Remote skin self-examination training of melanoma survivors and their skin check partners: A randomized trial and comparison with in-person training

Abstract

Background: Compared with other cancers, melanoma has the longest delays measured as the median time to patient presentation for care from symptom onset. Time to presentation for care is a key determinant of outcomes, including disease stage, prognosis, and treatment. Methods: Melanoma survivors with localized disease and their skin check partners enrolled in two sequential randomized control trials of skin self-examination (SSE) training. In Phase 1, the pair read a workbook in the office and had quarterly total body skin examinations with a study dermatologist. In Phase 2, materials were mailed to pairs, whose surveillance was with a community physician. SSE knowledge, performance (frequency and extent), and identification of concerning moles were compared between phases. Results: Among 341 patients, 197 received the workbook and the others were controls. Knowledge in performing SSE was higher for the workbook relative to controls in both phases. The SSE frequency ranged from 2.38 to 5.97 times in 9 months. Patients randomized to the workbook in both phases performed significantly more SSE than controls at 9 months (P