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 Senior Citizen Health & Medicine
Older Men Lead in Melanoma Deaths but Need Extra
Motivation to Seek Screening
Melanomas increase
15-fold in 50 years mostly in men over age 50
July 10, 2006 Half of all deaths from the skin
cancer melanoma in developed countries are among older men those over
age 50. Shockingly, they are also the least likely age group to be
screened and to take advantage of the potential life-saving early
detection. A new study says these aging men are more motivated to seek
screening if they are made aware of the risk factors through public
education and have access to screening exams.
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Published in the August 15, 2006 issue of CANCER, a
peer-reviewed journal of the American Cancer Society, the study reveals
that men who had skin lesions removed previously, who were concerned
about a mole, or who had identified personal risk factors for melanoma
were more likely to undergo a whole body skin exam.
This community-based, melanoma screening
intervention significantly increased screening rates in this older age
group.
Melanoma is one of the deadliest types of skin
cancer. It arises from pigmented cells called melanocytes, most commonly
found in the skin, and once invasive, will rapidly spread throughout the
body.
Exposure to ultraviolet radiation is known to
greatly increase risk. Though the incidence of all skin cancers is on
the rise, rates of melanomas have increased most rapidly, almost
15-fold, over the last 50 years.
That increase has been observed over-proportionally
in men over 50 years. Currently, this group represents almost half of
all deaths from melanoma in developed countries, but is the least likely
age group to be screened.
The American Cancer Society
says 62,190 new cases of melanoma are expected to be diagnosed in the
U.S. this year, and about 7,910 will die from this cancer. The death
rate has increased 50% since the 1970s.
Joanne Aitken, Ph.D. of the Viertel Centre for
Research in Cancer Control, Queensland Cancer Fund in Brisbane,
Australia and investigators conducted a melanoma screening intervention
trial in 18 communities in Queensland, Australia.
Nine communities were randomly selected to
participate in a three-year public education campaign that comprised
community education, local physician education, and the establishment of
easily accessible dedicated skin screening clinics. No intervention was
done in the other nine communities.
Subjects were then followed for two years after the
intervention. Investigators previously reported that the intervention
significantly increased screening rates. The most significant
improvement was observed in men over 50.
To evaluate the factors that motivated older men to
pursue screening for melanoma, the authors compared the results of
telephone interviews conducted at the beginning and end of the trial and
two years after the intervention.
Close to 500 men over 50 completed each of the
surveys. Older men who had a suspicious skin lesion removed in the past,
were concerned about an existing mole, recognized personal risk factors
for melanoma, or had a positive impression of screening were more likely
to conduct a whole body skin exam on themselves or receive a whole body
skin exam from a doctor.
Men not confident in their abilities to conduct a
self-exam were more likely to receive screening at baseline and at the
end of the intervention. However, after the intervention, men confident
in their self-exam skills were more likely to have continued screening
practices.
Men over 50 accounted for
● over 20 percent of screening
visits and
● almost 50 percent of all melanomas diagnosed.
At the end of the study, the self-screening rate
increased two-fold and the physician-screening rate increased four-fold.
The authors say that recommendations and instructions from doctors are
important for improving men's skin self-examination behavior although
"we did not observe a significant increase in doctors recommending such
skin self-examination behavior" within this program.
According to the authors, this is the first
published report of the motivating factors for screening and melanoma
diagnosis patterns in this age group in a population-based, melanoma
screening initiative.
"Our results," conclude the authors, "suggest that
to sustain screening rates in men 50 years and older, an understanding
of their susceptibility to melanoma and their doctor's encouragement of
early detection and screening behavior will be important."
More about study:
Article: "What Motivates Men Age >50 Years to
Participate in a Screening Program for Melanoma?" Monika Janda, Philippa
H. Youl, John B. Lowe, Peter D. Baade, Mark Elwood, Ian T Ring, Joanne F
Aitken, CANCER; Published Online: July 10, 2006 (DOI:
10.1002/cncr.22051); Print Issue Date: August 15, 2006.
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