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14-04-2011 | Article

Urgent access for high risk skin cases improves skin cancer detection

Abstract

Free abstract

MedWire News: Providing people with early stage melanoma and those at risk for skin cancer rapid and direct access to dermatology clinics could help to detect and treat skin cancer at an earlier stage, research shows.

"Improved access to medical care results in earlier detection of melanoma, and... earlier detection of melanoma improves survival," note Hensin Tsao and colleagues from Massachusetts General Hospital in Boston, USA.

"However, as melanoma rates increase, and the supply of medical dermatologists remains suboptimal to meet demand for services, early detection of melanoma has become an increasingly difficult challenge."

The current findings indicate that melanoma is four times as likely to be detected and diagnosed in high-risk patients receiving "urgent access track" to medical care as patients receiving routine access.

The researchers compared melanoma detection in 316 patients visiting an urgent access track clinic embedded within a pigmented lesion clinic, compared with detection in 4495 visiting the clinic routinely.

The patients involved had been educated on identifying the early signs of skin cancer and to use the urgent access clinic if they detected any concerning lesions.

In all, 45 melanomas were diagnosed among patients with routine access and 13 in patients receiving urgent access.

Patients receiving urgent access were nearly twice as likely to undergo a biopsy as patients with routine access, and urgent access resulted in a melanoma rate four times that of routine access. Over half of the biopsies carried out through urgent access were appropriate, and not just a result of the higher likelihood of patients reporting concerning lesions, the researchers point out.

Reporting in the Journal of the American Academy of Dermatology, they say that the "most striking" finding was the detection of relapsed melanoma in patients receiving urgent access, which was nearly 25 times that of patients receiving routine access.

"The urgent access clinic appears to have enriched melanoma detection," the researchers write.

The findings suggest that "should melanoma rates continue to outpace available dermatology resources in the future, it is possible that shifting some resources from pigmented lesion clinic routine visits to pigmented lesion clinic urgent access visits may be an effective means of diagnosing early melanomas," the team concludes.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Lucy Piper