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Physician Screening Increases Melanoma Detection Rate

Detection of thinner melanomas and higher detection rate attributed to dermatologist screening

FRIDAY, July 22 (HealthDay News) -- Physician-based screening is associated with higher melanoma detection and detection of thinner melanomas, according to a study published online July 18 in the Archives of Dermatology.

Ivanka Kovalyshyn, D.O., from the Memorial Sloan-Kettering Cancer Center in New York City, and colleagues compared melanoma characteristics and detection patterns in pigmented lesions in new versus established patients in an academic practice of two dermatologists with pigmented skin lesion management expertise. Data from 394 patients with cutaneous melanoma, diagnosed between 1998 and 2008, were used to assess the impact of physician screening on the rate of melanoma detection. The participants were divided into two groups: established patients receiving treatment in a pigmented lesion clinic for at least three months, and new patients.

The investigators found that, compared with new patients, established patients had significantly more in situ disease (70 versus 57 percent), significantly thinner invasive melanomas (0.45 mm versus 0.82 mm), and a lower likelihood of negative prognostic attributes, such as ulceration and dermal mitoses. Physicians detected 63 percent of melanomas in new patients, as opposed to 82 percent in established patients. Dermatologist detection was associated with thinner melanomas than self-detected melanomas. A total of 18 percent of all melanomas were patient detected, and change in pre-existing lesion (64 percent) was the most common reason for the detection. Over the 10-year period, the overall benign to malignant biopsy ratio was 5.4:1.

"This study suggests that physician screening leads to higher rates of physician-detected melanoma and detection of thinner melanoma," the authors write.

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