Predictors of skin self-examination performance

BACKGROUND. Skin self-examination (SSE) may reduce the death rate from melanoma by as much as 63%. Enhancing SSE performance may reduce mortality and morbidity. This study determined predictors of SSE performance in a population of individuals who were at risk of developing melanoma or nonmelanoma skin carcinoma (NMSC). METHODS. Patients (n = 200) were asked about their knowledge of the warning signs, their sense of the importance of SSE to them, their attitude about and confidence in their ability to perform SSE, and their impression of their partner's comfort and ability with assisting in the skin examination. The interval since last skin examination, the number of physician visits (nondermatologist and dermatologist), the number and type of skin malignancies, the time since initial diagnosis, the number of skin biopsies, and health insurance status were determined from the medical records for the prior 3 years. RESULTS. Seventy percent of participants performed SSE. The three strongest predictors of SSE performance were attitude, having dermatology visits with skin biopsies and at least one skin carcinoma in the previous 3 years, and confidence in performance (P = 0.0001). Other predictors of SSE performance were perceived risk (P = 0.0001), knowledge (P = 0.004), and younger age (P = 0.045). CONCLUSIONS. Annual skin examination by physicians and monthly SSE by patients reinforce one another in promoting early detection. In this high-risk population, the dermatologist reinforced SSE performance by biopsy of skin lesions that were skin malignancies. People have intimate knowledge of their own skin and bear the consequences for failure to detect and treat skin carcinoma early; thus, monthly SSE becomes relevant as a personal health-promotion habit.