Higher adherence to dermatology appointments after a first melanoma diagnosis is associated with a reduction in melanoma-specific mortality, according to research published in the Journal of the American Academy of Dermatology.1 The authors said that the findings support exploring different ways to improve adherence rates.
In the United States, melanoma represents the fifth most common cancer. Rates of the disease have been increasing significantly in the country over the past several decades, growing by over 320% since 1975.2 Although deaths from melanoma have fallen around 30% in the last 10 years, dermatology follow-up—which is universally recommended by melanoma care guidelines—is lagging among patients.
Key Takeaways
- Higher adherence to dermatology appointments after a first melanoma diagnosis is linked to a reduction in melanoma-specific mortality, emphasizing the importance of regular follow-up care.
- Only 28% of patients were fully adherent to annual dermatologic examinations, while nearly 27% never saw a dermatologist during follow-up, indicating a significant gap in adherence.
- Younger age, prior outpatient visits, female sex, higher income, and greater access to dermatology care were identified as strong predictors of adherence to follow-up dermatology appointments.
“A full body skin examination by a physician with appropriate expertise remains the gold standard in skin cancer follow-up, as most recurrences for early stage melanomas are locoregional,” the authors wrote. “Dermatologist-led surveillance facilitates early detection and intervention for recurrences or new primary tumors, as well as psychosocial support and patient education.”
A team of investigators from Queen’s University and the University of Toronto conducted a study to determine the level of adherence to annual dermatologic follow-up in patients with primary cutaneous melanoma. Data for the retrospective inception cohort analysis was gathered from health administrative data sets in Ontario, Canada.
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The study cohort included 10084 adult patients who were diagnosed with their first ever invasive cutaneous melanoma from January 2010 to December 2013. Patients were identified through the Ontario Cancer Registry. Dermatologist follow-up visits were identified via the Ontario Health Insurance Plan. Patients were followed until whichever of these 3 occurred first: death, loss of provincial health insurance coverage, or 5 years after diagnosis.
Patients were excluded from the study if they had a follow-up duration of 1 year or less, if they were not an Ontario resident eligible for the Ontario Health Insurance Plan, if they were under the age of 18, and if they had a previous diagnosis of melanoma. The median age at melanoma diagnosis was 63 and 53.1% of patients were male. The most common melanoma was Stage 1 at 44.7%, followed by unknown stage at 29.5%, stage 2 at 16%, stage 3 at 8.3%, and stage 4 at 1.5%.
