Dermatologists failing to screen family members for skin cancer
MedWire News: Dermatologists are good at discussing family risks for skin cancer with their patients but less good at actually screening the relatives for cancer, US experts believe.
They stress that dermatologists have a crucial role to play in identifying patients with skin cancer and their at-risk relatives, and thereby reducing the overall rates of this common but serious disease.
Invasive melanoma is the most serious form of skin cancer and is usually triggered by exposure to ultraviolet radiation from sunshine or sunbeds. In 2011, more than 70,000 people were diagnosed with invasive melanoma in the USA, and nearly 9000 people died from the disease.
Melanoma also has a genetic (inherited) component, which means that people are more likely to develop the cancer if a first-degree relative has also been diagnosed with the disease.
"The National Institutes of Health recommend that patients with atypical moles and a positive family history of melanoma should be closely followed up by a physician owing to their unusually high risk of developing melanoma," say Dr Susan Oliviera (Memorial Sloan Kettering Cancer Center, New York) and co-authors.
"The National Institutes of Health also advise an initial screening of first-degree family members for all patients with melanoma," they add.
Dr Oliviera's team sent questionnaires to 1000 US dermatologists to ask whether they followed this advice, of whom 406 responded.
Among the dermatologists who replied, more than eight out of ten said they "usually or always" discussed family risk with their melanoma patients.
However, less than half of dermatologists said they routinely offered screening to first-degree relatives of their melanoma patients, and just one in five said they put messages in their patients' medical notes to remind them to discuss the risks.
When quizzed about the reasons for their behavior, most dermatologists said there was no particular barrier to them discussing family risk; instead, they blamed more general reasons such as time constraints, absence of guidelines, and lack of written material.
Commenting on their findings, Dr Oliviera and colleagues write: "Dermatologists can potentially have a crucial role during the 'teachable moment' in communicating melanoma risk to their patients.
"Enhancing communication of melanoma risk for family members by dermatologists could reduce the public health burden of the disease, optimize screening of at-risk relatives, and serve as a model for other cancers with high family risk."
The research is published in the Archives of Dermatology.
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By Joanna Lyford