CUTANEOUS MALIGNANT-MELANOMA - CORRELATION BETWEEN TUMOR CHARACTERISTICS AND DIAGNOSTIC DELAY IN NORWEGIAN PATIENTS

Early diagnosis and treatment of cutaneous malignant melanoma are corn er stones of melanoma management. Delay in diagnosis may worsen the pr ognosis. The aim of the present study was to investigate reasons for d iagnostic delay in patients with melanoma in Norway and to relate dela y to Breslow thickness. Four hundred and fifty-seven patients with pri mary, invasive, cutaneous melanoma were diagnosed over a period of 7 m onths in 1994. All patients received a questionnaire 1-2 months after the diagnosis had been made: 352 patients (77%) responded. Information was collected from 345 patients concerning histological type, Breslow thickness/ invasional depth and stage of the disease, from The Cancer Registry of Norway. A histological classification was given for 307 m elanomas, of these, 231 were superficial spreading and 70 were nodular melanomas. Breslow thickness was given for 240, and Clark level for 7 0 melanomas. Mean Breslow thickness was 1.9 mm (median: 1.1 mm). Media n total diagnostic delay was 10 weeks, median patient delay 8 weeks. Y ounger men had a significantly longer patient delay than older men. Me dian professional delay was 1 week, 92% of patients reported less than 12 weeks professional delay. Sixty-three per cent of the cutaneous ma lignant melanomas had a Breslow thickness of less than 1.5 mm. Mean Br eslow thickness increased with shorter total diagnostic delay. Total d elay in diagnosis of cutaneous malignant melanoma, both patient; and p rofessional, is relatively small-in Norway compared to studies from ot her countries. Efforts to reduce mortality should focus on information to young men. There is no positive correlation between total diagnost ic delay and tumor thickness, reflecting the variability of melanoma b iology.