October 5, 2009

Dermatologists Detect Thinner Melanomas


In a study conducted at a private dermatology practice, a majority of melanomas were identified as a result of a full-body skin exam and not as a result of a patient complaint. Furthermore, melanomas detected by the dermatologist tended to be thinner than melanomas detected by the patient. These results were published in the Archives of Dermatology..

Skin cancer is the most common form of cancer in the United States, with more than 1 million new cases each year. Skin cancer is often divided into two broad categories: melanoma and non-melanoma. Melanoma is less common than non-melanoma skin cancer but tends to be much more aggressive. Of the more than 1 million new diagnoses of skin cancer each year, roughly 68,000 involve melanoma. More than 8,000 people die of melanoma each year in the United States. What makes melanoma so dangerous is that it is more likely than other types of skin cancer to spread (metastasize) to other parts of the body.

Survival varies by the thickness of the melanoma, with thinner melanomas having a better prognosis. This suggests that early detection of melanoma is important.

To explore how melanomas are detected and at what stage they are detected, researchers evaluated information from a private dermatology practice in Florida. Information was available for 126 patients with melanoma.

  • 56% of melanomas were found by the dermatologist during a skin exam and were not part of the patient’s presenting complaint (in other words, more than half the melanomas were found during a visit for something else).
  • Melanomas detected by the dermatologist tended to be thinner than melanomas detected by the patient.

Although this study suggests that full-body skin exams may improve melanoma detection and survival among patients who visit dermatologists, the role of routine skin cancer screening in the general population remains uncertain. According to the U.S. Preventive Services Task Force, “the current evidence is insufficient to assess the balance of benefits and harms of using a whole-body skin examination by a primary care clinician or patient skin self-examination for the early detection of cutaneous melanoma, basal cell cancer, or squamous cell skin cancer in the adult general population.”

Reference: Kantor J, Kantor DE. Routine dermatologist-performed full-body skin examination and early melanoma detection. Archives of Dermatology. 2009;145:873-876.

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