Objectives. An important factor that influence survival of patients with melanoma is tumour thickness sec. Breslow. To test relationship between tumour thickness and diagnosis/treatment delay we analysed data of 530 patients with melanoma from our Institute. Methods. The Breslow tumour thickness was categorized into two categories (≤ 1.49; ≥1.5). Three time intervals were examined to evaluate diagnostic delay: the Patient Delay (PD), time from first symptom to seeking medical advice, the Medical Delay (MD), time from the first medical consultation to hospital admission, the Total Delay (TD), time from first symptom to resection. The variables evaluated in the analysis were: age at diagnosis, education, occupational status, first symptom, visibility of tumour. Results. Significant risks of Breslow tumour thickness ≥ 1.5 mm were found in patients who had a low level of education (OR 3.0,95% CI 1.9-5.0), or unemployed (OR 1.7,95% IC 1.1-2.8). In PD there was a significant risk in >3 months delay for the anatomic location visually accessible to patients (OR 2.0; 0.95 CI 1.2-3.4) was found in patients examined by a dermatologist. Conclusion. Our results indicate that exist a certain independence of prognosis from delay in diagnosis, but prognosis rather closely correlated to the depth of the lesion. Therefore in melanoma, compared to other tumors like breast cancer, the delay in diagnosis seems to be not correlated with the prognosis of the neoplasm. The relation between diagnostic delay and thickness is not direct or casual, it is often attributed to chance and it is correlated to some socio-cultural variables, to type of physician who make the first visit, to mole sites and to other personal attitudes (18). In fact skin cancer of the inferior limbs, although very evident, contributes greatly to patient delay and overall delay compared with melanoma on the trunk, perhaps because the continued visibility is falsely reassuring and makes it more difficult to notice modifications.
Influence of delay in diagnosis of melanoma on tumour thickness / Fabbrocini, Gabriella; Montella, M; Crispo, A; Scalvenzi, Massimiliano; Ascierto, Pa; Barberio, Emanuela; Amore, A; Santoianni, Pietro. - (2002). (Intervento presentato al convegno The EDEN-IDEA MEETING AT THE WORLD CONGRESS, 4th international meeting epidemiology and prevention of skin disease tenutosi a Palais des Congres de Paris nel 30/06/2002).
Influence of delay in diagnosis of melanoma on tumour thickness
FABBROCINI, GABRIELLA;SCALVENZI, MASSIMILIANO;BARBERIO, EMANUELA;SANTOIANNI, PIETRO
2002
Abstract
Objectives. An important factor that influence survival of patients with melanoma is tumour thickness sec. Breslow. To test relationship between tumour thickness and diagnosis/treatment delay we analysed data of 530 patients with melanoma from our Institute. Methods. The Breslow tumour thickness was categorized into two categories (≤ 1.49; ≥1.5). Three time intervals were examined to evaluate diagnostic delay: the Patient Delay (PD), time from first symptom to seeking medical advice, the Medical Delay (MD), time from the first medical consultation to hospital admission, the Total Delay (TD), time from first symptom to resection. The variables evaluated in the analysis were: age at diagnosis, education, occupational status, first symptom, visibility of tumour. Results. Significant risks of Breslow tumour thickness ≥ 1.5 mm were found in patients who had a low level of education (OR 3.0,95% CI 1.9-5.0), or unemployed (OR 1.7,95% IC 1.1-2.8). In PD there was a significant risk in >3 months delay for the anatomic location visually accessible to patients (OR 2.0; 0.95 CI 1.2-3.4) was found in patients examined by a dermatologist. Conclusion. Our results indicate that exist a certain independence of prognosis from delay in diagnosis, but prognosis rather closely correlated to the depth of the lesion. Therefore in melanoma, compared to other tumors like breast cancer, the delay in diagnosis seems to be not correlated with the prognosis of the neoplasm. The relation between diagnostic delay and thickness is not direct or casual, it is often attributed to chance and it is correlated to some socio-cultural variables, to type of physician who make the first visit, to mole sites and to other personal attitudes (18). In fact skin cancer of the inferior limbs, although very evident, contributes greatly to patient delay and overall delay compared with melanoma on the trunk, perhaps because the continued visibility is falsely reassuring and makes it more difficult to notice modifications.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
