 |
|
Factors Associated With Physician Discovery of Early Melanoma in Middle-aged and Older Men
Alan C. Geller, MPH, RN;
Timothy M. Johnson, MD;
Donald R. Miller, ScD;
Katie R. Brooks, MPH;
Christle J. Layton, MD;
Susan M. Swetter, MD
Arch Dermatol. 2009;145(4):409-414.
Objective To determine factors associated with physician discovery of early melanoma in middle-aged and older men.
Design Survey.
Setting Three institutional melanoma clinics.
Participants A total of 227 male participants (aged  40 years) with invasive melanoma who completed surveys within 3 months of diagnosis.
Intervention Survey.
Main Outcome Measures Factors associated with physician-detected thin melanoma.
Results Patients with physician-detected melanoma were older, 57% were 65 years or older compared with 34% for other-detected (odds ratio [OR], 2.57; 95% confidence interval [CI], 1.19-5.55) and 42% for patient-detected melanoma (P = .07). Physician-detected melanoma in the oldest patients (aged 65 years) had tumor thickness equal to that of self-detected melanoma or melanoma detected by other means in younger patients. Back lesions composed 46% of all physician-detected melanoma, 57% of those detected by other means, and 16% of self-detected lesions (physician- vs self-detected: OR, 4.25; 95% CI, 1.96-9.23). Ninety-two percent of all physician-detected back-of-the-body melanomas were smaller than 2 mm compared with 63% of self-detected lesions (P = .004) and 76% of lesions detected by other means (P = .07).
Conclusions Skin screenings of at-risk middle-aged and older American men can be integrated into the routine physical examination, with particular emphasis on hard-to-see areas, such as the back of the body. "Watch your back" professional education campaigns should be promoted by skin cancer advocacy organizations.
Author Affiliations: Department of Dermatology, School of Medicine (Mr Geller and Ms Brooks) and School of Public Health (Mr Geller and Dr Miller), Boston University, Boston, Massachusetts; Departments of Dermatology, Otolaryngology, and Surgery, University of Michigan Medical School, Ann Arbor (Dr Johnson); Center for Health Quality, Outcomes, and Economic Research, Veterans Affairs Medical Center, Bedford, Massachusetts (Dr Miller); Department of Dermatology, Pigmented Lesion and Melanoma Program, Veterans Affairs Palo Alto Health Care System, Palo Alto, California (Dr Layton and Dr Swetter); and Stanford Comprehensive Cancer Center, Stanford, California (Dr Layton and Dr Swetter). Ms Brooks is now with Yale University School of Public Health, New Haven, Connecticut.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
RELATED ARTICLES
The Duty to Inspect the Skin and Counsel Those at Risk to Develop Melanoma
June K. Robinson and Kimberly A. Mallett
JAMA. 2009;301(16):1702-1704.
EXTRACT
| FULL TEXT
Engaging Patients and Their Partners in Preventive Health Behaviors: The Physician Factor
June K. Robinson, Kimberly A. Mallett, Rob Turrisi, and Jerod Stapleton
Arch Dermatol. 2009;145(4):469-473.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Briefly Noted
Journal Watch Dermatology 2009;2009:3-3.
FULL TEXT
The Duty to Inspect the Skin and Counsel Those at Risk to Develop Melanoma
Robinson and Mallett
JAMA 2009;301:1702-1704.
FULL TEXT
Melanoma in Middle-aged and Older Men: A Multi-institutional Survey Study of Factors Related to Tumor Thickness
Swetter et al.
Arch Dermatol 2009;145:397-404.
ABSTRACT
| FULL TEXT
Engaging Patients and Their Partners in Preventive Health Behaviors: The Physician Factor
Robinson et al.
Arch Dermatol 2009;145:469-473.
FULL TEXT
|
