ASPO Abstracts
Prevalence and correlates of physician skin exam in young adult melanoma survivors
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2019
Abstract Body:
Purpose: Annual physician skin exam is recommended for young adult (YA) melanoma survivors who are at high risk for a subsequent melanoma. This study examined prevalence and correlates of annual physician skin exam in this at-risk population. Methods: YA melanoma survivors were identified through the Los Angeles County Cancer Surveillance Program. Eligibility included diagnosis of stage 1 or greater melanoma; 5 years or more from treatment; and age < 24 in 1996-2010. Surveys took place through mail, internet, and phone. The outcome was dichotomized as “annual or more frequent” vs. “less frequent than annual” physician skin exam. Correlates included demographics (ethnicity, age, gender, health insurance); clinical factors such as stage at and years from diagnosis, follow-up with a dermatologist (vs. other provider type), having a written treatment summary, and regular source of non-cancer care; psychosocial factors included health care self-efficacy (i.e., HCSE, the perceived confidence to manage one’s health care), perceived risk of recurrence, depressive symptoms, and perceived overall health status. Results: The sample (N=128) was 61% female, 84% non-Hispanic white, and 95% insured. Sixty-five percent reported annual or more frequent physician skin exam. In univariate logistic regression analyses, follow-up with a dermatologist, having a written treatment summary, regular source of non-cancer care, greater HCSE, and perceived better health were positively associated with annual physician skin exam, while Hispanic ethnicity, depressive symptoms, and longer time from diagnosis were negatively associated (P<0.05). In a multivariable model, follow-up with a dermatologist, regular source of care, greater HCSE, perceived better health and longer time from diagnosis remained significant (P<0.05). Conclusions: The majority of YA melanoma survivors reported annual physician skin exam which may be facilitated by specialized (dermatologic) follow-up and having a regular non-cancer doctor, greater HCSE, and perceived better general health. However, efforts are needed to maintain annual physician skin exam as time from diagnosis increases, as well as among Hispanic YA melanoma survivors.
Keywords: Melanoma, survivor, young adult, follow-up