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Melanomas More Often Found By Dermatologists

Posted: August 25, 2009

A new report shows the majority of melanomas are found by dermatologists during full-body skin examinations, displaying the need for professional skin care.

Most melanomas detected in a general-practice dermatology clinic were found by dermatologists during full-body skin examinations of patients who had come to the clinic for different complaints, according to a report in the August issue of Archives of Dermatology, one of the JAMA/Archives journals. In addition, cancers detected by dermatologists were thinner and more likely to be in situ—only on the outer layer of skin—than were cancers detected by patients.

"Early melanoma detection is the cornerstone of effective treatment, but guidelines remain sparse regarding appropriate screening procedures for both the general population as well as high-risk patients," the authors write as background information in the article. "While it is known that screening identifies melanomas at an earlier stage than would be found otherwise and that physicians detect melanomas with less tumor thickness, the U.S. Preventive Services Task Force states that current evidence is insufficient to recommend for or against routine screening. The population seen in skin cancer screenings differs markedly from that seen in a dermatology practice with a high-risk patient population."

Jonathan Kantor, MD, MSCE, and Deborah E. Kantor, MSN, CRNP, of North Florida Dermatology Associates in Jacksonville, Florida, analyzed 126 cases of melanoma diagnosed at the practice between July 2005 and October 2008. Of these, 51 cases were invasive, meaning they had spread to deeper layers of the skin, and 75 were in situ.

Overall, 56.3% of all melanomas and 60% of melanomas in situ were detected by the dermatologists and were not among the reasons the patient had visited the clinic. "A greater proportion of melanomas in the physician-detected group (mean, 63.4%) than in the patient-detected group (mean, 54.5%) were in situ," the authors write.