Examination of the ability of people to identify early changes of melanoma in computer-altered pigmented skin lesions
P. F. Hanrahan, P. Hersey, S. W. Menzies, A. B. Watson and C. A. D'Este
Newcastle Melanoma Unit, Community Aged and Mental Health Services, Wallsend, New South Wales, Australia.
OBJECTIVES: To examine whether older people were less able to distinguish
changes of melanoma than younger people, and to test whether an educational
brochure illustrating changes of melanoma would increase their ability to
detect the changes. DESIGN: Photographic images of pigmented skin lesions
were altered using computer graphics software. Images of typical changes of
melanoma were shown to groups of volunteers younger than 30 years (n = 52)
and older than 45 years (n = 41). Short intervals (seconds) between viewing
of the original and changed lesions were used to test ability to
distinguish the changes, and longer intervals (29 and 60 days) were used to
test their ability over more realistic intervals. All participants were
randomized to receive an educational brochure (designed using the same
technology) to evaluate whether this would assist in identifying early
changes of melanoma. SETTING: A cross section of volunteers employed in a
large semigovernment utility. INTERVENTION: An educational brochure that
illustrated typical changes of melanoma. MAIN OUTCOME MEASURE: Score of
correct or incorrect detection of changed or unchanged skin lesions.
RESULTS: Tests at short intervals showed that both age groups were able to
detect early changes of melanoma but had poor ability to detect changes of
melanoma at longer intervals. Repeated viewing of the original lesions
enabled the participants to once more recognize the changes. Both groups
had low ability to detect the appearance of new pigmented lesions. The
educational brochure improved the ability of participants to detect change.
CONCLUSIONS: The main difficulty people have in self-detection of melanoma
is limited ability to recall the appearance of their skin. This ability did
not differ between the age groups. Educational material that focused on
change was effective in increasing the ability to detect changes over short
intervals. Photographic records may be the most effective aid for detection
of changes at longer intervals.
