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Making Melanoma Screenings More Patient Friendly

Skin Exam

It isn't possible to die from embarrassment—unless that embarrassment keeps patients from getting checked for melanoma.

New research from the University of Pittsburgh and University of Utah shows dermatologists can reduce that possible embarrassment by doing two things: letting patients pick the gender of the doctor doing their full-body skin check, and letting them decide if they would like to have their genitals examined.

"We were actually surprised by how many patients had strong preferences regarding the full-body skin cancer examination," says Aaron Secrest, MD, PhD, a dermatology chief resident at the University of Utah, and the lead statistician on the study. "More than one in four patients had a preference for a specific gender in the examining physician."

Young women under the age of 30 were the most likely to prefer a physician of the same sex, according to Secrest's study. This could be key when it comes to reducing melanoma rates because young women have the fastest-growing rates of the disease. "Allowing these patients to choose the gender of their provider could bring them in sooner, and lead to cancers being caught earlier," he says.

Traditionally, a patient is fully nude under a gown when undergoing a full-body skin examination. The new research shows the majority of patients would prefer if that wasn't the case. "Nearly half of all patients preferred keeping their underwear on for the examination and having the physician work around the underwear. Another one in five patients would not like to have their genitals examined at all," says Secrest.

Not examining the genitals can put patients at ease, but still allow a "full-body" scan, he adds. Melanoma can occur on the genitals, but that happens in less than 1 percent of all cases. So doctors need to balance the small risk they may miss a genital melanoma with keeping patients comfortable—and coming back for regular screenings.

"We really want all at-risk patients to be screened and help remove barriers," says Secrest. "Whether they are avoiding skin checks due to discomfort with the physician's gender or discomfort with requests to completely disrobe when they would prefer to leave underwear on for the exam, we need to honor their wishes."