Since melanoma is potentially fatal, one implication of the study is patients should see their physicians promptly if they notice a change in a mole or find a new mole, according to Susan E. Koch, MD, Department of Dermatology at Oregon Health Sciences University in Portland. "We want to reduce melanoma mortality by finding tumors when they are thinner and therefore less likely to metastasize [spread], " Dr. Koch said.

In the study group of 102 individuals, 55 percent of melanomas were detected by the patients, while 24 percent were found by physicians. Spouses and others, such as a child, other relative, or friend, found the remainder. Researchers were already aware that patients were more likely to find their own melanomas than their doctors, but this study went a step further and correlated the thickness of tumors with who found them.

Researchers found tumors detected by doctors were significantly thinner (averaging 0.23 millimeters) than those found by patients (averaging 0.9 millimeters). When tumors were detected by physicians, researchers found a biopsy, or removal of a tissue sample to check for cancer cells, was performed more quickly. In 83 percent of the physician-detected cases, a biopsy was performed within a month. For patient-detected tumors, only 16 percent of the tumors were biopsied within a month.

This difference could reflect the difficulty in scheduling a doctor?s appointment, but it could also be influenced by a lack of awareness of the signs and seriousness of melanoma, Dr. Koch said. "Many patients felt no urgency, " she explained. "It was the exception for them to act promptly. " Melanoma is not usually painful, so patients may not realize the condition is serious even if they notice bleeding or a change in the color or size of a mole.

This study reveals the need to raise awareness of skin cancer among physicians as well as patients, said Mary O?Connell, director of skin cancer initiatives for the American Cancer Society. She encouraged physicians to listen to their patients when they ask about changes to moles and birthmarks.

The ACS is participating in a program to help teach physicians more about evaluating melanomas, according to Martin Weinstock, MD, a professor of dermatology at Brown University in Providence, Rhode Island, and chairman of the ACS Skin Cancer Advisory Board.

The ACS estimates that 44,200 new cases of melanoma will be found in the US this year, and there will be 7,300 deaths from the disease. The ACS recommends a cancer-related checkup, including skin examination, every three years for individuals ages 20-40 and annual examinations for those over 40. Regular self-examination is also recommended.

• New Melanoma Test
• TA-90 Marker for Skin Cancer
• Melanoma Skin Cancer