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Canadian Journal of Public Health

, Volume 96, Issue 2, pp 136–139 | Cite as

Family Physician Visits and Early Recognition of Melanoma

  • Melanie L. Di Quinzio
  • Ron A. Dewar
  • Frederick I. Burge
  • Paul J. Veugelers
Article

Abstract

Background

Malignant melanoma is a deadly skin cancer with a rapidly-increasing incidence, mortality and public health burden. Thin melanomas are easily treated with good prognosis, while the thicker lesions have relatively poor survival. To broaden strategies for early recognition of melanoma, we investigated the relationship between primary care service and melanoma thickness at diagnosis.

Methods

All 714 patients diagnosed with a primary malignant melanoma between January 1995 and December 1999 in Nova Scotia were included in the present study and linked to provincial physician billing databases to reveal the patients’ use of family physician services prior to the diagnosis of melanoma. We examined the importance of physician use of services for tumour thickness using logistic regression while adjusting for potential confounders. Tumour thickness was dichotomized to thin and thick using 0.75 mm as a cutoff.

Results

Patients who regularly visited their family physician (2 to 5 times during a two-year interval prior to diagnosis) were 66% (95% CI, 31–84) less likely to be diagnosed with thick melanoma as compared to patients who consulted their family physician less or not at all. Progression to thick tumours could have been reduced by 11.70% (95% CI, -1.33–25.77) if all patients had consulted their family physician at least once a year.

Discussion

Increased awareness of the need for regular medical check-ups could reduce the public health burden of melanoma.

MeSH terms

Melanoma neoplasms prevention and control primary health care public health 

Résumé

Contexte

Le mélanome malin est un cancer mortel de la peau dont l’incidence, la mortalité et le fardeau pour la santé publique augmentent rapidement. Les mélanomes minces sont faciles à traiter et présentent un bon pronostic, mais les chances de survivre à une lésion plus épaisse sont relativement faibles. Pour étoffer les stratégies de dépistage précoce des mélanomes, nous avons étudié la relation entre les services de soins primaires et l’épaisseur du mélanome lors du diagnostic.

Méthode

Les 714 patientes et patients ayant reçu un diagnostic de mélanome primaire entre janvier 1995 et décembre 1999 en Nouvelle-Écosse ont été inclus dans la présente étude, et nous avons relié les informations à leur sujet aux bases de données de facturation des médecins de la province pour déterminer si ces patientes et patients avaient utilisé les services d’un médecin de famille avant leur diagnostic. Nous avons examiné l’importance du recours aux services d’un médecin selon l’épaisseur de la tumeur au moyen d’une analyse de régression logistique, après ajustement selon les facteurs confusionnels possibles. Les tumeurs mesurant moins de 0,75 mm d’épaisseur ont été jugées minces, et les autres, épaisses.

Résultats

Les personnes qui avaient périodiquement consulté leur médecin de famille (de deux à cinq fois pendant la période de deux ans précédant le diagnostic) étaient dans une proportion de 66 % (IC de 95 % = 31–84) moins susceptibles d’avoir reçu un diagnostic de mélanome épais que les patientes et les patients ayant consulté leur médecin de famille moins souvent ou ne l’ayant pas fait du tout. Il aurait été possible de réduire l’épaississement des tumeurs dans une proportion de 11,7 % (IC de 95 % = 1,33 25,77) si l’ensemble des patientes et des patients avaient consulté leur médecin de famille au moins une fois l’an.

Discussion

Une sensibilisation accrue au besoin de subir des examens de santé périodiques pourrait réduire le fardeau que représentent les mélanomes pour la santé publique.

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Copyright information

© The Canadian Public Health Association 2005

Authors and Affiliations

  • Melanie L. Di Quinzio
    • 1
  • Ron A. Dewar
    • 2
  • Frederick I. Burge
    • 3
  • Paul J. Veugelers
    • 1
    • 4
  1. 1.Department of Community Health and EpidemiologyDalhousie UniversityHalifaxCanada
  2. 2.Cancer Care Nova ScotiaCanada
  3. 3.Department of Family MedicineDalhousie UniversityCanada
  4. 4.Department of Public Health SciencesUniversity of AlbertaEdmontonCanada

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