Patients At High Risk For Melanoma Benefit When Partner Is Involved In Skin Self-Exams

Early detection of melanoma, the most serious form of skin cancer, is critical to effectively treat this potentially fatal disease that accounts for more than 73 percent of all skin cancer deaths. While dermatologists have long stressed the importance of conducting regular skin self-exams as an important detection tool in the fight against skin cancer, a new study finds that people who are assisted by a partner in performing skin self-exams are more likely to follow a regular detection routine than those who rely solely on themselves for motivation.

Speaking today at the 65th Annual Meeting of the American Academy of Dermatology, dermatologist June K. Robinson, MD, FAAD, professor of clinical dermatology at Northwestern University Feinberg School of Medicine in Chicago, discussed her article entitled "Examination of mediating variables in a partner assistance intervention designed to increase performance of skin self-examination" to be published in an upcoming issue of the Journal of the American Academy of Dermatology.

"There is evidence suggesting that deaths from melanoma could be lowered by as much as 63 percent if the general public performed monthly skin self-examinations," said Dr. Robinson. "However, routine skin self-exams may be even more important in people at high risk for skin cancer, such as those with a personal or family history of skin cancer. Our study examined how involving a partner affected detection attitudes and behaviors in a group of patients with melanoma or atypical moles."

Study participants included 130 patients with a history of melanoma who were randomly assigned to either a solo-learning control group or a partner-learning group (65 participants in each group). Partners were either a spouse of the participant or a person living in the same household as the participant for at least one year prior to the study.

At the beginning of the study, participants in each group (including partners) received instructions that included a 10-minute educational presentation, a skills training session about the rules of early melanoma detection, and a demonstration using a magnifying glass to look for moles with irregular borders and uneven colors. Each participant was given a take-home kit that consisted of a brochure, a lighted handheld magnifying glass and a bound set of body maps consisting of several diagrams of the body with a place to mark areas that were examined and any suspicious lesions. Using the body maps to document moles served as the key behavioral measure of the monthly examinations.

In conducting this study, Dr. Robinson and her team theorized that involving a partner would increase the likelihood of conducting regular skin self-exams by providing social support and modeling behaviors for the exams, by assisting participants in examining hard-to-see places and by helping participants understand the instructions and information provided to complete the study.

"Our study showed that participants in the partner-learning group were significantly more likely to conduct skin self-exams at the four-month follow-up compared with those in the solo-learning group," noted Dr. Robinson. "When we compared how each group used the body maps, we found that participants assisted by a partner used them twice as much as participants without a partner."

In order to assess what factors had the greatest impact on increasing the effectiveness of involving a partner in the skin self-exams, Dr. Robinson and her team measured six core belief/attitudinal variables. The variables that were measured included:

-- Attitudes toward skin self-exams

-- Self-efficacy or confidence in the ability to effectively perform skin -- self-exams

-- Comfort with having a partner help with skin self-exams

-- Perceived melanoma/skin cancer risk

-- Concern about developing skin cancer/sun damage, and

-- Melanoma/skin cancer knowledge.

"Having a partner assist in skin self-exams led to significantly more positive attitudes toward the importance of skin self-exams, higher reports of self-efficacy or confidence in the ability to perform the exams and more comfort with someone helping to examine their skin compared with those in the solo-learning group," reported Dr. Robinson. "It is interesting to note that participants with partners had significantly less concern about developing sun-damaged skin in the future than participants in the solo-learning group. This could be attributed to the fact that those with a partner may have felt more confident than the solo learners in their ability to protect themselves from the sun."

The other two variables that were studied perceived risk of skin cancer and knowledge about skin cancer did not produce significantly different attitude changes among either group of participants.

"Across both study groups, we found that as attitudes about the importance of skin self-exams increased, behaviors increased as well," added Dr. Robinson. "While this short-term study demonstrated the positive effects of enlisting the help of a partner in performing skin self-exams, future research should be conducted to test whether the reported attitudinal and behavioral changes lead to sustained, long-term screening behaviors. In the meantime, patients should be encouraged to utilize a partner when performing skin self-exams."

To learn more about a skin self-exam, visit http://www.aad.org/aad/newsroom.

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or http://www.aad.org.

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