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27-01-2011 | Article

Follow-up program helps detect melanoma early in high-risk people

Abstract

Free abstract

MedWire News: People at high risk for developing skin cancer could benefit from being referred to melanoma centers for regular follow-up, research indicates.

Follow-up programs could help detect melanomas in the early stages, improving patient outcome, say Susana Puig, from Instituto de Salud Carlos III in Barcelona, Spain, and colleagues.

"In the general population without specific surveillance, melanoma continues to be diagnosed at more advanced stages," note the researchers. They therefore recognized the potential importance of a follow-up program to help detect melanoma in individuals with increased risk.

"Fair-skinned persons, persons who tan with difficulty, blond or red-haired persons, and persons with blue eyes have more risk of developing melanoma than the general population," note Puig and team in the Archives of Dermatology.

The risk for melanoma is also increased in individuals who have freckles and moles and suffered severe sunburn as a child, as well as those with a strong family history of melanoma.

The researchers found that 40 people at increased risk for melanoma who participated in a follow-up program in which dermoscopy - microscopic analysis of moles - was used to monitor changes in mole characteristics had melanoma diagnosed at an earlier stage than 200 high-risk people referred by a primary care physician.

Indeed, most of the melanomas diagnosed among patients in the follow-up group were detected before clinical features indicative of melanoma were present. Overall, all melanomas in the follow-up group were diagnosed at stages 0 (only affecting top layer of skin) or IA (less than 1 mm thick), at 70% and 30%, respectively, while only 66% of melanomas in the referred group were diagnosed at these stages (28% and 38%, respectively).

The researchers also report that 70% of melanomas diagnosed in patients receiving follow-up had not spread, compared with just 28% of those diagnosed in referred patients, and melanomas in patients in the follow-up group tended to be less invasive.

"The inclusion of patients who are high risk for melanoma in follow-up programs allows the detection of melanomas in early stages, with good prognosis, even in the absence of clinical and dermascopic features of melanoma," the researchers comment.

"Further strategies and educational programs may be needed to improve the early detection of these lesions."

They conclude: "We believe that high-risk individuals, whenever proper resources are available, should be referred to melanoma centers of qualified institutions for regular follow-up."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Lucy Piper