Department of Dermatology, Northwestern University Feinberg School of Medicine, 645 N. Michigan Ave, Suite 1050, Chicago, IL, 60611, USA.
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
J Cancer Educ. 2021 Aug;36(4):858-864. doi: 10.1007/s13187-020-01714-4.
Identification of barriers to seeking health care for a concerning mole found during skin self-examination (SSE) by women educated during screening mammography. In this sequential mixed methods research, interviews with women who found a concerning mole and did not have health-care follow-up were analyzed and a survey was created. One year after SSE education, barriers to having health care for a self-identified concerning mole were assessed. The electronic medical records for all participants, who received education, were reviewed to ascertain who received health care related to a concerning mole or a screening mammogram. Among the 280 women who performed SSE, 85 found a concerning mole. Nine months later 51 women did not receive health care for the mole. Barriers were the burden of other medical concerns, fear of what the doctor will find, feeling like nothing is wrong, and being too busy. A positive screening mammogram (Fisher's two-sided exact test, p < 0.001) and a history of indoor tanning (Fisher's two-sided exact test, p = 0.011) were significantly associated with lack of follow-up for a concerning mole. Targeted melanoma self-identification with SSE relies upon participants initiating performance and seeking medical care for a concerning mole. The burden of a positive screening mammogram reported to women at about the same time as they identified the concerning mole was associated with failing to seek care for their concerning mole. Reminders to check moles for change 4 months after identifying a concerning mole may benefit women. Clinicaltrials.gov NCT03512457.
在接受过筛查性乳房 X 光检查的女性中，识别因自我皮肤检查（SSE）发现可疑痣而寻求医疗保健的障碍。在这项顺序混合方法研究中，对发现可疑痣但未进行医疗保健随访的女性进行了访谈，并进行了一项调查。在 SSE 教育一年后，评估了女性因自我识别的可疑痣而寻求医疗保健的障碍。审查了所有接受教育的参与者的电子病历，以确定谁接受了与可疑痣或筛查性乳房 X 光检查相关的医疗保健。在进行 SSE 的 280 名女性中，有 85 名发现了可疑痣。9 个月后，有 51 名女性未因该痣接受医疗护理。障碍是其他医疗问题的负担、担心医生会发现什么、感觉没什么问题和太忙。阳性筛查性乳房 X 光检查（Fisher 双侧精确检验，p<0.001）和室内晒黑史（Fisher 双侧精确检验，p=0.011）与未对可疑痣进行随访显著相关。使用 SSE 进行有针对性的黑色素瘤自我识别依赖于参与者主动进行自我检查并寻求医疗护理。在同一时间向女性报告阳性筛查性乳房 X 光检查结果，与未能为她们的可疑痣寻求护理有关。在发现可疑痣 4 个月后提醒检查痣的变化可能对女性有益。Clinicaltrials.gov NCT03512457。
