Providing telephone counseling and targeted educational materials to the siblings of recently diagnosed melanoma patients can help improve the rate and quality of skin self-screening, according to the results of new research.
In a randomized controlled trial that included 494 siblings of melanoma patients, those who received the study intervention were more likely to examine all of their moles, including those on the back, compared with siblings who had received usual care (odds ratio 1.76). Those receiving targeted education also were more likely to compare all of their moles to see if one stood out (odds ratio 2.20).
The study, which will appear in the print issue of the journal Cancer on Aug. 15, was published online July 10.
Alan C. Geller, R.N., of Boston University, and his colleagues contacted 667 siblings of recently diagnosed melanoma patients. Of this group, 494 consented to participate in the study and completed a baseline survey. The siblings were randomized to receive either the study intervention or usual care, which in the study was a suggestion by the dermatologist that siblings be screened for melanoma. A total of 314 siblings completed the 12-month survey.
The intervention included a motivational telephone session with a health educator, tailored print materials at various points in the first 6 months, three additional telephone counseling sessions, and information about free screening programs. The calls and materials were customized to the particular needs or concerns of the siblings. Study participants who said they had difficulty checking for moles on their back, for example, were given information on how to include that as part of their self-exam.
The researchers assessed the efficacy of the intervention by whether the siblings had a skin cancer screening exam by a dermatologist within 12 months of completing the baseline survey, whether they conducted a personal skin self-exam within 12 months, and whether they had always or often used sunscreen with SPF 15 or more during the past summer when spending more than 15 minutes in the sun.
Although the siblings in the intervention arm showed greater improvement in self-screening, both arms showed similar results in terms of obtaining an exam from a dermatologist within a year and routinely using sunscreen. At baseline, about 28% of participants in both groups had been to a dermatologist for an exam in the last year. That figure rose to about 68% after 12 months. About 56% of participants in both groups reported routinely using sunscreen at baseline and that figure rose to 66% for the usual-care group and 67% for the intervention group after 12 months.
Dr. June K. Robinson of Chicago, editor of the Archives of Dermatology, praised the study. Teaching skin self-examination to those who recognize their personal risk can help to improve the performance and quality of the exam, she said in an interview.
The lesson for clinicians making a diagnosis of melanoma is to ask patients to inform their first-degree relatives so they can be examined by a dermatologist. “One of the most important motivators for the patient is for the physician to tell them to do something,” she said.
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