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Yield of a barrier-free 'check-your-spot' day
Abstract
This article gives us the results of an open house project focusing on skin cancer. It was conducted at the dermatology department Deventer hospital. The public was informed about the clinical picture, the types and the treatment of skin cancer. All participants were given the opportunity to be examined by a dermatologist for suspected lesions. A total of 245 people were examined. In 11 of the 245 participants a skin cancer was diagnosed and confirmed histologically (10 basal cell carcinoma and 1 melanoma). This represents a yield of 4.5%. Furthermore 52 cases of actinic keratosis (in 12 of them histologically diagnosed) and 2 cases of histologically diagnosed dysplastic nevi were found. This open house shows how important it is to check suspicious spots professionally. A 'check your spot' day, where suspected lesions can be screened anonymously and free of any barrier (including costs), contributes to early detection and treatment of skin cancer. In addition, the combination of information and screening on request will contribute to the self-awareness for skin cancer in the general population.
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This study investigated the relationship between patient delay in seeking medical attention and prognostic indicators, tumor characteristics, and demographic and behavioral factors in 106 patients with cutaneous malignant melanoma. Patients with less readily apparent lesions, particularly on the back, had longer delays in seeking treatment, as might be expected. The prognostically unfavorable nodular melanomas were detected more frequently by patients themselves than they were found during visits to physicians for unrelated problems. In terms of behavioral variables, patients with less knowledge of melanoma or its appropriate treatment had significantly longer delays. Patients who minimized the seriousness of their condition were more likely to seek treatment sooner, perhaps because this reduced fear and anxiety about the disease or its treatment. For superficial spreading melanoma, delay was significantly and positively correlated with Clark's level of invasion, and also with tumor thickness when only noncoincidentally diagnosed patients were included; whereas for the nodular type, delay was significantly and positively associated with tumor thickness, whether the patient was coincidentally diagnosed or not. The significance of these findings for early detection, and hence improved prognosis of malignant melanoma, is discussed.
Despite numerous warnings regarding the dangers of exposure to the sun, the number of skin cancer patients continues to increase rapidly. Dermatologists speak of a 'skin cancer epidemic' and estimate that the number of patients is substantially higher than the number estimated on the basis of cancer registry data. According to the Netherlands and Eindhoven cancer registries, 35.500 Dutch people were newly diagnosed with 'skin cancer' in 2006. Many skin cancer patients develop multiple skin tumours, therefore the total number of skin tumours is much higher than this. One in 6 Dutch people will develop skin cancer in their lifetime, 1 in 50 will develop a melanoma. Despite the good prognosis for most skin tumours, there is a high level of morbidity as a result of treatment. The large number of skin tumours and patients puts a great deal of pressure on the health care system.