Abstract
Background/Aims In contrast to declines in the incidence of most common cancers, melanoma continues to rise with 76,250 new cases and over 9,000 deaths in the US in 2012. While melanoma detected at early stage has an excellent prognosis, most Americans do not know skin cancer signs. Population-based physician-initiated screening has proved impractical. Self-skin examination (SSE) has the potential to ameliorate the harm from melanoma in a feasible, cost-effective way. The limited studies of SSE to date were conducted mostly among patients receiving dermatology-specialty care.
Methods To test the acceptability and sensitivity/specificity of a SSE toolkit, we recruited subjects from the general membership of Kaiser Permanente Southern California, an integrated health plan serving a geographic area with one of the highest melanoma risks in the world. Potential non-Hispanic white subjects 22–50 years old without a history of cancer were offered the opportunity to compare their assessments of their nevi with clinical evidence from full body skin exams and digital imaging.
Results Forty percent of those reached by phone (493/1228) agreed to participate. Acceptors were more likely to be female (74% vs. 57%, P <.001), but no differences were found by age (mean age = 39 years), education (44% high school or less), or income (34% annual household less than $50,000). Few and only small differences in participation were found for diagnoses of overweight or obesity, hypertension, hyperlipidemia, or depression; and co-morbidity score or health care utilization including dermatology services. Participants were more likely to have had a flu shot (47% vs. 39%, P <.001) and to be a never smoker (71% vs. 65%, P = .05). As expected in this general patient population, fewer than 10% of those contacted had a clinical skin exam in the previous 3 years (8% of participants vs. 2% of non-participants P <.001).
Conclusions Self-skin examination appears to be of interest to a large proportion of adults contacted by the study, especially women. Few meaningful differences in participation were found. Modestly higher flu vaccination and lower never smoking may indicate a stronger health orientation among participants.
