HealthDay News — A structured surveillance program for high-risk melanoma patients can be scaled and successfully replicated even in a primary care skin cancer clinic, according to a study published online in JAMA Dermatology.

Pascale Guitera, MD, PhD, from the Melanoma Institute Australia at the University of Sydney, and colleagues examined the longer-term sustainability and expansion of a melanoma surveillance program for high-risk patients (full-body examinations every 6 months aided by total-body photography [TBP] and sequential digital dermoscopy imaging) to numerous practices, including a primary care skin cancer clinic setting. The analysis included 593 patients assessed from 2012 to 2018 at 3 dermatology clinics and 1 primary care skin cancer clinic.

The researchers found 1513 lesions were excised during follow-up, including 171 primary melanomas, and excision ratios were similar across the 4 centers. In the first 2 years, the risk for developing a new melanoma was 9% annually, which increased with time, particularly for those with multiple primary melanomas. The seven thicker melanomas (>1 mm Breslow thickness; 4.1% of melanomas) were mostly desmoplastic or nodular (4 of 7), self-detected (2 of 7), or clinician detected without the aid of TBP (3 of 7). New melanomas (171) were most likely to be detected by a clinician with the aid of TBP (31.6%) followed by digital dermoscopy monitoring (29.2%).


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“The findings of this cohort study suggest that the structured surveillance program may be implemented on a larger scale, including at primary care skin cancer clinics, with consistent and sustainable benefits observed,” the authors write.

One author disclosed financial ties to a medical technology company and one disclosed ties to the pharmaceutical industry.

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