Lack of selective attendance of participants at skin cancer/melanoma screening clinics.

Abstract

Whether persons who come for skin cancer/melanoma screening are those at highest risk for the disease remains a debatable issue. Our purpose was to evaluate the appropriateness of self-selection of persons attending screening clinics. We studied the frequency of malignant and/or premalignant clinical diagnoses according to certain demographic characteristics as a measure of selective attendance among 2463 persons screened in the regions of Arnhem and Eindhoven in 1990. The referral rates for tentative malignant and/or premalignant diagnoses were more or less similar in men (11.8%) and women (9.6%); in persons with symptoms (11.6%) and those who were symptom free (9.3%); in attendants from the towns in which the screenings were held (11.4%) and those coming from distant communities (9.0%); and in persons who attended for specific skin lesions (10.7%) and those who opted for general skin examination (8.8%). The referral rate was 9.2% in persons younger than 70 years of age against 18.5% in those 70 years of age or older (p < 0.001). Most presumptive melanoma diagnoses (15 of 22) were recorded in persons 50 years of age or older. Our findings suggest that participants of free skin cancer/melanoma screening clinics, on average, are unable to estimate their own risk profile properly.