Urgent access to a specialty care melanoma clinic is associated with a higher rate of melanoma detection - 10/08/11
Reprint requests: Hensin Tsao, MD, PhD, Department of Dermatology, Massachusetts General Hospital, Bartlett 622, 48 Blossom St, Boston, MA 02114.Abstract |
Background |
As melanoma rates increase, and the supply of dermatologists remains suboptimal to meet demand for services, detection of early melanoma has become an increasingly difficult challenge. Some authors advocate for shifting dermatologic resources from routine appointments to urgent visits for those with lesions concerning for melanoma.
Objective |
We sought to investigate the potential of an urgent access track (UAT) embedded within a pigmented lesion clinic to improve early melanoma detection.
Methods |
We conducted a retrospective review of patient records from a tertiary care hospital’s pigmented lesion clinic and the associated UAT. Results of procedures for all 4495 patient visits to the routine track and all 316 visits to the UAT during the 21-month study period were included, as were detailed chart reviews of all UAT patient visits.
Results |
UAT visits were more than 4 times as likely (4.1% vs 1.0%) to yield a diagnosis of melanoma as routine track visits (odds ratio 4.24; 95% confidence interval 2.28-7.88; P < .0001), and almost 25 times as likely (2.2% vs 0.1%) to yield a diagnosis of metastatic melanoma (odds ratio 25.4; 95% confidence interval 7.4-87.4; P < .0001).
Limitations |
This was a preliminary analysis with only limited data extracted from the routine track pigmented lesion clinic patient visits.
Conclusion |
This initial analysis of UAT strategy suggests that UATs have potential to detect patients with earlier melanomas; further research is needed to specifically delineate how resources should be best allocated between routine surveillance and urgent care to maximize melanoma early detection and survival.
Le texte complet de cet article est disponible en PDF.Key words : detection, melanoma, pigmented lesion, pigmented lesion clinic, routine visit, urgent access, urgent access track
Abbreviations used : CI, MGH, OR, PLC, UAT
Plan
| The first two authors contributed equally to this study. |
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| Supported in part by clinical revenues and generous donors to the Massachusetts General Hospital on behalf of melanoma research. |
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| Conflicts of interest: None declared. |
Vol 64 - N° 6
P. 1060-1067 - juin 2011 Retour au numéro
Article précédent
- A new American Joint Committee on Cancer staging system for cutaneous squamous cell carcinoma: Creation and rationale for inclusion of tumor (T) characteristics
- Sharifeh Farasat, Siegrid S. Yu, Victor A. Neel, Kishwer S. Nehal, Thomas Lardaro, Martin C. Mihm, David R. Byrd, Charles M. Balch, Joseph A. Califano, Alice Y. Chuang, William H. Sharfman, Jatin P. Shah, Paul Nghiem, Clark C. Otley, Anthony P. Tufaro, Timothy M. Johnson, Arthur J. Sober, Nanette J. Liégeois
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