Use of health services before the diagnosis of melanoma : implications for early detection and screening

To determine whether persons with melanoma were integrated into the health care system prior to diagnosis. Population-based survey by mailed questionnaire. 216 persons with malignant melanoma diagnosed in Massachusetts in 1986. Of the 216 cases, 87% stated that they had regular physicians, 63% had seen those physicians in the year prior to diagnosis, but only 20% had regular dermatologists. Overall, only 24% had examined their own skin prior to diagnosis and 20% reported physician skin examinations. Persons diagnosed with melanoma reported extensive contact with regular physicians in the year prior to diagnosis. However, most of these persons neither received skin examinations nor examined their own skin during that time. While additional study is necessary to confirm these findings, the authors suggest that physicians caring for patients at risk for melanoma integrate melanoma screening into routine care.