Abstract
Background
Dermoscopy is a widely used technique, recommended in clinical practice guidelines worldwide for the early diagnosis of skin cancers. Intra-European disparities are reported for early detection and prognosis of skin cancers, however, no information exists about regional variation in patterns of dermoscopy use across Europe.
Objective
To evaluate the regional differences in patterns of dermoscopy use and training among European dermatologists.
Materials & Methods
An online survey of European-registered dermatologists regarding dermoscopy training, practice and attitudes was established. Answers from Eastern (EE) versus Western European (WE) countries were compared and their correlation with their respective countries’ gross domestic product/capita (GDPc) and total and government health expenditure/capita (THEc and GHEc) was analysed.
Results
We received 4,049 responses from 14 WE countries and 3,431 from 18 EE countries. A higher proportion of WE respondents reported dermoscopy use (98% vs. 77%, p<0.001) and training during residency (43% vs. 32%) or anytime (96.5% vs. 87.6%) (p<0.001) compared to EE respondents. The main obstacles in dermoscopy use were poor access to dermoscopy equipment in EE and a lack of confidence in one’s skills in WE. GDPc, THEc and GHEc correlated with rate of dermoscopy use and dermoscopy training during residency (Spearman rho: 0.5–0.7, p<0.05), and inversely with availability of dermoscopy equipment.
Conclusion
The rates and patterns of dermoscopy use vary significantly between Western and Eastern Europe, on a background of economic inequality. Regionally adapted interventions to increase access to dermoscopy equipment and training might enhance the use of this technique towards improving the early detection of skin cancers.
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Acknowledgements: special thanks to Gerald Gabler, IDS webmaster, who accomplished the essential tasks of creating the study webpage, setting up and maintaining the online survey for 32 participating countries, creating the central online study database and participating in the data cleaning. Thanks also to all the members of National Coordinating Teams for their efforts in translating the questionnaires, disseminating the survey, motivating colleague dermatologists to respond, and collecting offline answers. Their names are listed on the Eurodermoscopy website http://euro.dermoscopy-ids.org. Funding: none. The web-based platform for online surveys used by the study was made available unconditionally by the International Dermoscopy Society. HPS holds an NHMRC MRFF Next Generation Clinical Researchers Program Practitioner Fellowship (APP1137127). Conflicts of interest: none.
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Forsea, AM., Tschandl, P., Zalaudek, I. et al. Inequalities in the patterns of dermoscopy use and training across Europe: conclusions of the Eurodermoscopy pan-European survey. Eur J Dermatol 30, 524–531 (2020). https://doi.org/10.1684/ejd.2020.3872
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DOI: https://doi.org/10.1684/ejd.2020.3872