Intended for healthcare professionals


Identifying melanomas in primary care: can we do better?

BMJ 2012; 345 doi: (Published 04 July 2012) Cite this as: BMJ 2012;345:e4244
  1. Julia Newton-Bishop, professor of dermatology1,
  2. Paul Lorigan, senior lecturer in medical oncology2
  1. 1Leeds Institute of Molecular Medicine, Leeds LS9 7TF, UK
  2. 2University of Manchester/Christie NHS Hospital, Manchester M20 4BX, UK
  1. paul.lorigan{at}

Teaching best clinical practice shows more promise than a new technology

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 …

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