PDF(Pubmed)
Abstract：
UNASSIGNED: Australia is known for its outdoor culture, with a large percentage of its population engaging in outdoor recreational activities, aquatic, non-aquatic and outdoor occupational activities. However, these outdoor enthusiasts face increased exposure to ultraviolet radiation (UVR), leading to a higher risk of skin cancer, including malignant melanoma (MM). Over the past 40 years, there has been a significant rise in skin cancer rates in Australia, with two out of three Australians expected to develop some form of skin cancer by age 70. Currently, skin cancer examinations are not endorsed in asymptomatic or low-risk individuals in Australia, with only high-risk individuals recommended to undergo regular skin examinations. Notably, the Melanoma Institute Australia suggests that one-half of patients identify MMs themselves, although this claim appears to be based on limited Australian data which may not reflect contemporary practice. Therefore this study sought to determine the percentage of patients who were able to self-identify MMs as lesions of concern when presenting for a skin cancer examination.
UNASSIGNED: Multi-site, cross-sectional study design incorporating a descriptive survey and total body skin cancer screening, including artificial intelligence by a skin cancer doctor.
UNASSIGNED: A total of 260 participants with suspect MM lesions were biopsied, with 83 (31.9%) found to be melanomas. Of the true positive MMs only a small percentage of participants (21.7% specificity) correctly had concerns about the suspect lesion being a MM. These MMs were located primarily on the back (44.4%), shoulder (11.1%) and upper leg (11.1%). There was no significant difference in the size between those participants aware of a MM versus those who were not (P = 0.824, 24.6 vs 23.4 mm2). Significantly more males identified lesions of concern that were MMs as compared to females (P = 0.008, 61.1% vs 38.9%, respectively). With regard to true negatives males and females were similar (52.1% vs 47.9%, respectively). With regard to false negatives (n = 65), a greater percentage of males than females did not recognize the MM as a lesion of concern (66.2% vs 33.8%, respectively). Participants were more likely to correctly identify an invasive MM as opposed to an in situ MM (27.3% versus 21.3%).
UNASSIGNED: Only a small percentage of participants in this study were able to self-identify either in situ or invasive MM as a lesion of concern with a tendency to identify the more advanced, thicker MMs. Given that MM is associated with a high mortality and cost of treatment, particularly when invasive, the inability of lay persons to identify these cancerous lesions will likely lead to delayed treatment and a possible adverse outcome. We believe the current melanoma screening practices in Australian general practice should be revisited to improve patient outcomes with regard to MM. Additionally, prevention campaigns should include images and primary risk factors for MM.
UNASSIGNED: Multi-site, cross-sectional study design incorporating a descriptive survey and total body skin cancer screening, including artificial intelligence by a skin cancer doctor.
UNASSIGNED: A total of 260 participants with suspect MM lesions were biopsied, with 83 (31.9%) found to be melanomas. Of the true positive MMs only a small percentage of participants (21.7% specificity) correctly had concerns about the suspect lesion being a MM. These MMs were located primarily on the back (44.4%), shoulder (11.1%) and upper leg (11.1%). There was no significant difference in the size between those participants aware of a MM versus those who were not (P = 0.824, 24.6 vs 23.4 mm2). Significantly more males identified lesions of concern that were MMs as compared to females (P = 0.008, 61.1% vs 38.9%, respectively). With regard to true negatives males and females were similar (52.1% vs 47.9%, respectively). With regard to false negatives (n = 65), a greater percentage of males than females did not recognize the MM as a lesion of concern (66.2% vs 33.8%, respectively). Participants were more likely to correctly identify an invasive MM as opposed to an in situ MM (27.3% versus 21.3%).
UNASSIGNED: Only a small percentage of participants in this study were able to self-identify either in situ or invasive MM as a lesion of concern with a tendency to identify the more advanced, thicker MMs. Given that MM is associated with a high mortality and cost of treatment, particularly when invasive, the inability of lay persons to identify these cancerous lesions will likely lead to delayed treatment and a possible adverse outcome. We believe the current melanoma screening practices in Australian general practice should be revisited to improve patient outcomes with regard to MM. Additionally, prevention campaigns should include images and primary risk factors for MM.
