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Delays in diagnosis and melanoma prognosis (I): The role of patients
Author(s) -
Richard Marie A.,
Grob Jean J.,
Avril Marie F.,
Delaunay Michèle,
Gouvernet Johany,
Wolkenstein Pierre,
Souteyrand Pierre,
Dreno Brigitte,
Bonerandi Jean J.,
Dalac Sophie,
Machet Laurent,
Guillaume Jean C.,
ChevrantBreton Jacqueline,
Vilmer Catherine,
Aubin François,
Guillot Bernard,
BeylotBarry Marie,
Lok Catherine,
RaisonPeyron Nadia,
Chemaly Philippe
Publication year - 2000
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/1097-0215(20000520)89:3<271::aid-ijc10>3.0.co;2-7
Subject(s) - medicine , melanoma , anxiety , lesion , intervention (counseling) , cancer , medical advice , prospective cohort study , surgery , dermatology , pediatrics , psychiatry , cancer research
A prospective survey was conducted to assess the role of patients in the melanoma prognosis. Consecutive patients with primary melanoma were interviewed and examined using a comprehensive questionnaire including a psychological instrument. Main outcome measures were the delay before medical intervention and the tumor thickness. Of 590 melanomas, 70.8% were detected by patients and this proportion was higher in females. Relatives were involved in the detection of half of the cases. Median delays before the patient realized he had a suspicious lesion, before this lesion was seen by a doctor, and before the melanoma was removed were 4 months, 2 months, and 1 week, respectively. Delays up to several years were observed in some cases. The rate of self‐detection tended to be lower, the delays before seeking medical advice to be longer, and the tumor thickness to be higher in old people, in males, in lower‐educated individuals, in those living out of towns, and in people with a low awareness about melanocytic tumors than in other cases. Conversely, individuals with a high number of atypical nevi, those who were aware to be at risk, and those who regularly visited a dermatologist tended to detect their melanoma more rapidly. No specific psychological traits were associated with a late reaction, although negligence and anxiety tended to prolong the delays. Knowledge about melanoma was poor in many patients, especially in males, and wrong beliefs were widespread. This study provides the targets of future education programs. Int. J. Cancer 89:271–279, 2000. © 2000 Wiley‐Liss, Inc.