title: Predictors of skin self-examination before and after a melanoma diagnosis: the role of medical advice and patient's level of education.
abstract: BACKGROUND
  Cutaneous melanoma is the fastest growing tumor of the skin and the median life span of patients with advanced disease is less than a year. Melanoma-related mortality can be reduced through early detection via clinical skin exams and patient self-examination. Despite the potential to reducing the medical burden associated with clinical skin exams, systematic and regular skin self-examinations (SSE) are rarely performed. The current study examined psychosocial predictors of SSE and changes in SSE behavior from pre- to post-diagnosis in order to guide future melanoma prevention initiatives.
  
  
  RESULTS
  A consecutive sample of 47 melanoma survivors was drawn from a tertiary care clinic. Most melanomas had been detected by patients, spouses and other laypersons. Higher education was related to more frequent SSE at pre-diagnosis, more thorough SSE at post-diagnosis, and more frequent reports of having been advised to perform SSE at post-diagnosis. SSE behaviors increased significantly from pre- to post-diagnosis.
  
  
  CONCLUSIONS
  These findings suggest that different patient subgroups display varied knowledge base, readiness for change, and receptiveness for medical advice. Thus, interventions seeking to enhance skin self-exam practice may be most effective when the individual's psychosocial characteristics are taken into account.
authors: Department of Educational and Counselling Psychology, McGill University, Montréal, Canada. annett.koerner@mcgill.ca.
authors: Annett
authors: A
authors: Körner
authors: Adina
authors: A
authors: Coroiu
authors: Claudia
authors: C
authors: Martins
authors: Beatrice
authors: B
authors: Wang