Study finds better outcomes in dermatologist-diagnosed melanoma patients

Atlanta - A new study suggests that melanomas detected by dermatologists tend to be smaller and at an earlier stage than those found by non-dermatologists - and that these patients have a higher rate of survival.

HealthDay News reports that a study conducted by researchers at Atlanta’s Emory University School of Medicine examined outcomes in 2,020 Medicare patients who had been diagnosed with melanoma. Seventy-three percent of the patients were diagnosed by a dermatologist, the remainder by a non-dermatologist.

According to the study, which appeared in the April issue of Archives of Dermatology, dermatologist-detected melanomas were earlier-stage and thinner compared with those detected in the non-dermatologist group. Patients whose tumors were detected by dermatologists had better survival rates (74 percent of the dermatologist-diagnosed patients had five-year survival, versus 69 percent of the other group), lower cancer-related mortality (13 percent versus 21 percent) and lower overall mortality (29 percent versus 37 percent).

The study concludes that “increasing access to dermatologists, particularly for older patients, may represent one approach to improving melanoma-related health outcomes.”

Joel Schlessinger, M.D., president of the American Society of Cosmetic Dermatology & Aesthetic Surgery and director of Skin Specialists P.C., Omaha, Neb., tells Dermatology Times that the study’s findings “corroborate what dermatologists have been telling patients and the insurance companies for years: Dermatologists are not only more effective than family practitioners, but their expertise may lead to a quicker diagnosis with potentially life-saving results. Unfortunately, until this study, this has been dismissed in favor of supposed cost-cutting measures.

“On the flip side, it is possible that dermatologists biopsy more nevi than family physicians, but this is one way to potentially find melanomas earlier, at a time when diagnosis may yield a significantly better prognosis - hopefully, the medical community and insurers will sit up and take notice,” he says. “The other factor in this early diagnosis is dermatopathology acumen, which may decrease as pathologists push for client billing laws, which restrict choices and opportunities for interpretation. The pathologists are lobbying in many states for provisions that may reverse some of the gains we have made in early melanoma detection.”

Steven R. Feldman, M.D., Ph.D., professor of dermatology, pathology and public health sciences at Wake Forest University School of Medicine, adds, “The results may also indicate that people who are more tuned in to their own health than others are, and who have a better awareness of what dermatologists do, know they need to see a dermatologist immediately when they find an unusual mark or mole.”