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Self screening for risk of melanoma: validity of self mole counting by patients in a single general practice.

机译:黑色素瘤风险的自我筛查:患者在单一常规实践中进行自我痣计数的有效性。

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摘要

OBJECTIVE--To validate self screening by patients of high mole counts, assess the within family association of sun protection behaviour and mole counts, and estimate prevalence of risk factors for melanoma. SETTING AND SUBJECTS--Systematic sample of families from a single affluent general practice population in Wessex. DESIGN--Subjects completed a questionnaire about risk factors for melanoma and counted their moles. Subsequently a mole count was done by a general practitioner trained at dermatology clinics. MAIN OUTCOME MEASURES--Validation of self counts by observer's count. Within family association of sun protection behaviour and mole counts; self reported risk factors. RESULTS--199/237 subjects (84%) returned the questionnaire; 212/237 (89%) were examined. High counts by patients on the front of the trunk (> 7 moles of > or = 2 mm) were reasonably sensitive (79%), predictive (75%), and specific (97%) of the observer's mole counts (kappa = 0.74), unlike arm or total body counts. Sun protection behaviour correlated between individuals and other family members (Spearman's coefficient r = 0.50, P < 0.01). In the past three months 15/114 adults (13.2%, 95% confidence interval 7.0% to 19.4%) reported any change in a mole and 6/114 (5.3%, 2.0% to 11.1%) "major" changes; 6/109 adults (5.5%, 2.1% to 11.6%) had both high mole counts and freckling. CONCLUSIONS--Asking patients to count trunk moles could be a feasible way of identifying patients at high risk of melanoma. Concentrating on reported major changes in moles should avoid considerable workload in general practice. The generalisability of these findings and the adverse effects, net benefit in earlier diagnosis and prevention, and workload implications of such self screening need further research.
机译:目的-为了验证高摩尔数患者的自我筛查,评估防晒行为和摩尔数在家庭内部的联系,并评估黑素瘤危险因素的患病率。地点和主题-来自韦塞克斯郡一个单一的富裕普通家庭的系统样本。设计-受试者完成了一份有关黑色素瘤危险因素的问卷调查,并计算了其摩尔数。随后,由经皮肤科诊所训练的全科医生进行了痣计数。主要观察指标-通过观察者的计数验证自身计数。在家庭内部的防晒行为和痣计数;自我报告的危险因素。结果-199/237名受试者(84%)返回了调查表;检查了212/237(89%)。躯干前部的患者高计数(> 7摩尔>或= 2 mm)对观察者的摩尔计数具有相当敏感的意义(79%),预测性(75%)和特定的(97%)(kappa = 0.74) ),而不是手臂或身体总数。个人和其他家庭成员之间的防晒行为相关(Spearman系数r = 0.50,P <0.01)。在过去三个月中,有15/114名成年人(13.2%,95%置信区间7.0%至19.4%)报告了摩尔变化,而6/114名成年人(5.3%,2.0%至11.1%)报告了“重大”变化; 6/109名成年人(5.5%,2.1%至11.6%)同时患有高痣和雀斑。结论-要求患者对躯干痣进行计数可能是鉴定高危黑色素瘤患者的可行方法。专注于报道的痣的主要变化应该避免一般实践中的大量工作。这些发现的普遍性及其不利影响,早期诊断和预防的净收益以及此类自我筛查的工作量影响需要进一步研究。

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