Melanoma early detection with thorough skin self-examination: the "Check It Out" randomized trial.

BACKGROUND

Monthly thorough skin self-examination (TSSE) is an important practice for early melanoma detection that is performed by a small minority of the population.

DESIGN

A randomized trial was conducted to determine whether a multicomponent intervention can increase TSSE performance and to describe the effects on performance of skin surgeries compared with a similar control intervention focused on diet.

SETTING/PARTICIPANTS

One thousand three hundred fifty-six patients attending a routine primary care visit in southeastern New England participated in this trial.

INTERVENTIONS

Participants received instructional materials, including cues and aids, a video, and a brief counseling session and (at 3 weeks) a brief follow-up phone call (from a health educator) and tailored feedback letters.

MEASURES

Performance of TSSE assessed by telephone interview and having a surgical procedure performed on the skin were confirmed by examining medical records.

RESULTS

TSSE was performed by substantially more participants at 2, 6, and 12 months in the intervention group than in the control group (55% vs 35%, p<0.0001 at 12 months). We also noted that a substantially higher proportion in the intervention group had skin surgery in the first 6 months (8.0% vs 3.6%, p=0.0005), but there was no difference at 6 to 12 months (3.9% vs 3.3%, p=0.5).

CONCLUSIONS

The TSSE intervention was effective in increasing performance of TSSE, in that it resulted in increased surgery on the skin, and that increase in skin procedures only persisted for 6 months. Intervention to increase TSSE may result in long-term benefit in early detection of melanoma while causing only a short-term excess of skin surgeries.