Can primary prevention or selective screening for melanoma be more precisely targeted through general practice ? A prospective study to validate a self administered risk score. Commentary.
To establish whether a questionnaire incorporating MacKie's risk factor now chart can identify patients at high risk for melanoma so that they can be targeted for primary and secondary prevention.
To validate the risk score derived from the questionnaire and test the feasibility of self completion by comparing patients'self reported skin characteristics with a skin examination performed by an experienced general practitioner.
Prospective questionnaire survey followed by a comparative study.
16 randomly selected group practices in a health district in Cheshire, United Kingdom.
Questionnaire survey-3105 consecutive patients aged 16 years and over attending for a primary care consultation ; comparative study-a self selected subsample of 388 of the 3105 patients.
Main outcome measures
MacKie risk group for melanoma.
Comparison of high risk skin characteristics reported by patients and those noted during a skin examination by a doctor (K statistic).
4.3% of patients (87% women) were in the highest risk group and 4.4% (79% men) were in the second highest risk group, as defined by the MacKie score.
Agreement between patients'self appraisal of skin characteristics and clinical skin examinations was reflected in K values of 0.67 for freckles, 0.60 for moles, and 0.43 for atypical naevi.
This questionnaire helped to identify a group at high risk for melanoma. (...)
Mots-clés Pascal : Mélanome malin, Dépistage, Enquête publique, Facteur risque, Etude comparative, Prospective, Arbre décision, Prévention, Médecine générale, Homme, Tumeur maligne
Mots-clés Pascal anglais : Malignant melanoma, Medical screening, Public inquiry, Risk factor, Comparative study, Prospective, Decision tree, Prevention, Internal medicine, Human, Malignant tumor
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0103039
Code Inist : 002B08A. Création : 22/06/1998.