Impact of a campaign to train general practitioners in screening for melanoma.

Melanoma is a serious cancer whose incidence is growing. At this time, its prognosis is dependent on the Breslow index and therefore on early screening. The objective of the study was to evaluate the impact of a campaign to train general practitioners based, in particular, on learning the ABCDE rule. The training, performed by Réseau Mélanome Ouest, involved 210 general practitioners from the Pays de la Loire (Loire region) in France. Eight identical 2-h sessions were held between 2004 and 2006, conducted by a hospital dermatologist, a dermatologist in private practice, and a general practitioner as a moderator. The training was evaluated in two stages, with a self-administered questionnaire followed by a telephone survey. Thirty-six percent of the doctors stated that they had detected melanomas since the training over a median period of 27 months (2-39 months); 15% sent in the corresponding pathological anatomy reports on 37 confirmed melanomas from 30 doctors. The Breslow index scores of the melanomas detected ranged from 0.16 to 4 mm. Therefore, our training promoted the screening of a large number of melanomas, most of them with a low Breslow index. As a result, after a short prior training, the ABCDE rule clearly seems to be a valuable tool. Dermatologists retain an important role both in the diagnostic confirmation of melanomas and in the training of general practitioners.