Lack of Confidence in Undertaking Skin Self-Examinations in Patients With Melanoma

A stressed woman examining her skin in the mirror
Efforts to integrate new digital technologies to increase regular and thorough skin self-examination for patients with melanoma are warranted, provided sufficient technical support is provided.

Patients with melanoma often report lack of confidence in performing skin self-examinations (SSE) after treatment for a first primary localized melanoma, according to a new study published in JAMA Dermatology.

Respondents to a telephone survey were included in the study. Respondents lived in Sydney, Australia, had previously been treated for a first primary localized melanoma, and had no recurrent or new primary melanoma (n=37; median age, 67 years [interquartile range, 59.5-72 years]). Posttreatment views and experiences were assessed thematically.

When queried on SSE, patients consistently reported the practice as important for identifying local recurrence or new melanomas early. Although this finding appeared promising, most participants did not report regularly undertaking full-body SSE. Lack of perceived self-efficacy, sole reliance on clinician assessments for early detection of melanomas, and fear of cancer recurrence were primary reasons for low rates of SSE. Patients without a partner were also less likely to undertake SSE, especially in hard-to-see areas of the body.

When asked about digital technologies to help with SSE, the ability to track lesions as well as automated notifications to remind patients to undertake SSE were motivating factors reported by participants.

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Limitations of the study were the inclusion of participants from 1 geographic region as well as the small number of participants in the final sample.

New technology for SSE in melanoma may be important for improving the rates of SSE, the researchers emphasized. “By facilitating regular and thorough SSE and rapid review by a clinician as needed,” the authors wrote, “new technologies may provide patients with the confidence to lead surveillance of their body.”

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Dieng M, Smit AK, Hersch J, et al. Patients’ views about skin self-examination after treatment for localized melanoma [published online May 15, 2019]. JAMA Dermatol. doi:10.1001/jamadermatol.2019.0434