Many Survivors of Melanoma Do Not Perform Thorough Skin Exams

Many patients who have had melanoma do not conduct regular skin self-examinations, and those who do check themselves do not use sufficient tools or techniques.

In a study that surveyed 176 patients diagnosed with stage 0 to stage 3 cutaneous malignant melanoma, more than 70 percent reported doing a self-exam within the past two months, but only 14.2 percent examined all areas of their bodies.

In addition, 13.4 percent used a full-length mirror, 11.3 percent used a handheld mirror, and 9.2 percent said that they had someone help them conduct the exam.

“The most common reasons given for not having conducted such an exam over the prior 2-month period were that patients didn’t think of it, didn’t know what to look for, or didn't know that they should. Other responses included they were never told by their doctor.” lead author Elliot J. Coups, a behavioral scientist at Rutgers Cancer Institute and an associate professor of medicine at Rutgers Robert Wood Johnson Medical School, said in a statement.

Nearly 99 percent of the participants were white, half of the volunteers were women, and the average age of patients was 62.

Survivors of melanoma are at an increased risk of developing subsequent melanomas. The American Cancer Society recommends that self-exams be conducted monthly for early detection of new or recurring skin cancer, with particular emphasis on the ABCDE rule — examining the asymmetry, border irregularity, color, diameter and evolution of the mole or affected area.

The study found that greater knowledge of the ABCDE rule was associated with more thorough skin self-examinations. Being shown how to do self-exams and what a suspicious mole would look like were also significantly associated with better self-exams.“Prior studies on this subject have shown between 14 percent and 39 percent of patients with a melanoma history perform a thorough skin self-exam on a regular basis,” Coups said. “But there has been limited information regarding their knowledge and confidence on how to perform the exam and how they are actually doing it.”

The authors concluded that self-exams can be improved through patient education. They write that healthcare professionals can increase self-efficacy by instructing patients on how to properly conduct self skin-exams and teaching them how to track and identify suspicious moles or affected areas.

“As shown in our study, nearly 75 percent of patients are taking the time to do a self-exam, but very few patients perform a thorough exam or use tools (like mirrors or the help of another person) to search for and track potentially suspicious moles,” Coups said.

“Our study supports the need for the development of interventions for this population so that they can increase their knowledge and skills for performing regular, thorough skin self-exams that can help to identify recurrent or new melanomas.”

Coups EJ, Manne SL, Stapleton JL, et al. Skin self-examination behaviors among individuals diagnosed with melanoma [published online before print September 29, 2015]. Melanoma Res.