TY - JOUR
T1 - Melanoma detection by skin self-examination targeting at-risk women
T2 - A randomized controlled trial with telemedicine support for concerning moles
AU - Robinson, June K.
AU - Wahood, Samer
AU - Ly, Sophia
AU - Kirk, Jessie
AU - Yoon, Jamie
AU - Sterritt, James
AU - Gray, Elizabeth
AU - Kwasny, Mary
N1 - Funding Information:
The authors declare no conflicts of interest. This work was supported in part by the National Cancer Institute of the National Institutes of Health [grant number P30CA060553 to the Robert H. Lurie Comprehensive Cancer Center]. This work was also supported by Gail Elden, in memory of Richard Elden. Pigmented lesion assay testing was provided by DermTech Inc. (La Jolla, CA). The data that support the findings of this study are available on request from the corresponding author, [JKR]. The data are not publicly available due to their containing information that could compromise the privacy of research participants.
Funding Information:
This work was supported in part by the National Cancer Institute of the National Institutes of Health [grant number P30CA060553 to the Robert H. Lurie Comprehensive Cancer Center]. This work was also supported by Gail Elden, in memory of Richard Elden.
Publisher Copyright:
© 2021 The Author(s)
PY - 2021/12
Y1 - 2021/12
N2 - Secondary melanoma prevention remains crucial to reduce morbidity and mortality for the 200,000 people in the United States estimated to develop melanoma in 2021. This 3-month randomized controlled trial of online skin self-examination (SSE) education among 1000 at-risk women who received care at Northwestern Medicine in Illinois sought to determine SSE initiation and monthly performance, SSE anxiety and confidence, and health care practitioner (HCP) visits for concerning moles. Positive responses to a personal history of sunburn, a personal or family history of skin cancer, and/or having 10 or more lifetime indoor tanning sessions identified and informed women of their increased risk of melanoma. At one month, 96.2% of women receiving SSE education (SSE women) initiated SSE compared to 48.1% in the active control arm (control) (p < 0.001). More control women sought HCP visits (n = 107) than SSE women (n = 39). Control women seen by HCPs identified benign lesions, especially seborrheic keratosis, more often than SSE women. More atypical nevi (SSE 38.5%, control 8.4%) and melanomas (SSE 25.6%, control 4.7%) were visually identified by SSE women seeing HPCs (p < 0.001). There was no significant difference in SSE anxiety between the control and SSE arms. Confidence increased significantly in the SSE arm whereas there was no change in the control group (p < 0.001). Women checked someone else for concerning moles [315/ 494 (63.8%) of SSE women]. Targeting at-risk women for SSE education may help reduce melanoma mortality, especially in rural communities where incidence and mortality are greater than in urban areas.
AB - Secondary melanoma prevention remains crucial to reduce morbidity and mortality for the 200,000 people in the United States estimated to develop melanoma in 2021. This 3-month randomized controlled trial of online skin self-examination (SSE) education among 1000 at-risk women who received care at Northwestern Medicine in Illinois sought to determine SSE initiation and monthly performance, SSE anxiety and confidence, and health care practitioner (HCP) visits for concerning moles. Positive responses to a personal history of sunburn, a personal or family history of skin cancer, and/or having 10 or more lifetime indoor tanning sessions identified and informed women of their increased risk of melanoma. At one month, 96.2% of women receiving SSE education (SSE women) initiated SSE compared to 48.1% in the active control arm (control) (p < 0.001). More control women sought HCP visits (n = 107) than SSE women (n = 39). Control women seen by HCPs identified benign lesions, especially seborrheic keratosis, more often than SSE women. More atypical nevi (SSE 38.5%, control 8.4%) and melanomas (SSE 25.6%, control 4.7%) were visually identified by SSE women seeing HPCs (p < 0.001). There was no significant difference in SSE anxiety between the control and SSE arms. Confidence increased significantly in the SSE arm whereas there was no change in the control group (p < 0.001). Women checked someone else for concerning moles [315/ 494 (63.8%) of SSE women]. Targeting at-risk women for SSE education may help reduce melanoma mortality, especially in rural communities where incidence and mortality are greater than in urban areas.
KW - COVID-19
KW - Melanoma
KW - Online patient education
KW - Randomized controlled trial
KW - Rural
KW - Screening
KW - Skin self-examination
KW - Telemedicine
KW - Women
UR - http://www.scopus.com/inward/record.url?scp=85114007503&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85114007503&partnerID=8YFLogxK
U2 - 10.1016/j.pmedr.2021.101532
DO - 10.1016/j.pmedr.2021.101532
M3 - Article
C2 - 34976609
AN - SCOPUS:85114007503
SN - 2211-3355
VL - 24
JO - Preventive Medicine Reports
JF - Preventive Medicine Reports
M1 - 101532
ER -