Developing Melanoma Screening in Primary Care

An increasing body of evidence indicates that effective early detection is our best hope for cutting melanoma deaths by at least half in the near future. Conventional education programs have had the effect of stabilizing mortality rates despite steadily increasing incidence trends, but we need to change our methods to get a substantial reduction in deaths. Today, knowledge and skills for melanoma screening remains low in primary care, performance of thorough skin self-examination remains low, and education of clinicians remains focused on teaching variations of the “ABCD”s of melanoma in conventional formats. We propose to develop an early detection training program that is web-based for widespread use, grounded in the realities of primary care delivery, and which includes a deeper image database and web-based format that together will allow a quantum leap in interactivity compared to prior efforts in melanoma, both to engage the learner and to improve the training achieved upon completion. Further, this training will incorporate dermoscopy (epiluminescence microscopy) which today is rarely used in primary care despite its proven ability to improve accuracy of the clinical examination. We have assembled a diverse team from multiple institutions with expertise and experience in melanoma early detection, medical education for cancer prevention, interventions with a variety of clinicians, and in large health systems, screening, and web-based instruction. We will measure both improvement in skills and effect on the health delivery system. This will provide a key exportable tool for mortality reduction efforts, including large definitive trials and health campaigns.

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