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Dermatologists must better facilitate screenings of melanoma patients’ first-degree relatives
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A high percentage of dermatologists communicated to patients with melanoma that their first-degree relatives are at risk for the disease, but less than half routinely offered to screen first-degree relatives who live nearby, survey results show.
Susan Oliveria, ScD, an assistant attending epidemiologist at Memorial Sloan-Kettering Cancer Center, and colleagues sent a descriptive survey to 1,000 board-certified US dermatologists, of which 974 were deemed eligible. Of those, 406 completed the survey (41.7% response rate); proportionally more female physicians responded than male physicians (42.6% vs. 35.5%, P=.02).
The 12-question survey — developed by dermatologists, skin cancer screening specialists and epidemiologists — assessed dermatologists’ self-reported risk communication practices conducted with their patients at the time of or shortly after their first melanoma diagnoses. Results were categorized by patients’ age and sex.
Survey respondents were asked to report whether they “never or rarely,” “sometimes,” or “often or always”:
- taught patients how to perform a full-body skin self-examination (80.5% to 82.0%, often or always)
- advised patients that their first-degree relatives may be at greater risk for skin cancer (82.3% to 84.2%, often or always)
- advised patients that their children aged 18 years or older may be at greater risk for skin cancer (79.1% to 81.8%, often or always)
- offered to have patients’ first-degree relatives who lived nearby screened (45.1% to 47.3%, often or always)
- advised patients about the use of sun protection for their children aged 18 years or older (79.1% to 83.5%, often or always)
- advised patients about the use of sun protection for their children younger than 18 years (82.0% to 90.6%, often or always)
In addition, only 19.7% of physicians who responded to the survey used medical record reminders to note communication of melanoma risk to patients’ family members, the researchers found.
First-degree relatives of patients with melanoma are two or eight times more likely than the general population to be diagnosed with melanoma during their lifetimes, the study reported.
“The observed high rates of self-reported risk communication by dermatologists to patients with melanoma about their first-degree family members are encouraging. However, the reported low rates of actual screening of first-degree relatives warrant easy-to-administer office-based medical record reminders to facilitate and optimize screening of at-risk relatives,” Oliveria and colleagues wrote.
“These findings highlight the need for improved risk communication by dermatologists to patients with melanoma about their first-degree family members.” the researchers concluded. “Enhancing communication of melanoma risk for family members by dermatologists could reduce the public health burden of the disease, optimize screening of at-risk relatives and serve as a model for other cancers with high family risk.”
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