency of medical care in our community. We conclude that the diagnosis of MM in our community is efficient and derives from the balanced partnership between surgeons, dermatologists, primary caregivers, and patient awareness.
Department of Plastic Surgery, Assaf Harofeh Medical Center, Zerifin, Israel.
Doron
D
Klein
Melvyn
M
Westreich
Avshalom
A
Shalom
D000328:Adult; D015331:Cohort Studies; D003880:Dermatology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000601:surgery; D008875:Middle Aged; D009367:Neoplasm Staging; D011320:Primary Health Care; D012017:Referral and Consultation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000601:surgery