Education Campaign Improves Skin Cancer Screening Rates
Screening for the skin cancer melanoma
Men over 50 years old are more motivated to seek screening for the skin cancer melanoma if they are made aware of the risk factors through public education and have access to screening exams, according to a new study. Published in the August 15, 2006 issue of CANCER, a peer-reviewed journal of the American Cancer Society, the study reveals that men who had skin lesions removed previously, who were concerned about a mole, or who had identified personal risk factors for melanoma were more likely to undergo a whole body skin exam. This community-based, melanoma screening intervention significantly increased screening rates in this older age group.
Melanoma is one of the deadliest types of skin cancer. It arises from pigmented cells called melanocytes, most commonly found in the skin, and once invasive, will rapidly spread throughout the body. Exposure to ultraviolet radiation is known to greatly increase risk. Though the incidence of all skin cancers is on the rise, rates of melanomas have increased most rapidly, almost 15-fold, over the last 50 years. That increase has been observed over-proportionally in men over 50 years. Currently, this group represents almost half of all deaths from melanoma in developed countries, but is the least likely age group to be screened.
Joanne Aitken, Ph.D. of the Viertel Centre for Research in Cancer Control, Queensland Cancer Fund in Brisbane, Australia and investigators conducted a melanoma screening intervention trial in 18 communities in Queensland, Australia. Nine communities were randomly selected to participate in a three-year public education campaign that comprised community education, local physician education, and the establishment of easily accessible dedicated skin screening clinics. No intervention was done in the other nine communities. Subjects were then followed for two years after the intervention. Investigators previously reported that the intervention significantly increased screening rates. The most significant improvement was observed in men over 50. To evaluate the factors that motivated older men to pursue screening for melanoma, the authors compared the results of telephone interviews conducted at the beginning and end of the trial and two years after the intervention.
Close to 500 men over 50 completed each of the surveys. Older men who had a suspicious skin lesion removed in the past, were concerned about an existing mole, recognized personal risk factors for melanoma, or had a positive impression of screening were more likely to conduct a whole body skin exam on themselves or receive a whole body skin exam from a doctor. Men not confident in their abilities to conduct a self-exam were more likely to receive screening at baseline and at the end of the intervention. However, after the intervention, men confident in their self-exam skills were more likely to have continued screening practices.
Men over 50 accounted for over 20 percent of screening visits and almost 50 percent of all melanomas diagnosed. At the end of the study, the self-screening rate increased two-fold and the physician-screening rate increased four-fold. The authors say that recommendations and instructions from doctors are important for improving men's skin self-examination behavior although "we did not observe a significant increase in doctors recommending such skin self-examination behavior" within this program.
According to the authors, this is the first published report of the motivating factors for screening and melanoma diagnosis patterns in this age group in a population-based, melanoma screening initiative. "Our results," conclude the authors, "suggest that to sustain screening rates in men 50 years and older, an understanding of their susceptibility to melanoma and their doctor's encouragement of early detection and screening behavior will be important."