EXAMINATION OF THE ABILITY OF PEOPLE TO IDENTIFY EARLY CHANGES OF MELANOMA IN COMPUTER-ALTERED PIGMENTED SKIN-LESIONS

Objectives: To examine whether older people were less able to distingu ish changes of melanoma than younger people, and to test whether an ed ucational brochure illustrating changes of melanoma would increase the ir ability to detect the changes. Design: Photographic images of pigme nted skin lesions were altered using computer graphics software. Image s of typical changes of melanoma were shown to groups of volunteers yo unger than 30 years (n=52) and older than 45 years (n=41). Short inter vals (seconds) between viewing of the original and changed lesions wer e used to test ability to distinguish the changes, and longer interval s (29 and 60 days) were used to test their ability over more realistic intervals. All participants were randomized to receive an educational brochure (designed using the same technology) to evaluate whether thi s would assist in identifying early changes of melanoma. Setting: A cr oss section of volunteers employed in a large semigovernment utility. Intervention: An educational brochure that illustrated typical changes of melanoma. Main Outcome Measure: Score of correct or incorrect dete ction of changed or unchanged skin lesions. Results: Tests at short in tervals showed that both age groups were able to detect early changes of melanoma but had poor ability to detect changes of melanoma at long er intervals. Repeated viewing of the original lesions enabled the par ticipants to once more recognize the changes. Both groups had low abil ity to detect the appearance of new pigmented lesions. The educational brochure improved the ability of participants to detect change. Concl usions: The main difficulty people have in self-detection of melanoma is limited ability to recall the appearance of their skin. This abilit y did not differ between the age groups. Educational material that foc used on change was effective in increasing the ability to detect chang es over short intervals. Photographic records may be the most effectiv e aid for detection of changes at longer intervals.