title: Demographic, behavioural and physician-related determinants of early melanoma detection in a low-incidence population.
abstract: BACKGROUND
  Knowledge of the factors that influence early detection of melanoma is important in developing strategies to reduce associated mortality.
  
  
  OBJECTIVE
  To identify sociodemographic, behavioural and medical care-related factors associated with melanoma thickness in a low-incidence population but with a high case fatality.
  
  
  METHODS
  In a multicentre, retrospective, survey-based study of 202 patients with a recent diagnosis of invasive melanoma (< 1 year), we collected data on demographic and behavioural factors, attitudes towards prevention, access to medical care, frequency of skin self-examination (SSE) and physician skin examination (PSE) in relation to melanoma thickness.
  
  
  RESULTS
  Thinner tumours (≤ 1 mm, 80 melanomas) were associated with female sex (P ≤ 0.049), nonnodular (superficial spreading melanoma, lentigo maligna melanoma, acral lentiginous melanoma) histological subtypes (P < 0.001), absence of ulceration (P ≤ 0.001), and location other than lower extremity or trunk location (P ≤ 0.004). Patients married at the time of diagnosis or who performed SSE during the year prior to diagnosis were more likely to have thinner tumours than those who did not [odds ratio (OR) 3.45, 95% confidence interval (CI) 1.48-8.04 and OR 2.43, 95% CI 1.10-5.34, respectively]. Full-body skin examination by a physician was not significantly associated with thinner melanoma (OR 1.99, 95% CI 0.66-6.07).
  
  
  CONCLUSIONS
  SSE was shown to be an important factor in the detection of thin melanoma, in contrast to partial or full-body PSE, which did not show any statistically significant effect on tumour thickness.
authors.affiliation: Department of Dermatology, University of Athens Medical School, Andreas Sygros Hospital, Dragoumi 5, 161 21, Athens, Greece.
authors.forename: J A
authors.initials: JA
authors.lastname: Talaganis
authors.forename: K
authors.initials: K
authors.lastname: Biello
authors.forename: M
authors.initials: M
authors.lastname: Plaka
authors.forename: D
authors.initials: D
authors.lastname: Polydorou
authors.forename: O
authors.initials: O
authors.lastname: Papadopoulos
authors.forename: M
authors.initials: M
authors.lastname: Trakatelli
authors.forename: D
authors.initials: D
authors.lastname: Sotiriadis
authors.forename: D
authors.initials: D
authors.lastname: Tsoutsos
authors.forename: G
authors.initials: G
authors.lastname: Kechagias
authors.forename: H
authors.initials: H
authors.lastname: Gogas
authors.forename: C
authors.initials: C
authors.lastname: Antoniou
authors.forename: S M
authors.initials: SM
authors.lastname: Swetter
authors.forename: A C
authors.initials: AC
authors.lastname: Geller
authors.forename: A J
authors.initials: AJ
authors.lastname: Stratigos
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D055088:Early Detection of Cancer / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006115:Greece / Q000453:epidemiology; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D017533:Marital Status; D008545:Melanoma / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010808:Physical Examination / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016353:Self-Examination / Q000379:methods / Q000706:statistics & numerical data; D012737:Sex Factors; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000453:epidemiology