Comparing Melanoma Invasiveness in Dermatologist- versus Patient-Detected Lesions : A Retrospective Chart Review

Abstract EN

This study examined whether patient-identified melanomas were more advanced than dermatologist-identified tumors at routine clinic visits, and whether a personal or family history of skin cancer was associated with patterns of detection.

A retrospective chart review was performed on melanoma patients (N=201) in a private dermatology clinic.

Variables included age, gender, pattern of detection (i.e., patient or a board certified dermatologist), personal or family history of skin cancer, skin type, and previous sun exposure, as well as tumor location and severity.

Dermatologist-diagnosed melanomas were less invasive (P<0.0005), and more likely present on the chest, back, and legs (P<0.01).

Conversely, patient-identified lesions were more likely to occur on the face, neck and scalp, be associated with younger patients, and a family history of melanoma, but not other types of skin cancer (P<0.01).

In a post-hoc analysis examining these factors as predictors of tumor invasiveness, only diagnostic source was significant.

Specifically, dermatologist-identified tumors were significantly less invasive than patient-identified tumors.

Although age, family history, and tumor location played roles in the early detection of melanomas, the most important factor was diagnostic source.

Thus, board-certified dermatologists play a key role in the early detection of malignant melanoma.