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Melanoma Diagnosis Often Delayed for Rural Poor

Posted: August 23, 2007
The farther a patient has to travel to see the doctor who diagnoses their melanoma, the more likely they are to have thicker -- and more lethal -- skin cancer at the time of diagnosis, a new study warns.

Patient income also makes a difference, with poorer patients getting diagnosed with thicker melanomas, the researchers said.

"Survival for patients with melanoma is dependent on stage at diagnosis. As Breslow (depth of tumor cells in the skin) thickness increases, overall survival decreases," wrote Dr. Karyn B. Stitzenberg, of the School of Public Health at the University of North Carolina at Chapel Hill, and her colleagues.

"Consequently, early diagnosis may substantially improve patient outcomes," the researchers added. But, "because melanoma can only be definitively diagnosed based on biopsy findings, diagnosis requires detection of the suspicious lesion and biopsy. Some primary care providers perform diagnostic biopsies, but many prefer to refer patients to dermatologists or surgeons."

Among the patients in this study, the median distance to a diagnosing physician was eight miles, and the median Breslow thickness was 0.6 millimeters. For each one-mile increase in distance to the doctor, there was a 0.6 percent increase in Breslow thickness, the study found.