Continuing medical educationScreening, early detection, and trends for melanoma: Current status (2000-2006) and future directions
Section snippets
Incidence and mortality trends in the United States and internationally
The American Cancer Society (ACS) estimates that there will be 59,940 cases of melanoma in the United States in 2007 (33,910 cases in males, and 26,030 cases in females). Estimates also indicate that there will be 8110 melanoma deaths (5220 in males; 2890 females).1
Clinical strategies for earlier recognition and identification
Recent advances have heightened our understanding of recognition patterns, the descriptive epidemiology of “melanoma histogenetic type epidemiology,” the relationship between moles and melanoma, and risk factors for melanoma.
Early identification, screening, and early detection
The early identification of melanoma can be potentially enhanced in multiple venues, such as community-wide screenings, dermatology-led mass screenings, non-dermatologist physician or health-care professional surveillance, by skin-self examination (SSE), specialized pigmented lesion clinics, and education targeted to patients and the public at greatest risk of disease.45
New technologies: dermoscopy and photography
We highlight the dermoscopy studies from meta-analyses, randomized trials, links with other outcome data (eg, cancer registries), and comparisons with naked-eye examinations.
Annual total cutaneous examination, total cutaneous photography, and dermoscopy were employed for patients with classic atypical mole syndrome (CAMS) and a heterogeneous group of patients at high risk (ie, those with high-risk non-CAMS [HRNCAMS]). A total of 258 patients (160 CAMS and 98 HRNCAMS) were studied. In the CAMS
Professional and public education
We describe the prevalence of screening by physicians, medical students, and nurses, and report on most recent professional training programs.
Conclusions
With the recent, abrupt cessation of the population-based, randomized screening trial in Queensland, randomized studies of large cohorts with many years of follow-up, as required to rigorously demonstrate that early detection of melanoma is desirable, may never be funded. Thus, there is the possibility that we will never have the evidence required to conclude that screening effectively reduces melanoma mortality.
Disturbingly low screening rates in the presence of persistent and avoidable
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Funding sources: National Cancer Institute.
Conflicts of interest: None declared.