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Learning with a partner improves skin cancer self-examination practices

January 16, 2007

Individuals who received instruction on skin self-examination with their partners may be more likely to engage in this cancer prevention behavior, according to a report in the January issue of Archives of Dermatology, one of the JAMA/Archives journals.

Skin self-examination can help detect the skin cancer melanoma early, decreasing death rates and the physical and emotional burdens associated with the disease, according to background information in the article. "Persons who perform skin self-examination present for care at an earlier stage in the disease process and have 50 percent less advanced melanoma and markedly lower mortality from melanoma," the authors write. "Skin self-examination can be learned by those who recognize that they are at risk of developing melanoma, including the elderly," who are more likely to both develop melanoma and to die from it than younger individuals.

June K. Robinson, M.D., Northwestern University Feinberg School of Medicine, Chicago, and colleagues performed a trial of a skin self-examination instruction program with 130 participants who had previously had melanoma. Sixty-five of the participants were randomly assigned to undergo the instruction alone and the other 65 to receive the instruction with their live-in partners. During the instruction session, a trained research assistant explained the ABCDE rule for examining moles (asymmetry of shape, border irregularity, color variegation, diameter of 6 millimeters or more and evolution or changing of the lesion, all of which can indicate the presence of melanoma). All of the participants took a skills quiz and a written assessment of skin self-examination performance immediately after the session and again four months later.

"At the four-month follow-up visits, paired-learning individuals (treatment) showed significantly stronger intentions to perform skin self-examinations on the face and skin in general than the solo-learning individuals (controls)," the authors write. "Significantly more solo learners than dyadic [paired] learners did not check their skin at the long-term follow-up visit (45 vs. 23), whereas significantly more dyadic learners checked their skin one time (19 vs. 9) and several times (13 vs. 4)."

Because about half of melanomas are initially discovered by the patients themselves, skin self-examination may be the best opportunity for early detection among those at risk, they continue. "The present study confirms that dyadic learning of skin self-examination enhances the perceived importance of skin self-examination, self-efficacy [belief in one's ability] in performing skin self-examination, and performance of skin self-examination," the authors conclude. "Attitude and belief in the ability to perform skin self-examination are fostered when the partners learn about melanoma recognition and skills training together. Partners may provide social reinforcement for skin self-examination and in checking locations that are difficult for the patient to see, for example the scalp, back, ears and back of legs."

JAMA and Archives Journals