A Retrospective Analysis of Surveillance Adherence of Patients after Treatment of Primary Cutaneous Melanoma Journal Article


Authors: Reserva, J; Janeczek, M; Joyce, C; Goslawski, A.; Hong, H.; Yuan, F. N.; Balasubramanian, N; Winterfield, L.; Swan, J; Tung, R
Article Title: A Retrospective Analysis of Surveillance Adherence of Patients after Treatment of Primary Cutaneous Melanoma
Abstract: BACKGROUND: Melanoma surveillance serves to identify new primary melanomas and curable locoregional or early distant recurrences. Although an optimal melanoma surveillance strategy has not been determined, several clinical guidelines exist. OBJECTIVE: The aim of this study was to identify demographic and clinico-pathologic variables associated with poor adherence to National Comprehensive Cancer Network (NCCN) melanoma surveillance guidelines. DESIGN: We retrospectively reviewed the initial five-year dermatology follow-up visit frequencies of melanoma patients and extracted basic demographic and clinical data from their medical records. PARTICIPANTS: Of 186 patients included, the mean age was 55 (standard deviation=15); 47.5 percent (n=85) were female, 93.0 percent (n=173) were white, and 76.2 percent (n=141) were married. Sixty percent of patients lived at locations more than 10 miles from the clinic, and 58.6 percent had private insurance. MEASUREMENTS: quot;Aggressivequot; and quot;conservativequot; surveillance schedules were adapted from National Comprehensive Cancer Network visit frequency guidelines. RESULTS: Between 58.4 and 74.5 percent of patients adhered to quot;aggressivequot; surveillance, with decreasing rates over the five-year period. Annual rates of poor surveillance adherence (7.3-23.6%) increased over time. Based on adjusted odds ratios, patients younger than 50 years of age (odds ratios 2.11 [95% CI 1.13-3.93], plt;0.05), those lacking health insurance (odds ratios 3.08 [95% CI 1.09-8.68], plt;0.05), and those with at least Stage IIB disease (odds ratios 3.21 [95% CI 1.36-7.58], plt;0.01) are more likely to be poorly adherent to melanoma surveillance. CONCLUSION: This study#39;s findings highlight some variables associated with poor surveillance adherence among melanoma survivors that could help to guide efforts in counseling this at-risk population.
Keywords: Clinical and Experimental Research; Primary cutaneous melanoma; follow-up visit; melanoma surveillance
Journal Title: The Journal of clinical and aesthetic dermatology
Volume: 10
Issue: 12
ISSN: 1941-2789; 1941-2789
Publisher: Unknown  
Journal Place: United States
Date Published: 2017
Start Page: 44
End Page: 48
Language: eng
Notes: LR: 20180207; JID: 101518173; OTO: NOTNLM; 2018/02/06 06:00 [entrez]; 2018/02/06 06:00 [pubmed]; 2018/02/06 06:01 [medline]; ppublish