SpringerLink
Log in

Melanoma Skin Self-Examination Education During Mammography: Health Burden of Women Impairs Implementation

  • Published:
Journal of Cancer Education Aims and scope Submit manuscript

Abstract

Identification of barriers to seeking health care for a concerning mole found during skin self-examination (SSE) by women educated during screening mammography. In this sequential mixed methods research, interviews with women who found a concerning mole and did not have health-care follow-up were analyzed and a survey was created. One year after SSE education, barriers to having health care for a self-identified concerning mole were assessed. The electronic medical records for all participants, who received education, were reviewed to ascertain who received health care related to a concerning mole or a screening mammogram. Among the 280 women who performed SSE, 85 found a concerning mole. Nine months later 51 women did not receive health care for the mole. Barriers were the burden of other medical concerns, fear of what the doctor will find, feeling like nothing is wrong, and being too busy. A positive screening mammogram (Fisher’s two-sided exact test, p < 0.001) and a history of indoor tanning (Fisher’s two-sided exact test, p = 0.011) were significantly associated with lack of follow-up for a concerning mole. Targeted melanoma self-identification with SSE relies upon participants initiating performance and seeking medical care for a concerning mole. The burden of a positive screening mammogram reported to women at about the same time as they identified the concerning mole was associated with failing to seek care for their concerning mole. Reminders to check moles for change 4 months after identifying a concerning mole may benefit women. Clinicaltrials.gov NCT03512457

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (France)

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Robinson JK, Wayne JD, Martini MC, Hultgren BA, Mallett KA, Turrisi R (2016) Early detection of new melanomas by patients with melanoma and their partners using a structured skin self-examination skills training intervention: a randomized clinical trial. JAMA Dermatol 152(9):979–985

    Article  Google Scholar 

  2. Robinson JK, Perez M, Abou-el-Seoud D et al (2019) Skin self-examination education for melanoma during mammography for women. JNCI Cancer Spectrum 3(3):1–8

    Article  Google Scholar 

  3. Weinstock MA, Martin RA, Risica PM, Berwick M, Lasater T, Rakowski W, Goldstein MG, Dubé CE (1999) Thorough skin examination for the early detection of melanoma. Am J Prev Med 17(3):169–175

    Article  CAS  Google Scholar 

  4. Kamińska-Winciorek G, Gajda M, Wydmański J, Tukiendorf A (2015) What do web users know about skin self-examination and melanoma symptoms? Asian Pac J Cancer Prev 16(7):3051–3056

    Article  Google Scholar 

  5. Manne S, Fasanella N, Connors J, Floyd B et al (2004) Sun protection and skin surveillance practices among relatives of patients with malignant melanoma: prevalence and predictors. Prev Med 39(1):36–47

    Article  Google Scholar 

  6. Robinson JK, Fisher SG, Turrisi RJ (2002) Predictors of skin self-examination. Cancer. 95:135–146

    Article  Google Scholar 

  7. Boniol M, Autier P, Boyle P, Gandini S (2012) Cutaneous melanoma attributable to sunbed use: systematic review and meta-analysis. BMJ. 345:e4757

    Article  Google Scholar 

  8. Fears TR, Sagebiel RW, Halpern A, Elder DE et al (2011) Sunbeds and sunlamps: who used them and their risk for melanoma. Pigment Cell Mel 24:574–581

    Article  Google Scholar 

  9. Keating NL, Pace LE (2018) Breast cancer screening in 2018: time for shared decision making. JAMA. 319(17):1814–1815

    Article  Google Scholar 

  10. Johnson MM, Leachman SA, Aspinwall LG, Cranmer LD, Curiel-Lewandrowski C, Sondak V et al (2017) Skin cancer screening: recommendations for data-driven screening guidelines and a review of the USPHSTF controversy. Melanoma Manag 4:13–37

    Article  Google Scholar 

  11. Rzepecki AK, Jain N, Ali Y et al (2017) Promoting early detection of melanoma during the mammography experience. Int J Women’s Dermatol 3(4):195–200

    Article  CAS  Google Scholar 

  12. Gathirua-Mwangi W, Cohee A, Tarver WL, Marley A, Biederman E, Stump T, Monahan P, Rawl S, Skinner CS, Champion VL (2018) Factors associated with adherence to mammography screening among insured women differ by income levels. Womens Health Issues 28(5):462–469

    Article  Google Scholar 

  13. Katz ML, Reiter PL, Young GS, Pennell ML, Tatum CM, Paskett ED (2015) Adherence to multiple cancer screening tests among women living in Appalachia Ohio. Cancer Epi Biomark Prev 24(10):1489–1494

    Article  Google Scholar 

  14. Elo S, Kyngäs H (2008) The qualitative content analysis process. J Adv Nursing 62(1):107–115

    Article  Google Scholar 

  15. Hsieh H-F, Shannon SE (2005) Three approaches to qualitative content analysis. Qual Health Res 15(9):1277–1288

    Article  Google Scholar 

  16. Charmaz K 2006 Constructing grounded theory: a practical guide through qualitative analysis.London; Thousand Oaks, Calif.: Sage Publications

  17. Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77–101

    Article  Google Scholar 

  18. Sweeny K, Christianson D, McNeill J (2019) The psychological experience of awaiting breast diagnosis. Ann Behav Med 53(7):630–641

    Article  Google Scholar 

  19. Schonberg MA, Silliman RA, Ngo LH, Birdwell RL, Fein-Zachary V, Donato J, Marcantonio ER (2014) Older women’s experience with a benign breast biopsy-a mixed methods study. J Gen Intern Med 29(12):1631–1640

    Article  Google Scholar 

  20. Schacter DL (1999) The seven deadly sins of memory: insights from psychology and cognitive neuroscience. Am Psychol 54:182–185

    Article  CAS  Google Scholar 

  21. Redelmeier DA, Katz J, Kahneman D (2003) Memories of colonoscopy: a randomized trial. Pain. 104:187–194

    Article  Google Scholar 

Download references

Acknowledgments

Namita Jain, MD, Department of Dermatology, Northwestern University, Feinberg School of Medicine, assisted with thematic analysis of the transcripts of interviews with women who did not make an appointment for a concerning mole with a health-care provider. Elizabeth L. Gray, MS, Biostatistics Collaboration Center, Department of Preventive Medicine, Northwestern University performed the statistical analysis.

Funding

This research was supported by Gail Elden, in memory of Richard Elden. Research reported in this publication was also supported by the National Cancer Institute R01CA154908.

Author information

Authors and Affiliations

  1. Department of Dermatology, Northwestern University Feinberg School of Medicine, 645 N. Michigan Ave, Suite 1050, Chicago, IL, 60611, USA

    June K. Robinson & Zoe Brown

  2. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Bonnie Spring

Authors
  1. June K. Robinson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zoe Brown
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bonnie Spring
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to June K. Robinson.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflicts of interest.

Disclaimer

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic Supplementary Material

ESM 1

(DOCX 36 kb)

ESM 2

(DOCX 51 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Robinson, J.K., Brown, Z. & Spring, B. Melanoma Skin Self-Examination Education During Mammography: Health Burden of Women Impairs Implementation. J Canc Educ 36, 858–864 (2021). https://doi.org/10.1007/s13187-020-01714-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13187-020-01714-4

Keywords

Search

Navigation