title: Visual images for patient skin self-examination and melanoma detection: a systematic review of published studies.
abstract: BACKGROUND
  Early detection of skin cancer by patients is an important strategy for reducing morbidity and mortality caused by melanoma. However, the effectiveness of interventions or educational aids that use visual images to promote skin self-examination (SSE) and early melanoma detection has not been systematically investigated.
  
  
  OBJECTIVE
  We undertook a systematic review of peer-reviewed research on SSE for skin cancer to examine the outcomes of studies that used visual images as part of their methodology. Our objective was to describe the impact of visual images on patient SSE knowledge, attitudes, behaviors, and accuracy.
  
  
  METHODS
  Seven databases were searched resulting in 5330 citations. A total of 25 studies met the inclusion criteria.
  
  
  RESULTS
  Images positively affected knowledge and self-efficacy related to SSE. Images motivated the performance of SSE and increased the accuracy of SSE and melanoma detection. The types of visual images that were effective are described and the implications are discussed.
  
  
  CONCLUSIONS
  Articles not uncovered by the search strategy may have been unintentionally excluded. Lack of image description in the studies made specific recommendations challenging.
  
  
  CONCLUSIONS
  The use of visual images to promote accurate and frequent SSE is encouraged.
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: McWhirter
authors.forename: Laurie
authors.initials: L
authors.lastname: Hoffman-Goetz
mesh_terms: D055088:Early Detection of Cancer / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008545:Melanoma / Q000175:diagnosis*; D016353:Self-Examination / Q000379:methods*; D012878:Skin Neoplasms / Q000175:diagnosis*