Thin primary cutaneous melanomas

Associated detection patterns, lesion characteristics, and patient characteristics

Authors

  • Jennifer L. Schwartz M.D.,

    Corresponding author
    1. Department of Dermatology, University of Michigan Medical Center and University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
    • Department of Dermatology, University of Michigan, 1910 Taubman Center, Ann Arbor, MI 48109-0314
    Search for more papers by this author
    • Fax: 734-936-6395

  • Timothy S. Wang M.D.,

    1. Department of Dermatology, University of Michigan Medical Center and University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
    Search for more papers by this author
  • Ted A. Hamilton M.S.,

    1. Department of Dermatology, University of Michigan Medical Center and University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
    Search for more papers by this author
  • Lori Lowe M.D.,

    1. Department of Dermatology, University of Michigan Medical Center and University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
    2. Department of Pathology, University of Michigan Medical Center and University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
    Search for more papers by this author
  • Vernon K. Sondak M.D.,

    1. Department of Surgery, University of Michigan Medical Center and University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
    Search for more papers by this author
  • Timothy M. Johnson M.D.

    1. Department of Dermatology, University of Michigan Medical Center and University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
    2. Department of Otorhinolaryngology, University of Michigan Medical Center and University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
    3. Department of Surgery, Division of Plastic Surgery, University of Michigan Medical Center and University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
    Search for more papers by this author

Abstract

BACKGROUND

Public awareness and education may lead to the detection of thinner melanomas, which may result in a decrease in morbidity and mortality rates. Which detection patterns, lesion, and patient characteristics are associated with early detection?

METHODS

Using the University of Michigan prospective melanoma database, the detection patterns, lesion characteristics, and patient characteristics of 1515 consecutive patients with in situ or invasive cutaneous melanomas were reviewed. Tumor thickness (measured in millimeters) was evaluated in relationship to detection patterns (patient, physician, spouse), lesion characteristics (change in color, size, shape/elevation, ulceration, bleeding, tenderness, itching), and patient characteristics (gender, skin type, number of atypical and clinically benign nevi, history of sunburn, personal and family history of melanoma).

RESULTS

Patient characteristics associated with early detection included female gender, at least one atypical nevus, greater than 20 clinically benign nevi, and/or a personal history of melanoma. Skin types I, II, and III, a history of sunburn, and/or a family history of melanoma were also associated with thinner lesions, but these associations were not statistically significant. Lesion characteristics associated with earlier detection included a change in color, size, shape/elevation, and/or itching. Physician-detected melanomas were significantly thinner than patient or spouse-detected lesions.

CONCLUSIONS

Educational campaigns should include increasing melanoma awareness in males and educating the public on the early signs and symptoms. Education should be directed at both high and low-risk groups. Physicians should consider performing total skin examinations routinely on patients. Although they detect a relatively small percentage of all melanomas, physicians detect significantly thinner lesions. Cancer 2002;95:1562–8. © 2002 American Cancer Society.

DOI 10.1002/cncr.10880

Ancillary