Australia has the highest melanoma rates in the world, with one person dying every 6 hours from the disease. Melanoma is also the most common cancer in 20 to 39-year-olds.
The first sign of melanoma is often a new or changing spot or mole on the skin, and the ABCDE guidelines are a helpful tool to identify a melanoma. However, melanoma can vary greatly in its appearance and many subtle clues can only be detected by a trained healthcare professional using a magnifying tool, known as a dermatoscope, to check the skin.
The research, published today in the prestigious journal JAMA Dermatology, found that in a group of 2,452 patients diagnosed with melanoma, slower-growing melanomas were more likely to be detected at a routine skin check and be thinner, whereas faster-growing melanomas were more likely to be patient-detected and thicker. It was estimated that patients whose melanoma was detected by their doctor during a routine skin check were 32% less likely to die from melanoma compared to patients who identified their own melanoma.
The study also found that melanomas easily detected using the ABCDE rule were more likely to be detected by the patients (70%), whereas atypical ones were more often detected by a doctor during a routine skin check.
“This evidence highlights the importance of not only knowing your own skin and seeking advice from your doctor if you notice any changes but also the critical role of trained healthcare professionals for detecting melanomas early, before they have had a chance to spread,” said study author Prof Richard Scolyer AO, pathologist and Co-Medical Director of Melanoma Institute Australia.
Current Australian guidelines recommend that individuals at very high risk of melanoma receive full skin examinations every 6 months. However, melanoma screening programs for the general population are not currently undertaken in Australia because of inadequate evidence that melanoma screening ultimately saves lives, uncertainty about overdiagnosis and unnecessary biopsy, and limited evidence that it is cost effective.
In the last decade there has been renewed interest in melanoma screening, driven by the changing landscape of melanoma care.
“We found that melanoma detection during a routine skin check was associated with lower risk of dying from any cause, but it was not statistically significant for melanoma-specific mortality,” said cancer epidemiologist and lead author Prof Anne Cust, from Melanoma Institute Australia, The Daffodil Centre and The University of Sydney. “Based on our early findings, the cost-effectiveness of a population melanoma screening program should be re-assessed, and a large randomised controlled trial is needed to provide definitive evidence.”