title: Melanoma detection in Italian pigmented lesion clinics.
abstract: OBJECTIVE
  Accuracy in melanoma detection is important to recognize early curable melanomas and to minimize the unnecessary excision of benign lesions. The aim of this paper was to evaluate melanoma screening accuracy of Italian pigmented lesion clinics in terms of number needed to excise (NNE), melanoma thickness, and number of melanomas diagnosed during patient follow-up.
  
  
  METHODS
  Information on all skin tumors excised in 2011 were extracted from the databases of the participating centers. Information whether the lesion was excised at the baseline examination or during patient follow-up was recorded, as well as the overall number of patients examined in each center in 2011.
  
  
  RESULTS
  After e-mail solicitation, 22 of 40 centers agreed to participate. A total of 8229 excised lesions were collected. The overall number of examined patients was 86.564, thus 9.5% of screened patients had a lesion removed. Of the excised lesions, 866 were diagnosed as melanoma (1% of examined patients) and 5311 (88.9%) were melanocytic nevi. Three NNE were calculated giving values of 7.9 excised lesions to find 1 melanoma, 7.1 melanocytic lesions to find 1 melanoma, and 3.7 lesions to find 1 skin malignancy. The median melanoma thickness was 0.6 mm, with only 15.1% of melanomas ≥ 1 mm of thickness. Melanomas detected over time were 96 (11.1%; mean thickness, 0.3 mm), with 15.6% of lesions excised after short-term follow-up and 84.4% after long-term follow-up.
  
  
  CONCLUSIONS
  The NNE values comparable to those achieved in specialized clinical settings and the high number of early melanomas diagnosed at the baseline examination or during patient follow-up indicate a high level of accuracy in melanoma screening achieved by Italian pigmented lesion clinics.
authors.affiliation: Skin Cancer Unit Arcispedale Santa Maria Nuova IRCCS Reggio Emilia, Italy - g.argenziano@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Argenziano
authors.forename: E
authors.initials: E
authors.lastname: Moscarella
authors.forename: A
authors.initials: A
authors.lastname: Annetta
authors.forename: V C
authors.initials: VC
authors.lastname: Battarra
authors.forename: B
authors.initials: B
authors.lastname: Brunetti
authors.forename: C
authors.initials: C
authors.lastname: Buligan
authors.forename: C
authors.initials: C
authors.lastname: Cantisani
authors.forename: R
authors.initials: R
authors.lastname: Capizzi
authors.forename: A
authors.initials: A
authors.lastname: Carbone
authors.forename: A
authors.initials: A
authors.lastname: Carlino
authors.forename: V
authors.initials: V
authors.lastname: Corsetti
authors.forename: A
authors.initials: A
authors.lastname: Damiano
authors.forename: V
authors.initials: V
authors.lastname: De Salvo
authors.forename: P
authors.initials: P
authors.lastname: De Simone
authors.forename: P
authors.initials: P
authors.lastname: Di Caterino
authors.forename: M C
authors.initials: MC
authors.lastname: Fargnoli
authors.forename: A
authors.initials: A
authors.lastname: Ferrari
authors.forename: B
authors.initials: B
authors.lastname: Fossati
authors.forename: P
authors.initials: P
authors.lastname: Frascione
authors.forename: G
authors.initials: G
authors.lastname: Ghigliotti
authors.forename: M A
authors.initials: MA
authors.lastname: González Inchaurraga
authors.forename: C
authors.initials: C
authors.lastname: Guerriero
authors.forename: C
authors.initials: C
authors.lastname: Landi
authors.forename: L
authors.initials: L
authors.lastname: Mazzoni
authors.forename: S
authors.initials: S
authors.lastname: Mirizzi
authors.forename: G
authors.initials: G
authors.lastname: Palazzo
authors.forename: A
authors.initials: A
authors.lastname: Pedretti
authors.forename: K
authors.initials: K
authors.lastname: Peris
authors.forename: P
authors.initials: P
authors.lastname: Piemonte
authors.forename: A
authors.initials: A
authors.lastname: Rossi
authors.forename: R
authors.initials: R
authors.lastname: Satta
authors.forename: F
authors.initials: F
authors.lastname: Savoia
authors.forename: M
authors.initials: M
authors.lastname: Scalvenzi
authors.forename: I
authors.initials: I
authors.lastname: Stanganelli
authors.forename: G
authors.initials: G
authors.lastname: Stinco
authors.forename: P
authors.initials: P
authors.lastname: Zampieri
authors.forename: I
authors.initials: I
authors.lastname: Zalaudek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D002280:Basal Cell Carcinoma / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D003880:Dermatology / Q000458:organization & administration*; D046169:Dermoscopy; D055088:Early Detection of Cancer; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D017492:Keratosis, Seborrheic / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D060787:Neoplasm Grading; D009508:Nevus, Pigmented / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D055815:Young Adult