Physicians key in detecting melanomas early

NEW YORK (Reuters Health) - Among middle-age and older men, physician-detected invasive melanomas tend to be thinner than those discovered by patients or their domestic partners.

"Public education, in particular targeting less-educated, middle-aged and older men for improved self-examination and physician skin surveillance should become an integral component of skin cancer risk reduction strategies promoted by cancer advocacy organizations," write Dr. Susan M. Swetter, at Stanford University Medical Center, California, and co-investigators.

Melanoma is the most serious form of skin cancer. It can be cured if it is diagnosed and treated in the early stages, but melanoma is difficult to control once it spreads to other areas of the body.

To identify behavioral, social, and medical access factors that differ between men with thinner versus thick melanomas, Swetter's team surveyed 227 men (ages 40-88 years) within 3 months of diagnosis of invasive cutaneous melanoma. One quarter of the men had tumors that were more than 2.00 millimeter thick. The findings are reported in the current issue of the Archives of Dermatology.

The authors found that "thinner tumors were associated with (1) physician detection, (2) a higher melanoma awareness and certain health preventive attitudes, (3) a higher level of education, and (4) the presence of atypical nevi (moles)."

In addition to targeted public education, the researchers recommend that medical schools and primary care residency programs "consider intensive efforts to teach the skin cancer examination."

Another path toward earlier detection of malignant melanoma, Dr. June K. Robinson, at Feinberg School of Medicine in Chicago, and colleagues suggest in a related editorial, is the comprehensive training of patients by physicians on how to conduct skin self-examinations.

SOURCE: Archives of Dermatology, April 2009.