title: Are we seeing the effects of public awareness campaigns? A 10-year analysis of Breslow thickness at presentation of malignant melanoma in the South West of England.
abstract: BACKGROUND
  The last 20 years has seen a marked improvement in skin cancer awareness campaigns. We sought to establish whether this has affected the presenting Breslow thickness of malignant melanoma in the South West.
  
  
  METHODS
  This is a retrospective study looking at the first presentation of melanomas from 2003 to 2011. Data was accessed using the local online melanoma database.
  
  
  RESULTS
  A total of 2001 new melanomas presented from 2003 to 2012 (Male:Female = 1:1.062). The average yearly number of melanomas was 200.1 (range = 138-312). The mean age was 62.5 years (range 12-99). Data was analysed using a Chi² test. For 0-1 mm melanomas, there is a significant difference in the observed versus expected values over the 10 years (p = 0.0018). There is an increasing proportion of 0-1 mm (thin) melanomas presenting year on year, with a positive linear trend. This is very statistically significant (p < 0.0001). The 1-2 mm melanomas are decreasing in proportion with a negative linear trend (p = 0.0013). The 2-4 mm are also decreasing in proportion (p = 0.0253). There is no significant change in the thick >4 mm melanomas (p = 0.1456).
  
  
  CONCLUSIONS
  The proportion of thin 0-1 mm melanomas presenting in South West England has significantly increased from 2003 to 2012. There is no significant change in the thick >4 mm melanomas. This may be a result of increased public awareness due to effective public health campaigns which has significant prognostic and financial implications.
authors.affiliation: Department of Plastic Surgery, Royal Devon & Exeter Hospital, Barrack Road, Exeter, Devon EX2 5DW, UK. Electronic address: acgarmstrong@doctors.net.uk.
authors.forename: A
authors.initials: A
authors.lastname: Armstrong
authors.affiliation: Department of Plastic Surgery, Royal Devon & Exeter Hospital, Barrack Road, Exeter, Devon EX2 5DW, UK; Specialist Training Registrar in Plastic Surgery, Frenchay Hospital, Frenchay Park Rd, Bristol, South Gloucestershire BS16 1LE, UK.
authors.forename: C
authors.initials: C
authors.lastname: Powell
authors.affiliation: Department of Plastic Surgery, Royal Devon & Exeter Hospital, Barrack Road, Exeter, Devon EX2 5DW, UK; Research Design Consultant, Research Design Service (RDS) South West, Royal Devon and Exeter Hospital, Barrack Road, Exeter, Devon EX2 5DW, UK.
authors.forename: R
authors.initials: R
authors.lastname: Powell
authors.affiliation: Department of Plastic Surgery, Royal Devon & Exeter Hospital, Barrack Road, Exeter, Devon EX2 5DW, UK; Cancer Audit Facilitator, Royal Devon and Exeter Hospital, Barrack Road, Exeter, Devon EX2 5DW, UK.
authors.forename: N
authors.initials: N
authors.lastname: Hallam
authors.affiliation: Department of Plastic Surgery, Royal Devon & Exeter Hospital, Barrack Road, Exeter, Devon EX2 5DW, UK; Department of Radiology, Royal Devon and Exeter Hospital, Barrack Road, Exeter, Devon EX2 5DW, UK.
authors.forename: J
authors.initials: J
authors.lastname: Taylor
authors.affiliation: Department of Plastic Surgery, Royal Devon & Exeter Hospital, Barrack Road, Exeter, Devon EX2 5DW, UK; Research Fellow ENT Surgery, University Hospital Southampton NHS Foundation Trust, Tremona Road, Hampshire SO16 6YD, UK.
authors.forename: J
authors.initials: J
authors.lastname: Bird
authors.affiliation: Department of Plastic Surgery, Royal Devon & Exeter Hospital, Barrack Road, Exeter, Devon EX2 5DW, UK; Heath Research Analyst, Met Office, Fitzroy Road, Exeter, Devon EX1 3PB, UK.
authors.forename: C
authors.initials: C
authors.lastname: Sarran
authors.affiliation: Department of Plastic Surgery, Royal Devon & Exeter Hospital, Barrack Road, Exeter, Devon EX2 5DW, UK; Consultant Plastic Surgeon, Department of Plastic Surgery, Royal Devon & Exeter Hospital, Barrack Road, Exeter, Devon EX2 5DW, UK.
authors.forename: D
authors.initials: D
authors.lastname: Oliver
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004739:England; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology* / Q000517:prevention & control; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology* / Q000517:prevention & control; D055815:Young Adult
keywords: Breslow thickness; Melanoma; Patient education; Public awareness; Sun bed; UV