Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089-9175, USA.
Int J Dermatol. 2010 Feb;49(2):126-34. doi: 10.1111/j.1365-4632.2009.04268.x.
The National Cancer Institute's "Melanoma Action Plan" calls for reduction of melanoma mortality through early detection. Routine skin self-examination (SSE) has the potential to increase chances of early detection and treatment and may be the key to melanoma survival. We provide a focused review of the accuracy of SSE for detecting premalignant lesions and cutaneous risk factors for melanoma, with suggestions for future directions for enhancing measurement of SSE accuracy and ways in which to improve the public's perceptions of melanoma efficacy. We examined published data on the efficacy of skin self-examination for the early detection of melanoma. We searched the MEDLINE database for publications between January 1, 1987 and June 1, 2007 using search terms for "melanoma" and "self-examination." We found that sensitivity of skin self-examination is low, ranging from 25% to 93%, while specificity is generally higher (83% to 97%). Attempts to increase improve the lay public's perceptions of the early signs of melanoma have proved effective, while those aimed at increasing accuracy of SSE with targeted interventions have been moderately successful. SSE's insensitivity for detection of pigmented lesions should prompt further investigation of educational interventions to enhance its accuracy and lead to its adoption as a cheap, simple screening tool. Assessment of the accuracy and efficacy of SSE should proceed using standardized definitions and measurements such that it is easier to pool data on the overall value of SSE as a screening modality.
美国国家癌症研究所的“黑色素瘤行动计划”呼吁通过早期发现来降低黑色素瘤的死亡率。常规皮肤自我检查（SSE）有可能增加早期发现和治疗的机会，并且可能是黑色素瘤生存的关键。我们提供了对 SSE 检测癌前病变和皮肤黑色素瘤危险因素的准确性的重点回顾，并对提高 SSE 准确性测量的未来方向提出了建议，以及改善公众对黑色素瘤疗效的看法的方法。我们检查了关于皮肤自我检查早期检测黑色素瘤的功效的已发表数据。我们使用“黑色素瘤”和“自我检查”的搜索词在 MEDLINE 数据库中搜索了 1987 年 1 月 1 日至 2007 年 6 月 1 日之间的出版物。我们发现，皮肤自我检查的敏感性较低，范围为 25％至 93％，而特异性通常较高（83％至 97％）。试图提高公众对黑色素瘤早期迹象的看法的努力已经证明是有效的，而那些旨在通过有针对性的干预措施提高 SSE 准确性的努力则取得了中等成功。SSE 对色素性病变的检测不敏感，应促使进一步研究教育干预措施，以提高其准确性，并将其作为一种廉价，简单的筛选工具。应使用标准化的定义和测量来评估 SSE 的准确性和功效，以便更容易汇总关于 SSE 作为筛选方式的总体价值的数据。
