M. Vu1, Y. Pan1, A. Sharfe2, J. Kelly1, A. Bowling2
Aim: Public health messages in skin cancer education advocate for regular self-examination to aid in the early detection of skin cancer. In order to assess the validity of this advice, MoleMap technology was used in a national skin cancer screening programme.
Method: A cross-sectional study was performed from January 2015 to December 2016 in 44 MoleMap centres in New Zealand. MoleMap was used at each visit which entailed the use of digital dermoscopy and total body photography. At each visit, patients self-reported the anatomical location of concerning lesions. Digital dermoscopy was interpreted by a dermatologist and a diagnosis made for every lesion. Graphical representation tools were used to electronically map the lesions on a three dimensional human model to demonstrate the correlation between self-reported lesions of concern and clinically diagnosed lesions of concern by dermatologists.
Results: Over the study there were 25,313 patient visits with 480,085 lesions reviewed. There were 1743 clinical diagnoses of melanoma made by a dermatologist. Patients self-reported 18,608 lesions of concern, of which 414 had been diagnosed as suspicious of melanoma (OR 1:45), indicating 76% of clinically diagnosed melanomas were missed by patients. The majority of melanomas not detected by patients were located on the back of the body.
Conclusion: This study demonstrated that the vast majority of melanomas were missed by patients and the utility of advising patients to perform self skin examinations may need to be investigated further. Public health campaigns should focus on directing patients to skilled medical practitioners for regular skin examination.