Screening for cutaneous melanoma.
ABSTRACT Current data do not support widespread population-based screening for melanoma. While the incidence of melanoma is high, the overall mortality is low, and thus any potential benefit of screening the general population is hard to demonstrate. No randomized controlled trial showing reduction in mortality has ever been completed and, given the expense and time necessary for such a trial, probably will never be completed. The idea of skin screening remains appealing for this common, visible malignancy which is eminently treatable when detected early. Efforts should be focused on populations at particularly high risk of developing melanoma and on those at high risk of death from melanoma once diagnosed. Persons in kindreds of familial melanoma, and persons who have atypical mole syndrome, those who have a prior diagnosis of melanoma, or those who have diagnosed atypical nevi are all reasonable candidates for routine screening, based on lower-level evidence in the absence of randomized clinical trials targeting these groups. Programs targeting persons of low socioeconomic status and targeting white men over the age of 50 could address groups known to beat especially high risk of melanoma mortality.
- SourceAvailable from: Wilma Bergman
Article: Management of Melanoma Families[Show abstract] [Hide abstract]
ABSTRACT: In this review we have aimed to focus on the clinical management of familial melanoma patients and their relatives. Along this line three major topics will be discussed: (1) management/screening of familial melanoma families: what is advised and what is the evidence thereof; (2) variability of families worldwide with regard to clinical phenotype, including cancer spectrum and likelihood of finding germline mutations and (3) background information for clinicians on the molecular biology of familial melanoma and recent developments in this field.06/2010; 2(2):549-566. DOI:10.3390/cancers2020549
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ABSTRACT: The biopsy lies at the heart of the management of the suspected melanocytic neoplasm. Dermatologists are the ideal physicians to examine patients with suspect melanocytic lesions and an understanding of when and how to perform a biopsy is vital. Various algorithms have been formulated to allow for facilitation of the clinical examination, including the ABCDE rule, the Glasgow 7-point checklist, and the "ugly duckling" sign. Along with this, dermoscopy can increase the sensitivity of diagnosis. Proper training regarding dermatoscopy is essential, especially with algorithms such as the Menzies method, the 7-point checklist, and pattern analysis. Digital photography and digital dermatoscopy allows for surveillance of suspect nevi or patients with multiple nevi. For neoplasms suspected of being melanoma, an excision for diagnosis with 1- to 3-mm borders is ideal, although a shave, punch, or other incisional biopsy can be performed in special circumstances. Finally, research has allowed for promising technologies including gene profiling of tape-stripped samples along with automated software analysis of digital dermatoscopic images.Journal of the American Academy of Dermatology 09/2008; 59(5):852-71. DOI:10.1016/j.jaad.2008.05.027 · 5.00 Impact Factor
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ABSTRACT: Cutaneous melanoma (CM) incidence and mortality have risen dramatically during the past 2 generations, particularly among Caucasian populations. Detailed, long-term trends of CM in relation to clinical and pathologic characteristics in a Central European population have not been published to date. The current study was based on 1980 patients with invasive CM diagnosed in Southern Germany during the years from 1976 to 2003 documented by the Central Malignant Melanoma Registry. The German standard population was used to calculate age-standardized rates, and the annual percent change was estimated by using age, anatomic site, histologic type, and tumor thickness. During the study period, the incidence of CM approximately was tripled for males and females, reaching 10.3 and 13.3 per 100,000 per year, respectively (P < .001). The largest increases occurred for melanoma localized on the upper limbs (annual change, 5.9% for males and 5.0% for females; P < .001) and superficially spreading melanoma (annual change, 7.8% for males and 5.9% for females; P < .001). Thin tumors (Breslow thickness <1 mm) were presented significantly more often during the study period (annual change, 9.8% for males and 6.1% for females; P < .001), predominantly in younger patients. Thick tumors and nodular melanomas were more frequent among older patients (age >70 years), particularly among males. The age-standardized mortality decreased from 1.5 to 0.8 per 100,000 males and from 2.6 to 0.8 per 100,000 females with a significant downward trend for the female population (P < .001). The current results indicated which diverging trends between incidence and mortality may be explained by improved public awareness regarding suspicious pigmented lesions and the earlier detection of these tumors. Continuation of the current preventive strategy and its expansion to include older age groups in the population are warranted.Cancer 10/2006; 107(6):1331-9. DOI:10.1002/cncr.22126 · 4.90 Impact Factor