Video-based behavioral intervention benefits clinical skin examinations

Image: PD 

1. In men 50 years or older, video-based skin awareness material correlated with higher rates of whole-body clinical skin examinations and skin cancer diagnosis. 

Evidence Rating: 1 (Excellent) 

Study Rundown: Early-detection and removal of melanoma lowers morbidity and mortality rates. Some studies have shown that skin examination screening may offer a survival benefit in such cases. However, older men are less likely to participate in routine clinical skin examinations (CSEs), despite increasing mortality rates compared to other groups. As such, this study investigates the effectiveness of video-based skin cancer education on CSE behaviors. These authors found that intervention increased rates of whole-body CSE within 6 months compared to the control group. Additionally, the intervention group was diagnosed with a higher proportion of malignant lesions. Strengths of this study include confirmation of self-reported CSE rate by physicians and the study’s focus on men aged >50 years, a high-risk group. However, limitations do exist. Men who enrolled in this study may have been more health-conscious than represented in the general population, leading to a potential overestimation of benefit to the general population. Future studies may focus on whether CSE screening confers a mortality benefit.

Click to read the study in JAMA Dermatology

Relevant Reading: Skin self-examination education for early detection of melanoma: a randomized controlled trial of Internet, workbook, and in-person interventions

In-Depth [randomized controlled trial]: This study enrolled 930 men aged at least 50 years from the Queensland area. Video and written educational material on melanoma skin cancer was given to the intervention group while the control group received only written materials. Results indicated that participants who received both video and written education were more likely than those who received only written materials to report whole-body CSE during the first 6 months of intervention (35.3% vs. 27.2%; P = .01). Additionally, the Cohen κ test was used to analyze agreement between participant-reported and physician-reported data, which confirmed that the intervention group was more likely to have undergone a whole-body CSE than those in the control group (74.5% vs. 61.4%; P = .046). Notably, skin lesions that required some form of management were detected in 76.3% of men with a physician-reported CSE. Significantly more of those cancers were identified in the intervention group than the control group (60.0% vs. 40.0%; P = .03), suggesting video-based behavioral intervention led to early detection of skin cancers and increased whole-body CSE in older men.

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