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An assessment of factors related to tumor thickness and delay in diagnosis of melanoma in southern Italy.

Abstract：

BACKGROUND:Since survival of patients with melanoma is strongly correlated with the Breslow tumor thickness of the primary lesion, factors that influence stage at diagnosis and delay in diagnosis are considered to be crucial. To test the relationship between tumor thickness and some social and clinical variables (including diagnosis/treatment delay) and the relationship between the diagnosis/treatment delay and some clinical variables, we analyzed data on 530 patients with melanoma from our Institute. METHODS:In the analysis, Breslow tumor thickness was categorized into two categories (< or =1.49, > or =1.5). Three time intervals were examined to evaluate diagnostic delay: patient delay, time from first symptom to seeking medical advice; medical delay, time from first medical consultation to hospital admission; total delay, time from first symptom to resection. The variables evaluated in the analysis were: age at diagnosis, education, occupational status, first symptom, visibility of tumor, anatomic site, and physician who made the initial diagnosis. RESULTS:A significant risk of having a Breslow tumor thickness > or =1.5 mm was noted in patients who had a low level of education (odds ratio 3.0, 95% confidence interval 1.9-5.0) or who were unemployed (odds ratio 1.7, 95% confidence interval 1.1-2.8). With respect to patient delay, a delay >3 months for anatomic locations visible to patients was associated with significant risk (odds ratio 1.7, 95% confidence interval 1.1-2.6); with respect to medical delay, a delay >3 months was associated with a higher risk in patients examined by a dermatologist (odds ratio 2.0, 95% confidence interval 1.2-3.4). CONCLUSIONS:Our results clearly indicate that in Southern Italy poorly educated and unemployed subjects are at risk of being diagnosed at a more advanced stage, and admission to an oncological hospital causes a delay (waiting list) in the time interval related to the doctor (medical delay).

journal_name

Prev Med

journal_title

Preventive medicine

authors

Montella M,Crispo A,Grimaldi M,De Marco MR,Ascierto PA,Parasole R,Melucci MT,Silvestro P,Fabbrocini G

doi

10.1006/pmed.2002.1067

subject

Has Abstract

pub_date

2002-09-01 00:00:00

pages

271-7

issue

eissn

0091-7435

issn

1096-0260

pii

S0091743502910674

journal_volume

pub_type

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An assessment of factors related to tumor thickness and delay in diagnosis of melanoma in southern Italy.