Melanoma early detection with thorough skin self-examination: the "Check It Out" randomized trial

Am J Prev Med. 2007 Jun;32(6):517-24. doi: 10.1016/j.amepre.2007.02.024.


Background: Monthly thorough skin self-examination (TSSE) is an important practice for early melanoma detection that is performed by a small minority of the population.

Design: A randomized trial was conducted to determine whether a multicomponent intervention can increase TSSE performance and to describe the effects on performance of skin surgeries compared with a similar control intervention focused on diet.

Setting/participants: One thousand three hundred fifty-six patients attending a routine primary care visit in southeastern New England participated in this trial.

Interventions: Participants received instructional materials, including cues and aids, a video, and a brief counseling session and (at 3 weeks) a brief follow-up phone call (from a health educator) and tailored feedback letters.

Measures: Performance of TSSE assessed by telephone interview and having a surgical procedure performed on the skin were confirmed by examining medical records.

Results: TSSE was performed by substantially more participants at 2, 6, and 12 months in the intervention group than in the control group (55% vs 35%, p<0.0001 at 12 months). We also noted that a substantially higher proportion in the intervention group had skin surgery in the first 6 months (8.0% vs 3.6%, p=0.0005), but there was no difference at 6 to 12 months (3.9% vs 3.3%, p=0.5).

Conclusions: The TSSE intervention was effective in increasing performance of TSSE, in that it resulted in increased surgery on the skin, and that increase in skin procedures only persisted for 6 months. Intervention to increase TSSE may result in long-term benefit in early detection of melanoma while causing only a short-term excess of skin surgeries.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Dermatologic Surgical Procedures
  • Early Diagnosis*
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Melanoma / classification
  • Melanoma / diagnosis*
  • Middle Aged
  • New England
  • Self-Examination / statistics & numerical data*