LACK OF SELECTIVE ATTENDANCE OF PARTICIPANTS AT SKIN-CANCER MELANOMA SCREENING CLINICS

Background: Whether persons who come for skin cancer/melanoma screenin g are those at highest risk for the disease remains a debatable issue. Objective: Our purpose was to evaluate the appropriateness of self-se lection of persons attending screening clinics. Methods: We studied th e frequency of malignant and/or premalignant clinical diagnoses accord ing to certain demographic characteristics as a measure of selective a ttendance among 2463 persons screened in the regions of Arnhem and Ein dhoven in 1990. Results: The referral rates for tentative malignant an d/or premalignant diagnoses were more or less similar in men (11.8%) a nd women (9.6%); in persons with symptoms (11.6%) and those who were s ymptom free (9.3%); in attendants from the towns in which the screenin gs were held (11.4%) and those coming from distant communities (9.0%); and in persons who attended for specific skin lesions (10.7%) and tho se who opted for general skin examination (8.8%). The referral rate wa s 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 diagno ses (15 of 22) were recorded in persons 50 years of age or older. Conc lusion: Our findings suggest that participants of free skin cancer/mel anoma screening clinics, on average, are unable to estimate their own risk profile properly.