Efficacy of a general practitioner training campaign for early detection of melanoma in France. (1st January 2014)

• Record Type: Journal Article
• Authors: Grange, F.; Woronoff, A.S.; Bera, R.; Colomb, M.; Lavole, B.; Fournier, E.; Arnold, F.; Barbe, C.
• Is Part Of: British journal of dermatology. Volume 170:Number 1(2014:Jan.)
• Page Start: 123
• Page End: 129
• Publication Date: 2014-01-01
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.12585
• Languages: English
• ISSNs: 0007-0963

Abstract

Summary: Background: To date, no strategy for improving early diagnosis of melanoma has been evaluated on a population basis in France. Objective: To evaluate the efficacy of a general practitioner (GP) awareness and training campaign in a pilot French geographical region (Champagne‐Ardenne), including 1·34 million inhabitants, 1241 GPs, 56 dermatologists and a population‐based melanoma registry. Methods: All GPs received repeated awareness postal mailings in 2008 and 398 (32·1%) attended training sessions organized by 27 dermatologists. The pre‐ (2005–7) and post‐campaign (2009–11) periods were compared for the following: primary endpoint – the world‐standardized incidence of very thick melanomas (VTM) (Breslow thickness ≥ 3 mm); secondary endpoints – the mean Breslow thickness; the proportions of VTM and of thin (< 1 mm) melanomas among invasive cases; and the ratio of in situ /all melanoma cases. Similar measures were performed in the control area of Doubs/Belfort territory (655 000 ha), where no similar campaign was carried out. Results: The incidence of VTM decreased from 1·07 to 0·71 per 100 000 habitants per year ( P = 0·01), the mean Breslow thickness from 1·95 to 1·68 mm ( P = 0·06) and the proportion of VTM from 19·2% to 12·8% ( P = 0·01). The proportion of thin and in situ melanomas increased from 50·9% to 57·4% ( P = 0·05) and from 20·1% to 28·2% ( P = 0·001), respectively. No significant variation was observed in Doubs/Belfort territory. Conclusion: These results strongly support the efficacy of such a campaign targeting GPs and provide a rationale for a larger public health campaign in France, including training of GPs by dermatologists and encouraging patients to ask their GP for a systematic skin examination.