According to the American Cancer Society, more than 70,000 people are diagnosed with melanoma each year in the United States. It is recommended that such individuals perform a thorough skin self-exam on a regular basis to look for potential disease recurrence or new melanomas. But research by Rutgers Cancer Institute of New Jersey investigators shows fewer than 15 percent of melanoma patients surveyed regularly examine all parts of their body. Rutgers Cancer Institute behavioral scientist Elliot J. Coups, PhD, an associate professor of medicine at Rutgers Robert Wood Johnson Medical School, is the lead author of the work just published in the journal Melanoma Research (doi: 10.1097/CMR.0000000000000204). He shares more about the research.
Q: How was the study structured?
A: The study included a sample of 176 individuals diagnosed with stage 0 to stage III cutaneous malignant melanoma. Participants completed either a written or phone survey regarding their skin self-examination behaviors and associated factors. Participants were mostly Caucasian (99 percent) and female (51 percent) with an average age of 62 years.
Q: What did you and your colleagues find?
A: While nearly three-quarters (72 percent) of participants reported doing a skin self-exam in the past two months, only 14 percent had looked at all parts of their body. In terms of how they conducted the self-exams, few said they always used a full-length mirror (13 percent) or a hand-held mirror (11 percent). And only 9 percent said they always had someone help them to do the exam.
Q: What accounts for this?
A: The most common reasons given for not having conducted such an exam over the prior two month period were that patients didn’t think of it, didn’t know what to look for, or didn’t know that they should. Other responses included they were never told by their doctor to do it and that they receive a regular exam from a doctor. Our research shows that a higher level of education (more than half in the study were college graduates) and a greater knowledge of the ABCDE rule for detecting melanoma (looking at the asymmetry, border irregularity, color, diameter and evolution of the mole or affected area of the skin) were significantly associated with conducting a more thorough skin self-exam. Being shown what suspicious moles look like, how to do a proper skin self-exam, and patients’ level of confidence in knowing what to look for also were associated with more thorough self-exams.
Q: Why is this research important?
A: Prior studies on this subject have shown between 14 and 39 percent of patients with a melanoma history perform a thorough skin self-exam on a regular basis. But there has been limited information regarding their knowledge and confidence on how to perform the exam and how they are actually doing it. As shown in our study, nearly 75 percent of patients are taking the time to do a self-exam, but very few patients perform a thorough exam or use tools (like mirrors or the help of another person) to search for and track potentially suspicious moles. Our study supports the need for the development of interventions for this population so that they can increase their knowledge and skills for performing regular, thorough skin self-exams that can help to identify recurrent or new melanomas.