January 21, 2011

Follow-Up Program Detects Melanoma Earlier

(Ivanhoe Newswire) -- A new report shows a follow-up program could help detect melanoma earlier in high-risk patients.

According to the American Academy of Dermatology, melanoma is the deadliest form of skin cancer. Researchers say the latest efforts to improve melanoma prognosis have focused on identifying high-risk individuals. Gabriel Salerni, M.D., from the Hospital Clinic of Barcelona, and colleagues, noted that dermoscopy (a noninvasive diagnostic technique used to examine skin lesions) can improve the accuracy of melanoma diagnoses.

For this study, researchers analyzed data from about 200 melanoma patients. Forty of them were in a follow-up program for high-risk individuals, and the remaining 161 were referred for evaluation by another health professional. All melanomas diagnosed among these patients were evaluated by dermoscopy.

Most of the melanomas diagnosed in the follow-up program did not match clinical or dermoscopic characteristics of melanoma. Researchers found that only 12 percent fulfilled all four criteria outlined for melanoma detection (asymmetry, uneven borders, colors and differential dermoscopic structures). This compares to more than 60 percent of the melanomas detected among people referred to the institution but not in the follow-up program.

Researchers also found that 70 percent of melanomas diagnosed in the follow-up group had not spread beyond the initial site compared with 27.9 percent of those in the referred group. Researchers said the Breslow index (which measures tumor thickness) was also lower among the melanomas diagnosed through the follow-up program, and the follow-up cancers tended to be diagnosed at earlier stages.

The authors concluded that including patients who are at high-risk for melanoma in follow-up programs allows for the detection of melanoma in early stages with good prognosis even when clinical and dermoscopic features of melanoma are not present.

"In the general population, without specific surveillance, melanoma continues to be diagnosed at more advanced stages. Our findings suggest that current efforts in public and medical education might have no substantial effect in this group. We believe that high-risk individuals, whenever proper resources are available, should be referred to melanoma centers or qualified institutions for regular follow-up," the authors were quoted as saying.

SOURCE: Archives of Dermatology, January 17, 2011