Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr 7;21(1):371.
doi: 10.1186/s12885-021-08072-4.

Patient-identified early clinical warning signs of nodular melanoma: a qualitative study

Adina Coroiu  1 , Chelsea Moran  2 , Jessica A Davine  3 , Kyla Brophy  4 , Catherine Bergeron  4 , Hensin Tsao  5   6 , Annett Körner  4 , Susan M Swetter #  7   8 , Alan C Geller #  3
Affiliations

Patient-identified early clinical warning signs of nodular melanoma: a qualitative study

Adina Coroiu et al. BMC Cancer. .

Abstract

Background: Nodular (NM) and superficial spreading melanoma (SSM) show different disease trajectories, with more rapid development in NM and fewer opportunities for early detection often resulting in worse outcomes. Our study described the patient-identified early signs of thin NM via comparisons to thin (≤ 2 mm) SSM and thick (> 2 mm) NM.

Methods: We conducted semi-structured interviews with NM and SSM patients and analyzed the data using thematic analysis.

Results: We enrolled 34 NM and 32 SSM patients. Melanoma early signs uniquely identified by patients with thin NM included white, blue or black coloration, "dot-like" size, fast changes in shape and color observed over 2 weeks, elevation and texture or "puffiness" over 6-12 months, and the sensation that the mole "did not feel right". Early signs reported by both thin NM and thin SSM patients included round or oblong shape, "jagged" border, pink/red, brown/reddish or dark coloration, "elevated like a pimple" or "tiny bump", fast color darkening, diameter growth, and border irregularity, and mole feeling "really itchy".

Conclusions: We found evidence that early signs of NM can be self-identified, which has important implications for the earlier detection of this most aggressive type of melanoma by both health professionals and patients.

Keywords: Nodular melanoma; Patient-identified early signs; Semi-structured interviews; Superficial spreading melanoma; Thematic analysis.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study flowchart detailing study selection, enrollment, and completion. Legend. NM = nodular melanoma; SSM = superficial spreading melanoma; MGH = Masachussetts General Hospital
See this image and copyright information in PMC

References

    1. Little EG, Eide MJ. Update on the current state of melanoma incidence. Dermatol Clin. 2012;30(3):355–361. doi: 10.1016/j.det.2012.04.001. - DOI - PubMed
    1. Tripp MK, Watson M, Balk SJ, Swetter SM, Gershenwald JE. State of the science on prevention and screening to reduce melanoma incidence and mortality: the time is now. CA Cancer J Clin. 2016;66(6):460–480. doi: 10.3322/caac.21352. - DOI - PMC - PubMed
    1. Thrift AP, Gudenkauf FJ. Melanoma incidence among non-hispanic whites in all 50 US States from 2001 through 2015. J Natl Cancer Inst. 2019;112:533–539. doi: 10.1093/jnci/djz153. - DOI - PMC - PubMed
    1. Greenwald HS, Friedman EB, Osman I. Superficial spreading and nodular melanoma are distinct biological entities: a challenge to the linear progression model. Melanoma Res. 2012;22(1):1–8. doi: 10.1097/CMR.0b013e32834e6aa0. - DOI - PMC - PubMed
    1. Elder DE, Massi D, Scolyer R, Willemze R. WHO Classification of Skin Tumours. 4 2018.