Identifying melanomas in primary care: can we do better?

The prognosis for patients with melanoma depends on the stage of disease at diagnosis. In some European countries tumour thickness is much higher at presentation than in others, with consequent adverse effects on survival.1 The thickness of tumours at presentation to secondary care in the United Kingdom is such that the overall survival at five years is around 80% for men and 90% for women.2 Survival rates are higher in some countries, such as Australia, where excision of thinner tumours is more common.3 Such better outcomes are thought to be due to higher levels of awareness among patients and general practitioners.

The incidence of melanoma continues to increase in many areas of the world, and greater awareness is needed so that the thickness of tumours at presentation is reduced without excessive increases in referral to secondary care. In the linked study (doi:10.1136/bmj.e4110),4 Walter and colleagues tested a computerised diagnostic tool, the MoleMate system, as a means of increasing diagnostic accuracy and referral to secondary care for …