Funding sources This study was supported by grants from the Ligue Contre le Cancer, the Groupement Régional de Santé Publique de Champagne-Ardenne and the Société Française de Dermatologie.
Epidemiology and Health Services Research
Efficacy of a general practitioner training campaign for early detection of melanoma in France†
Article first published online: 13 JAN 2014
© 2013 British Association of Dermatologists
British Journal of Dermatology
Volume 170, Issue 1, pages 123–129, January 2014
How to Cite
Grange, F., Woronoff, A.S., Bera, R., Colomb, M., Lavole, B., Fournier, E., Arnold, F. and Barbe, C. (2014), Efficacy of a general practitioner training campaign for early detection of melanoma in France. British Journal of Dermatology, 170: 123–129. doi: 10.1111/bjd.12585
Conflicts of interest None declared.
Plain language summary available online
- Issue published online: 13 JAN 2014
- Article first published online: 13 JAN 2014
- Accepted manuscript online: 12 AUG 2013 07:50AM EST
- Manuscript Accepted: 5 AUG 2013
- Ligue Contre le Cancer
- Groupement Régional de Santé Publique de Champagne-Ardenne
- Société Française de Dermatologie
To date, no strategy for improving early diagnosis of melanoma has been evaluated on a population basis in France.
To evaluate the efficacy of a general practitioner (GP) awareness and training campaign in a pilot French geographical region (Champagne-Ardenne), including 1·34 million inhabitants, 1241 GPs, 56 dermatologists and a population-based melanoma registry.
All GPs received repeated awareness postal mailings in 2008 and 398 (32·1%) attended training sessions organized by 27 dermatologists. The pre- (2005–7) and post-campaign (2009–11) periods were compared for the following: primary endpoint – the world-standardized incidence of very thick melanomas (VTM) (Breslow thickness ≥ 3 mm); secondary endpoints – the mean Breslow thickness; the proportions of VTM and of thin (< 1 mm) melanomas among invasive cases; and the ratio of in situ/all melanoma cases. Similar measures were performed in the control area of Doubs/Belfort territory (655 000 ha), where no similar campaign was carried out.
The incidence of VTM decreased from 1·07 to 0·71 per 100 000 habitants per year (P = 0·01), the mean Breslow thickness from 1·95 to 1·68 mm (P = 0·06) and the proportion of VTM from 19·2% to 12·8% (P = 0·01). The proportion of thin and in situ melanomas increased from 50·9% to 57·4% (P = 0·05) and from 20·1% to 28·2% (P = 0·001), respectively. No significant variation was observed in Doubs/Belfort territory.
These results strongly support the efficacy of such a campaign targeting GPs and provide a rationale for a larger public health campaign in France, including training of GPs by dermatologists and encouraging patients to ask their GP for a systematic skin examination.