The use of mole-mapping diagrams to increase skin self-examination accuracy.

Abstract

Monthly skin self-examination (SSE) is associated with reduced incidence of advanced melanoma, but SSE is prone to error in detecting early changes of melanoma. We sought to improve SSE accuracy by requiring participants to complete a mole-mapping diagram. After completing a baseline survey, participants received SSE instruction, had their backs digitally photographed, and half were randomized to complete a mole-mapping diagram. Some photographs were altered by adding an image of a 5-mm pigmented lesion. At follow-up, participants were asked to identify any changes introduced to their photographs. A total of 88 participants completed the study. In all, 33% (n = 15) of the control group (no diagram) and 52% (n = 22) of the intervention group (mole-mapping diagram) (P = .06) gave accurate assessments. Analysis of only altered images indicated that the intervention group gave more accurate assessments (60% vs 33%, P = .01). This study was limited by sample size, only addressed lesions on the back, and did not involve actual melanomas in study participants. Mole-mapping diagrams may improve SSE accuracy, and may be useful as a simple, cost-effective intervention in reducing melanoma mortality.