摘要
Self-detection of suspicious pigmented skin lesion combined with rapid referr al to dermatologie centres is the key strategy in the fight against melanoma. Th e investigation of factors associated with pattern of detection of melanoma (sel f-vs. nonself-detection) may be useful to refine educational strategies for th e future. We investigated the frequency of melanoma self-detection in a Mediter ranean populat ionatintermediatemelanoma risk. A multicentric survey identified 816 consecutive cases of cutaneous melanoma in the period January to December 20 01 in 11 Italian clinical centres belonging to the Italian Multidisciplinary Group on M elanoma. All patients filled a standardized questionnaire and were clinically ex amined by expert dermatologists. Self-detected melanomas were 40.6%, while the remaining lesions were detected by a dermatologist (18.5%), the family physici an (15.2%), other specialists (5%), the spouse (12.5%), a friend or someone e lse (8.2%). Variablesassociated with self-detected melanomas were female sex, young age, absence of atypical nevi, knowledge of the ABCD rule, habit of perfor ming skin self-examination. Self-detected melanomas did not differ from nonsel f-detected tumours in term of lesion thickness; however, patients with self-de tected melanomas waited a longer period before having a diagnostic confirmation (patient’s delay) (>3 months:odds ratio, 3.89; 95%confidence interval, 2.74- 5.53). In order to reduce the patients’delays, educational messages should adeq uately stress the need for a prompt referral to a physician once a suspicious pi gmented lesion is self-detected.
Self-detection of suspicious pigmented skin lesion combined with rapid referr al to dermatologie centres is the key strategy in the fight against melanoma. Th e investigation of factors associated with pattern of detection of melanoma (sel f-vs. nonself-detection) may be useful to refine educational strategies for th e future. We investigated the frequency of melanoma self-detection in a Mediter ranean populat ionatintermediatemelanoma risk. A multicentric survey identified 816 consecutive cases of cutaneous melanoma in the period January to December 20 01 in 11 Italian clinical centres belonging to the Italian Multidisciplinary Group on M elanoma. All patients filled a standardized questionnaire and were clinically ex amined by expert dermatologists. Self-detected melanomas were 40.6%, while the remaining lesions were detected by a dermatologist (18.5%), the family physici an (15.2%), other specialists (5%), the spouse (12.5%), a friend or someone e lse (8.2%). Variablesassociated with self-detected melanomas were female sex, young age, absence of atypical nevi, knowledge of the ABCD rule, habit of perfor ming skin self-examination. Self-detected melanomas did not differ from nonsel f-detected tumours in term of lesion thickness; however, patients with self-de tected melanomas waited a longer period before having a diagnostic confirmation (patient's delay) (>3 months:odds ratio, 3.89; 95%confidence interval, 2.74- 5.53). In order to reduce the patients'delays, educational messages should adeq uately stress the need for a prompt referral to a physician once a suspicious pi gmented lesion is self-detected.