摘要：
■澳大利亚以其户外文化而闻名，很大一部分人口从事户外娱乐活动，水生,非水生和户外职业活动。然而,这些户外爱好者面临更多的紫外线辐射（UVR），导致皮肤癌的风险更高，包括恶性黑色素瘤（MM）。在过去的40年里,澳大利亚皮肤癌发病率显著上升，预计到70岁时，三分之二的澳大利亚人会患上某种形式的皮肤癌。目前,在澳大利亚，无症状或低风险个体不认可皮肤癌检查，只有高危人群建议接受定期皮肤检查。值得注意的是,澳大利亚黑色素瘤研究所建议一半的患者自己识别MMs，尽管这一说法似乎是基于有限的澳大利亚数据，这些数据可能无法反映当代实践。因此，这项研究旨在确定在进行皮肤癌检查时能够自我识别MM为关注病变的患者百分比。
■多站点，横断面研究设计，包括描述性调查和全身皮肤癌筛查，包括皮肤癌医生的人工智能。
■共260名疑似MM病变的参与者进行了活检，83（31.9％）被发现是黑色素瘤。在真正的阳性MM中，只有一小部分参与者（21.7％的特异性）正确地担心可疑病变是MM。这些MMs主要位于背面(44.4%)，肩膀(11.1%)和大腿(11.1%)。意识到MM的参与者与未意识到MM的参与者之间的大小没有显着差异（P=0.824，24.6vs23.4mm2）。与女性相比，男性明显更多的被关注病变（P=0.008，61.1％vs38.9％，分别)。关于真阴性，男性和女性相似(52.1%vs47.9%，分别)。关于假阴性(n=65)，与女性相比，男性比例更高（66.2％vs33.8％，分别)。与原位MM相比，参与者更有可能正确识别侵入性MM（27.3％对21.3％）。
本研究中只有一小部分参与者能够自我识别原位或侵袭性MM为关注的病变，并倾向于识别更晚期的病变，考虑到MM与高死亡率和治疗成本相关，特别是在侵入性的时候，非专业人员无法识别这些癌性病变可能会导致治疗延迟和可能的不良结果。我们认为，应该重新审视澳大利亚全科医生目前的黑色素瘤筛查做法，以改善患者在MM方面的预后。此外,预防活动应包括MM的图像和主要危险因素。
■多站点，横断面研究设计，包括描述性调查和全身皮肤癌筛查，包括皮肤癌医生的人工智能。
■共260名疑似MM病变的参与者进行了活检，83（31.9％）被发现是黑色素瘤。在真正的阳性MM中，只有一小部分参与者（21.7％的特异性）正确地担心可疑病变是MM。这些MMs主要位于背面(44.4%)，肩膀(11.1%)和大腿(11.1%)。意识到MM的参与者与未意识到MM的参与者之间的大小没有显着差异（P=0.824，24.6vs23.4mm2）。与女性相比，男性明显更多的被关注病变（P=0.008，61.1％vs38.9％，分别)。关于真阴性，男性和女性相似(52.1%vs47.9%，分别)。关于假阴性(n=65)，与女性相比，男性比例更高（66.2％vs33.8％，分别)。与原位MM相比，参与者更有可能正确识别侵入性MM（27.3％对21.3％）。
本研究中只有一小部分参与者能够自我识别原位或侵袭性MM为关注的病变，并倾向于识别更晚期的病变，考虑到MM与高死亡率和治疗成本相关，特别是在侵入性的时候，非专业人员无法识别这些癌性病变可能会导致治疗延迟和可能的不良结果。我们认为，应该重新审视澳大利亚全科医生目前的黑色素瘤筛查做法，以改善患者在MM方面的预后。此外,预防活动应包括MM的图像和主要危险因素。
