07 Jun Primary Care Screening Detects Melanoma at Earlier Stage
MedicalResearch.com Interview with:
Laura Ferris, M.D., Ph.D.
Associate professor, Department of Dermatology
University of Pittsburgh School of Medicine and
Member of the Melanoma Program
University of Pittsburgh Cancer Institute
MedicalResearch.com: What is the background for this study?
Dr. Ferris: Rates of melanoma, the most dangerous form of skin cancer, are on the rise, and skin cancer screenings are one of the most important steps for early detection and treatment. Typically, patients receive skin checks by setting up an appointment with a dermatologist. UPMC instituted a new screening initiative, which was modeled after a promising German program, the goal being to improve the detection of melanomas by making it easier for patients to get screened during routine office visits with their primary care physicians (PCPs). PCPs completed training on how to recognize melanomas and were asked to offer annual screening during office visits to all patients aged 35 and older. In 2014, during the first year of the program, 15 percent of the 333,788 eligible UPMC patients were screened in this fashion.
MedicalResearch.com: What are the main findings?
Dr. Ferris: On average, the melanomas detected in the group who received a screening at a primary care visit were nearly twice as thin as those detected in the group that was not screened by a PCP. Thinner melanomas have a better prognosis than thicker ones that are more advanced, so the new findings suggest PCP screening is able to find melanomas at an earlier, more treatable stage.
In addition, only 5 percent of people in the screening group had especially worrisome melanomas that were thicker than 1 millimeter—which are more likely to metastasize and require a biopsy of a nearby lymph node—while 20 percent of the unscreened group did.
MedicalResearch.com: What should readers take away from your report?
Dr. Ferris: Our findings suggest that PCP screening is an effective way to improve early detection of melanoma, which could potentially save lives. The PCP screenings may prevent a lot of people from needing more aggressive therapy. Additionally, we did not see a high rate of false positive biopsies, in which no skin cancer was present, nor did we see a high rate of unnecessary dermatology referrals or skin surgeries, all of which suggest that the program did not simply drive up health care costs needlessly.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Ferris: Future research should focus on understanding if patients with screen-detected melanomas are less likely to die from melanoma than patients with melanoma not detected in screening and if the cost of treating these melanomas is lower than the cost of treating melanomas in unscreened patients.
MedicalResearch.com: Is there anything else you would like to add?
Dr. Ferris: Another important finding was that nearly half of the screened patients were men, who are more likely to get and die from melanoma than women but have been underrepresented in other skin cancer screenings published to date. It’s exciting that our approach improves detection in this especially vulnerable population.
Funding for this study was provided by a National Cancer Institute Specialized Program of Research Excellence (SPORE) grant in skin cancer (5P50CA121973-08).
Additional members of the research team included Melissa Saul, M.S., Francis Solano, M.D., Erica Neuren, B.A., Jian-Min Yuan, M.D., Ph.D., and John Kirkwood, M.D., all of UPMC; Martin Weinstock, M.D., Ph.D., of Brown University; and Allan Geller, M.P.H., R.N., of Harvard University.
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Citation: Presented at the 2016 ASCO meeting
Preliminary outcomes of a primary care-based skin cancer screening program
2016 ASCO Annual Meeting
Abstract No: 1508
J Clin Oncol 34, 2016 (suppl; abstr 1508)
Author(s): Laura Ferris, Melissa Saul, Yan Lin, Martin A. Weinstock, Alan Geller, Francis Solano, Erica Bromberg Neuren, John M. Kirkwood; University of Pittsburgh Medical Center, Pittsburgh, PA; Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh Cancer Institute, Pittsburgh, PA; Brown University, Providence, RI; Harvard T.H. Chan School of Public Health, Boston, MA; Solano & Kokales Internal Medicine Associates – UPMC, Pittsburgh, PA; UPMC – University of Pittsburgh Medical Center, Pittsburgh, PA; Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
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