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Disparities in the management of cutaneous malignant melanoma. A population-based high-resolution study
- Source :
- European journal of cancer care. 28(4)
- Publication Year :
- 2018
-
Abstract
- Population-based cancer registry data from three Spanish areas were used to assess the patterns of care and adherence to guidelines for cutaneous malignant melanoma. We included 934 cases diagnosed in 2009-2013. Completeness of the pathology reports, imaging for detecting distant metastasis and the use of sentinel lymph node biopsy (SLNB) were analysed. The proportion of pathology reports that mentioned the essential pathological features required for T staging was 93%, ranging across geographic areas from 81% to 98% (p 0.001). The percentage of low-risk patients who underwent no imaging studies, as proposed by guidelines, or only chest imaging ranged among areas from 0.6% to 84% (p 0.001). Of the patients with clinically node-negative melanoma1 mm thick and no distant metastases, 68% underwent SLNB, varying by area from 61% to 78% (p = 0.017). This study revealed wide geographic variation in different aspects of melanoma care. The use of a standardised structured pathology report could strengthen the completeness of reporting. Improvement strategies should also include efforts to reduce overuse of imaging in low-risk patients and to increase the adherence to guidelines recommendations on the use of SLNB.
- Subjects :
- Adult
Diagnostic Imaging
Male
medicine.medical_specialty
Skin Neoplasms
Population
Sentinel lymph node
03 medical and health sciences
0302 clinical medicine
Internal medicine
Biopsy
Medicine
Humans
Healthcare Disparities
education
Pathological
Melanoma
Aged
Retrospective Studies
education.field_of_study
medicine.diagnostic_test
business.industry
Sentinel Lymph Node Biopsy
Pathology Report
Middle Aged
medicine.disease
Cancer registry
Oncology
Spain
030220 oncology & carcinogenesis
Lymphatic Metastasis
Cutaneous melanoma
Practice Guidelines as Topic
Lymph Node Excision
Female
Guideline Adherence
business
Subjects
Details
- ISSN :
- 13652354
- Volume :
- 28
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- European journal of cancer care
- Accession number :
- edsair.doi.dedup.....d1a549966a39caa93e7c40e18c601239