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Inclusion of populations at risk of advanced melanoma in an opportunistic targeted screening project involving general practitioners
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Edité par CCSD ; Taylor & Francis Open -
International audience. Objective: The study objective was to measure the rates of inclusion of populations at risk ofadvanced melanoma in a pilot targeted screening project involving general practitioners.Design: This cross-sectional database study compared the inclusion rates of patients who signedinclusion in a targeted screening project with those of patients who did not, during a period inwhich both groups of patients consulted investigators.Setting: Data were extracted from the national healthcare insurance records in western Francefrom 11 April to 30 October 2011.Patients: Patients, older than 18, considered for the data extraction had consulted one of the 78participating GPs during the study period, and were affiliated with the national healthcareinsurance.Main outcome measures: Inclusion in the screening was the main outcome measure. Patients atrisk of advanced melanoma were characterized by male gender, age over 50, low income, ruralresidence, farmer, and presence of chronic disease.Results: A total of 57,279 patients consulted GPs during the inclusion period and 2711 (4.73%)were included in the targeted screening. Populations at risk of advanced melanoma were lessincluded: men (OR¼0.67; 95%CI [0.61–0.73]; p<0.001), older than 50 (OR¼0.67; 95%CI[0.60–0.74]; p<0.001), low income (OR¼0.65; 95%CI [0.55–0.77]; p<0.001), farmer (OR¼0.23;95%CI [0.17–0.30]; p<0.001) and presence of a chronic disease (OR¼0.87; 95%CI [0.77–0.98];p<0.028).Conclusion: This study demonstrated inequalities in the inclusion of patients in a melanomascreening. Patients at risk of advanced cancer were screened less often. Further studies shouldfocus on GPs ability to identify and screen these patients.
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