Men 50 years or over underrepresented in skin cancer screening
MedWire News: Men aged 50 years or older represent only a quarter of individuals who present for skin cancer screening despite them being the highest risk group for the disease, study results show.
Furthermore, most of these men presented to screening having already previously been diagnosed with skin cancer, report researchers who call for better educational campaigns with specific screening recommendations.
The 5-year survival rates for melanoma decrease with increased depth of the primary lesion, and thus it is logical to assume that early detection of melanoma results in increased survival, say Laura Ferris (University of Pittsburgh, Pennsylvania, USA) and colleagues in the Archives of Dermatology.
However, studies have shown that screening asymptomatic individuals without regard for risk factors yields a low rate of diagnosis.
In the current study, the researchers sought to determine the factors that influence patients' screening decisions and behavior.
They surveyed 487 individuals aged 18 years or older who were seen for skin cancer screening from May to October 2009.
The most common reasons given for seeking skin cancer screening were a history of skin cancer (47.1%), followed by concern about sun exposure (30.0%), and a family history of nonmelanoma skin cancer (29.0%). Of note only 19.4% of patients stated that they were worried about a particular lesion on their skin.
Although melanoma has the highest prevalence among men 50 years or older, this group represented only 26.8% of the surveyed population presenting for screening. Also, the majority (64.6%) sought screening because of a previous skin cancer diagnosis compared with 40.8% for all other individuals.
Despite being at higher risk for melanoma, men aged 50 years or older were no more likely than other patients to have been recommended screening by their primary care practitioner (11.8% vs 17.1%).
Most of the participants wrongly believed that skin cancer screening had been proven to prevent skin cancer (72.3%) and reduce the risk of death from skin cancer (89.9%).
Discussing their findings, the researchers note that 20% of those who sought screening were considered to be at extremely low risk for melanoma in that they were younger than 50 years, lacked a personal history of skin cancer as well as a family history of melanoma, and were not worried about a particular spot being cancerous.
Since prospective screening trials are "unlikely to be performed in the near future," Ferris et al advise "screening the general population for melanoma once at age 50 years and screening patients who have a first-degree relative with melanoma every 2 years."
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By Andrew Czyzewski