BACKGROUND: To date, no strategy for improving early diagnosis of melanoma has been evaluated on a population basis in France. OBJECTIVE: To evaluate the efficacy of a general practitioner (GP) awareness and training campaign in a pilot French geographical region (Champagne-Ardenne), including 1.34 million inhabitants, 1241 GPs, 56 dermatologists and a population-based melanoma registry. METHODS: All GPs received repeated awareness postal mailings in 2008 and 398 (32.1%) attended training sessions organized by 27 dermatologists. The pre- (2005-7) and post-campaign (2009-11) periods were compared for the following: primary endpoint - the world-standardized incidence of very thick melanomas (VTM) (Breslow thickness ≥ 3 mm); secondary endpoints--the mean Breslow thickness; the proportions of VTM and of thin (< 1 mm) melanomas among invasive cases; and the ratio of in situ/all melanoma cases. Similar measures were performed in the control area of Doubs/Belfort territory (655,000 ha), where no similar campaign was carried out. RESULTS: The incidence of VTM decreased from 1.07 to 0.71 per 100 000 habitants per year (P = 0.01), the mean Breslow thickness from 1.95 to 1.68 mm (P = 0.06) and the proportion of VTM from 19.2% to 12.8% (P = 0.01). The proportion of thin and in situ melanomas increased from 50.9% to 57.4% (P = 0.05) and from 20.1% to 28.2% (P = 0.001), respectively. No significant variation was observed in Doubs/Belfort territory. CONCLUSION: These results strongly support the efficacy of such a campaign targeting GPs and provide a rationale for a larger public health campaign in France, including training of GPs by dermatologists and encouraging patients to ask their GP for a systematic skin examination.
BACKGROUND: To date, no strategy for improving early diagnosis of melanoma has been evaluated on a population basis in France. OBJECTIVE: To evaluate the efficacy of a general practitioner (GP) awareness and training campaign in a pilot French geographical region (Champagne-Ardenne), including 1.34 million inhabitants, 1241 GPs, 56 dermatologists and a population-based melanoma registry. METHODS: All GPs received repeated awareness postal mailings in 2008 and 398 (32.1%) attended training sessions organized by 27 dermatologists. The pre- (2005-7) and post-campaign (2009-11) periods were compared for the following: primary endpoint - the world-standardized incidence of very thick melanomas (VTM) (Breslow thickness ≥ 3 mm); secondary endpoints--the mean Breslow thickness; the proportions of VTM and of thin (< 1 mm) melanomas among invasive cases; and the ratio of in situ/all melanoma cases. Similar measures were performed in the control area of Doubs/Belfort territory (655,000 ha), where no similar campaign was carried out. RESULTS: The incidence of VTM decreased from 1.07 to 0.71 per 100 000 habitants per year (P = 0.01), the mean Breslow thickness from 1.95 to 1.68 mm (P = 0.06) and the proportion of VTM from 19.2% to 12.8% (P = 0.01). The proportion of thin and in situ melanomas increased from 50.9% to 57.4% (P = 0.05) and from 20.1% to 28.2% (P = 0.001), respectively. No significant variation was observed in Doubs/Belfort territory. CONCLUSION: These results strongly support the efficacy of such a campaign targeting GPs and provide a rationale for a larger public health campaign in France, including training of GPs by dermatologists and encouraging patients to ask their GP for a systematic skin examination.
Authors: June K Robinson; Namita Jain; Ashfaq A Marghoob; William McGaghie; Michael MacLean; Pedram Gerami; Brittney Hultgren; Rob Turrisi; Kimberly Mallett; Gary J Martin Journal: J Gen Intern Med Date: 2018-02-05 Impact factor: 5.128
Authors: Mary K Tripp; Meg Watson; Sophie J Balk; Susan M Swetter; Jeffrey E Gershenwald Journal: CA Cancer J Clin Date: 2016-05-27 Impact factor: 508.702
Authors: Ashley E Brown; Maleka Najmi; Taylor Duke; Daniel A Grabell; Misha V Koshelev; Kelly C Nelson Journal: J Gen Intern Med Date: 2022-06-16 Impact factor: 6.473
Authors: Mariah M Johnson; Sancy A Leachman; Lisa G Aspinwall; Lee D Cranmer; Clara Curiel-Lewandrowski; Vernon K Sondak; Clara E Stemwedel; Susan M Swetter; John Vetto; Tawnya Bowles; Robert P Dellavalle; Larisa J Geskin; Douglas Grossman; Kenneth F Grossmann; Jason E Hawkes; Joanne M Jeter; Caroline C Kim; John M Kirkwood; Aaron R Mangold; Frank Meyskens; Michael E Ming; Kelly C Nelson; Michael Piepkorn; Brian P Pollack; June K Robinson; Arthur J Sober; Shannon Trotter; Suraj S Venna; Sanjiv Agarwala; Rhoda Alani; Bruce Averbook; Anna Bar; Mirna Becevic; Neil Box; William E Carson; Pamela B Cassidy; Suephy C Chen; Emily Y Chu; Darrel L Ellis; Laura K Ferris; David E Fisher; Kari Kendra; David H Lawson; Philip D Leming; Kim A Margolin; Svetomir Markovic; Mary C Martini; Debbie Miller; Debjani Sahni; William H Sharfman; Jennifer Stein; Alexander J Stratigos; Ahmad Tarhini; Matthew H Taylor; Oliver J Wisco; Michael K Wong Journal: Melanoma Manag Date: 2017-03-01