Melanoma screening - Report of a survey in occupational medicine

Background: Epidemiological studies concerning melanoma are most often perf ormed by general practitioners and dermatologists in patients previously aw are of the risk of nevi. Objective: To determine the efficiency of early detection BE melanoma by oc cupational medicine specialists trained in the use of ABCDE criteria during annual systematic examination of workers. Methods: A total of 370 subjects with suspect lesions that demonstrated at least 2 of 5 ABCDE criteria were selected from 65 000 employees examined; t hese subjects were requested to see their physician about possible excision . Of the 370 subjects, 273 (73.8%) were seen at a second-year follow-up vis it to determine their outcome. Results: Among the 273 subjects who were seen again, 172 (63.0%) had consul ted a physician. For the 101 subjects who had not seen a physician, the mai n reason was the negligence (86.1%). A total of 353 atypical nevi were obse rved. The mean number of ABCDE criteria noted per lesion was 2.6. Lesion di ameter greater than 6 mm was the most frequent (80.5%) and enlargement the least frequent criteria seen; heterochromous coloration and diameter greate r than 6 mm was the most common association (54.5%). Five histologically co nfirmed melanomas were found among nevi excised in 78 subjects. Conclusion: This screening approach seems efficient for the early detection of melanoma, demonstrating an incidence of 7.7 per 100 000 vs 9 per 100 00 0 in the general French population.