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Spotting Melanomas - a new study says it isn't easy

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Lara Leahy

07 July 2024, 10:09 PM

Spotting Melanomas - a new study says it isn't easyFindings say 80% of lay people misdiagnose melanomas.

Taking care of our skin's health without specialist consultation appears to be problematic. Southern Cross University (SCU) has identified this and done a study on it. The recommendation - get checked!

“Our findings are alarming. It was only 21% of those with a melanoma that could identify it was a lesion of concern. So basically, 80% of our participants did not realise they had melanoma,” says Associate Professor Mike Climstein Director of Aquatic Based Research at SCU.

Another discovery was the high percentage of people who would self-diagnose a false negative outcome. Prof. Climstein says, “A “false negative” is a big problem. A false negative is where the lesion of concern was thought to be a regular mole but was, in fact, a melanoma.”

Men are better at spotting a melanoma - it is not known why. But even that incremental advantage does not allow them to make a sufficiently accurate reading.

Melanomas are categorised into two diagnoses - In Situ or Invasive. Prof. Climstein explains the difference.

“Melanomas are either in situ, meaning the cancer cells are only at the top level of the skin, or invasive, meaning the cancer cells have invaded the skin (deeply) and may have metastasised through the body.

“When a melanoma has metastasised, we get a “Breslow thickness” on the histopathology report. The Breslow thickness is a measure (in mm) of how far the cancer has penetrated through the skin. The deeper the penetration, the poorer the outcome for the patient.

“Unfortunately, there is no way for the specialist to know which melanomas are in situ and will metastasise or when they will metastasise.”

(Misdiagnosing a melanoma means delayed treatment, more extensive/invasive treatment and poorer patient outcome. Photo: Prof Climstein’s research)

This research came about after a discussion among peers. “We have six skin cancer (medical) specialists in the Aquatic Based Research Unit, and we hold regular Zoom meetings. 

“During one of the meetings, the discussion was on melanoma, and there was a consensus that most patients had no idea that the skin lesion they had was melanoma. Worse was when the patient had a lesion where they could see it and still did not recognise that it was a melanoma.”

At the time, they were working on another paper regarding melanomas. For the release, they selected a volunteer to undergo screening, “For the TV cameras, lo and behold, the specialist found a melanoma on her leg.”

All melanomas need to be identified and treated early for the best patient outcomes. It depends on your risk factor as to how often you are tested by a professional. 

“If any person does not have a history of melanoma, then a whole body screening at least once per year is recommended.  

“If a person has had skin cancer of any type, a 6-monthly total body skin check is recommended. For example, squamous cell carcinomas (SCC skin cancer) can spread to other parts of the body. 

“High risk for melanoma includes individuals who had a previous melanoma. 

"Very High risk includes a previous history of melanoma and multiple atypical nevi (moles), family history of melanoma, and genetic risk (i.e. CDKN2A gene).

“The general risk for skin cancer includes pale skin (or many freckles) that burns easily (does not tan), red or fair hair, and many moles.”

However, no one is immune to melanoma. 

If you would like to have a closer look, you can find the study here.

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