Is physician detection associated with thinner melanomas?

Darin S. Epstein, Julie R Lange, Stephen B. Gruber, Mona Mofid, Susan E. Koch

Research output: Contribution to journalArticle

Abstract

Context: In cutaneous melanoma, tumor depth remains the best biologic predictor of patient survival. Detection of prognostically favorable lesions may be associated with improved survival in patients with melanoma. Objective: To determine melanoma detection patterns and relate them to tumor thickness. Design: Interview survey. Setting and Patients: All patients with newly detected primary cutaneous melanoma at the Melanoma Center, Johns Hopkins Medical Institutions, between June 1995 and June 1997. Main Outcome Measure: Tumor thickness grouped according to detection source. Results: Of the 102 patients (47 men, 55 women) in the study, the majority of melanomas were self-detected (55%), followed by detection by physicians (24%), spouse (12%), and others (10%). Physicians were more likely to detect thinner lesions than were patients who detected their own melanomas (median thickness, 0.23 mm vs 0.9 mm; P <.001). When grouped according to thickness, 11 (46%) of 24 physician-detected melanomas were in situ, vs only 8 (14%) of 56 patient-detected melanomas. Physician detection was associated with an increase in the probability of detecting thinner (≤0.75 mm) melanomas (relative risk, 4.2; 95%) confidence interval, 1.4-11.1; P = .01). Conclusions: Thinner melanomas are more likely to have been detected by physicians. Increased awareness by all physicians may result in greater detection of early melanomas.

Original languageEnglish (US)
Pages (from-to)640-643
Number of pages4
JournalJournal of the American Medical Association
Volume281
Issue number7
DOIs
StatePublished - Feb 17 1999

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Melanoma
Physicians
Neoplasms
Skin
Survival
Spouses
Outcome Assessment (Health Care)
Confidence Intervals
Interviews

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Is physician detection associated with thinner melanomas? / Epstein, Darin S.; Lange, Julie R; Gruber, Stephen B.; Mofid, Mona; Koch, Susan E.

In: Journal of the American Medical Association, Vol. 281, No. 7, 17.02.1999, p. 640-643.

Research output: Contribution to journalArticle

Epstein, Darin S. ; Lange, Julie R ; Gruber, Stephen B. ; Mofid, Mona ; Koch, Susan E. / Is physician detection associated with thinner melanomas?. In: Journal of the American Medical Association. 1999 ; Vol. 281, No. 7. pp. 640-643.
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abstract = "Context: In cutaneous melanoma, tumor depth remains the best biologic predictor of patient survival. Detection of prognostically favorable lesions may be associated with improved survival in patients with melanoma. Objective: To determine melanoma detection patterns and relate them to tumor thickness. Design: Interview survey. Setting and Patients: All patients with newly detected primary cutaneous melanoma at the Melanoma Center, Johns Hopkins Medical Institutions, between June 1995 and June 1997. Main Outcome Measure: Tumor thickness grouped according to detection source. Results: Of the 102 patients (47 men, 55 women) in the study, the majority of melanomas were self-detected (55{\%}), followed by detection by physicians (24{\%}), spouse (12{\%}), and others (10{\%}). Physicians were more likely to detect thinner lesions than were patients who detected their own melanomas (median thickness, 0.23 mm vs 0.9 mm; P <.001). When grouped according to thickness, 11 (46{\%}) of 24 physician-detected melanomas were in situ, vs only 8 (14{\%}) of 56 patient-detected melanomas. Physician detection was associated with an increase in the probability of detecting thinner (≤0.75 mm) melanomas (relative risk, 4.2; 95{\%}) confidence interval, 1.4-11.1; P = .01). Conclusions: Thinner melanomas are more likely to have been detected by physicians. Increased awareness by all physicians may result in greater detection of early melanomas.",
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