Abstract:
BACKGROUND:Increasing incidence and mortality rates from cutaneous melanoma are a major public health concern. As part of a national effort to enhance early detection of melanoma/skin cancer, the American Academy of Dermatology (AAD) has sponsored an annual education and early detection program that couples provision of skin cancer information to the general public with almost 750,000 free skin cancer examinations (1985-1994). OBJECTIVE:To begin to evaluate the impact of this effort, we determined the final pathology diagnosis of persons attending the 1992-1994 programs who had a suspected melanoma at the time of examination. METHODS:We directly contacted all such persons by telephone or mail and received pathology reports from those who had a subsequent biopsy. RESULTS:We contacted 96% of the 4458 persons with such lesions among the 282,555 screenings in the 1992-1994 programs. We obtained a final diagnosis for 72%, and the positive predictive value for melanoma was 17%. Three hundred seventy-one melanomas were found in 364 persons. More than 98% had localized disease. More than 90% of the confirmed melanomas with known histology were in situ or "thin" lesions (< or = 1.50 mm thick). The median thickness of all melanomas was 0.30 mm. The 8.3% of AAD cases with advanced melanoma (metastatic disease, regional disease, or lesions > or = 1.51 mm) is a lower proportion than that reported by the 1990 Surveillance, Epidemiology and End Result Registry. The rate of thickest lesions (> or = 4 mm) and late-stage melanomas among all participants was 2.83 per 100,000 population. Of persons with a confirmed melanoma, 39% indicated (before their examination) that without the free program, they would not have considered having a physician examine their skin. CONCLUSION:The 1992-1994 free AAD programs disseminated broad skin cancer educational messages, enabled thousands to obtain a free expert skin cancer examination, and found mostly thin, localized stage 1 melanomas (usually associated with a high projected 5-year survival rate). Because biases impose possible limitations, future studies with long-term follow-up and formal control groups should determine the impact of early detection programs on melanoma mortality.
journal_name
J Am Acad Dermatoljournal_title
Journal of the American Academy of Dermatologyauthors
Koh HK,Norton LA,Geller AC,Sun T,Rigel DS,Miller DR,Sikes RG,Vigeland K,Bachenberg EU,Menon PA,Billon SF,Goldberg G,Scarborough DA,Ramsdell WM,Muscarella VA,Lew RAdoi
10.1016/s0190-9622(96)90274-1subject
Has Abstractpub_date
1996-06-01 00:00:00pages
971-8issue
6eissn
0190-9622issn
1097-6787pii
S0190-9622(96)90274-1journal_volume
34pub_type
杂志文章abstract::Melanomas are rare in patients who have albinism, compared with the frequent occurrence of squamous cell carcinomas and basal cell carcinomas. This report describes amelanotic metastatic melanoma in a 58-year-old Japanese man who had tyrosinase-positive oculocutaneous albinism. A prolonged bleeding time, facioscapuloh...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/0190-9622(93)70128-g
更新日期:1993-05-01 00:00:00
abstract::Treatment with systemic immunomodulatory agents is indicated for patients with moderate to severe plaque psoriasis and psoriatic arthritis. In these patients, surgery may confer an increased risk of infectious or surgical complications. We conducted a literature review to examine studies addressing the use of methotre...
journal_title:Journal of the American Academy of Dermatology
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abstract:BACKGROUND:There are multiple therapeutic options for the treatment of moderate to severe psoriasis. The process of choosing among potential treatment options requires both the physician and the patient to weigh the benefits of individual modalities against their potential risks. Traditional systemic therapies for psor...
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journal_title:Journal of the American Academy of Dermatology
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journal_title:Journal of the American Academy of Dermatology
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更新日期:1998-05-01 00:00:00
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journal_title:Journal of the American Academy of Dermatology
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更新日期:2007-08-01 00:00:00
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更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Enfuvirtide is the first of a new class of antiretroviral agents for the treatment of HIV-1 infection, called the fusion inhibitors. The most common type of adverse event associated with enfuvirtide treatment is injection site reactions, occurring in up to 98% of patients. Many of these lesions are symptomat...
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journal_title:Journal of the American Academy of Dermatology
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