title: Delay in cutaneous melanoma diagnosis: Sequence analyses from suspicion to diagnosis in 211 patients.
abstract: Advanced melanoma is an incurable disease with complex and expensive treatments. The best approach to prevent melanoma at advanced stages is an early diagnosis. A knowledge of factors associated with the process of detecting cutaneous melanomas and the reasons for delays in diagnosis is essential for the improvement of the secondary prevention of the disease.Identify sociodemographic, individual, and medical aspects related to cutaneous melanoma diagnosis delay.Interviews evaluated the knowledge of melanoma, signals, symptoms, persons who were suspected, delays in seeking medical attention, physician's deferrals, and related factors of 211 patients.Melanomas were self-discovered in 41.7% of the patients; healthcare providers detected 29.9% of patients and others detected 27%. The main component in delay was patient-related. Only 31.3% of the patients knew that melanoma was a serious skin cancer, and most thought that the pigmented lesion was not important, causing a delay in seeking medical assistance. Patients (36.4%) reported a wait interval of more than 6 months from the onset of an observed change in a pigmented lesion to the first visit to a physician. The delay interval from the first physician visit to a histopathological diagnosis was shorter (<1 month) in 55.5% of patients. Improper treatments without a histopathological confirmation occurred in 14.7% of patients. A professional delay was related to both inappropriate treatments performed without histopathological confirmation (P = 0.003) and long requirements for medical referrals (P < 0.001).A deficient knowledge in the population regarding melanoma and physicians' misdiagnoses regarding suspicious lesions contributed to delays in diagnosis.
authors: Faculty of Medical Sciences, Belo Horizonte, MG, Brazil Oncad, Surgical Oncology, Belo Horizonte, Brazil.
authors: Marcus H S B
authors: MHSB
authors: Xavier
authors: Ana P
authors: AP
authors: Drummond-Lage
authors: Cyntia
authors: C
authors: Baeta
authors: Lorena
authors: L
authors: Rocha
authors: Alessandra M
authors: AM
authors: Almeida
authors: Alberto J A
authors: AJA
authors: Wainstein
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001938:Brazil; D016009:Chi-Square Distribution; D015331:Cohort Studies; D057210:Delayed Diagnosis / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000235:genetics; D008875:Middle Aged; D020380:Needs Assessment; D018570:Risk Assessment; D016353:Self-Examination / Q000639:trends; D017421:Sequence Analysis; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000235:genetics; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D000096142:Cutaneous Malignant Melanoma