Clinical whole-body skin examination reduces the incidence of thick melanomas

Aitken, Joanne F., Elwood, Mark, Baade, Peter D., Youl, Philippa and English, Dallas (2010) Clinical whole-body skin examination reduces the incidence of thick melanomas. International Journal of Cancer, 126 2: 450-458. doi:10.1002/ijc.24747


Author Aitken, Joanne F.
Elwood, Mark
Baade, Peter D.
Youl, Philippa
English, Dallas
Title Clinical whole-body skin examination reduces the incidence of thick melanomas
Journal name International Journal of Cancer   Check publisher's open access policy
ISSN 0020-7136
1097-0215
0898-6924
Publication date 2010-01-15
Year available 2009
Sub-type Article (original research)
DOI 10.1002/ijc.24747
Volume 126
Issue 2
Start page 450
End page 458
Total pages 9
Place of publication Hoboken, NJ, U.S.A.
Publisher John Wiley & Sons
Collection year 2011
Language eng
Formatted abstract
Survival from melanoma is strongly related to tumour thickness, thus earlier diagnosis has the potential to reduce mortality from this disease. However, in the absence of conclusive evidence that clinical skin examination reduces mortality, evidence- based assessments do not recommend population screening. We aimed to assess whether clinical whole-body skin examination is associated with a reduced incidence of thick melanoma and also whether screening is associated with an increased incidence of thin lesions (possible overdiagnosis). We conducted a population-based case-control study of all Queensland residents aged 20–75 years with a histologically confirmed first primary invasive cutaneous melanoma diagnosed between January 2000 and December 2003. Telephone interviews were completed by 3,762 eligible cases (78.0%) and 3,824 eligible controls (50.4%). Whole-body clinical skin examination in the three years before diagnosis was associated with a 14% lower risk of being diagnosed with a thick melanoma (>0.75 mm) (OR = 0.86, 95% CI = 0.75, 0.98). Risk decreased for melanomas of increasing thickness: the risk of being diagnosed with a melanoma 0.76–1.49 mm was reduced by 7% (OR = 0.93, 95% CI 0.79, 1.10), by 17% for melanomas 1.50–2.99 mm (OR = 0.83, 95% CI = 0.65, 1.05) and by 40% for melanomas ≥3 mm (OR = 0.60, 95% CI = 0.43, 0.83). Screening was associated with a 38% higher risk of being diagnosed with a thin invasive melanoma (≤0.75 mm) (OR =1.38, 95% CI = 1.22, 1.56). This is the strongest evidence to date that whole-body clinical skin examination reduces the incidence of thick melanoma. Because survival from melanoma is strongly related to tumour thickness, these results suggest that screening would reduce melanoma mortality.
Keyword Cutaneous melanoma
High-risk
Malignant-melanoma
Invasive melanoma
Self-examination
Staging systems
Australia
Cancer
Population
Queensland
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online 16 July 2009

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Public Health Publications
 
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Created: Sun, 17 Jan 2010, 00:05:32 EST