Post-excision melanoma surveillance by patients effective in small trial


Findings from a pilot trial suggest that after excision of localized melanoma, patient-led surveillance appears to be safe, feasible and acceptable.


The study, published in JAMA Dermatology (Nov. 24, 2021, online ahead of print) included 100 patients who were randomized into two groups for six months of surveillance. One group was patient-led surveillance, which involved both usual care plus reminders to perform skin self-examinations (SSEs), patient-performed dermoscopy with a smartphone camera attachment, teledermatology assessments, and fast-tracked unscheduled clinic visits. The second, the control group received usual care alone.


In a press release from the University of Queensland, study author Monika Janda, PhD, said the patient-led surveillance group detected five new melanoma cases before clinical visits.


“This suggests the methods used were effective in assisting this group to identify the lesions, while the standard care group did not identify any new melanomas,” said Dr. Janda who is a professor in the university’s Centre for Health Services Research.


“There were three participants with new melanomas found in routine follow-up visits in each group.


“The trial also showed that patient-reporting improved participants’ self-examination knowledge and practices, and led to better psychological outcomes.”


Dr. Janda said that many melanomas could be self-detected if patients were trained to systematically self-examine their skin and had access to timely review through this type of patient-led surveillance.


“Routine in-person clinic visits are resource-intensive and had not previously been tested compared to patient-led surveillance,” she said.


“If confirmed in a larger study, this new model of patient care could reduce clinical visits and the burden on health care systems, and be convenient for people, especially those living further away from treatment centres.”

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