Background: Melanoma incidence is growing and more people require follow-up to detect recurrent melanoma\r\nquickly. Those detecting their own recurrent melanoma appear to have the best prognosis, so total skin self\r\nexamination (TSSE) is advocated, but practice is suboptimal. A digital intervention to support TSSE has potential but\r\nit is not clear which patient groups could benefit most. The aim of this study was to explore cutaneous melanoma\r\nrecurrence patterns between 1991 and 2012 in Northeast Scotland. The objectives were to: determine how\r\nrecurrent melanomas were detected during the period; explore factors potentially predictive of mode of recurrence\r\ndetection; identify groups least likely to detect their own recurrent melanoma and with most potential to benefit\r\nfrom digital TSSE support.\r\nMethods: Pathology records were used to identify those with a potential recurrent melanoma of any type\r\n(local, regional and distant). Following screening of potential cases available secondary care-held records were\r\nsubsequently scrutinised. Data was collected on demographics and clinical characteristics of the initial and recurrent\r\nmelanoma. Data were handled in Microsoft Excel and transported into SPSS 20.0 for statistical analysis. Factors\r\npredicting detection at interval or scheduled follow-up were explored using univariate techniques, with potentially\r\ninfluential factors combined in a multivariate binary logistic model to adjust for confounding.\r\nResults: 149 potential recurrences were identified from the pathology database held at Aberdeen Royal Infirmary.\r\nReliable data could be obtained on 94 cases of recurrent melanoma of all types. 30 recurrences (31.9%) were found\r\nby doctors at follow-up, and 64 (68.1%) in the interval between visits, usually by the patient themselves. Melanoma\r\nrecurrences of all types occurring within one-year were significantly more likely to be found at follow-up visits, and\r\nthis remained so following adjustment for other factors that could be used to target digital TSSE support.\r\nConclusions: A digital intervention should be offered to all newly diagnosed patients. This group could benefit\r\nmost from optimal TSSE practice.
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