Epidemiologic and organizational aspects of remote screening for cutaneous melanoma in the Novgorod region

BACKGROUND: Analysis of risk factors and the increasing incidence of cutaneous melanoma in the Novgorod Region, along with the low quality of preventive examinations in older patients, indicates the need for new approaches to detecting melanocytic neoplasms.

AIM: The work aimed to study the epidemiologic features of cutaneous melanoma incidence in the Novgorod Region in order to substantiate optimal approaches to organizing population screening for melanocytic neoplasms using teledermatoscopy.

METHODS: In a pilot project, photomicroscopy of pigmented nevi prone to change (assessed by the ABCDE algorithm) was performed with a portable USB microscope and a standard laptop at the primary screening stage, followed by remote consultation. Three categories of cases were distinguished: 1) low risk of nevus transformation; 2) melanoma-prone nevi (requiring preventive measures); 3) melanocytic dysplasia and melanomas in the horizontal growth phase requiring treatment.

RESULTS: A total of 252 photomicrographs were analyzed after a survey of 1902 patients who reported suspicious moles. Photomicrographic diagnosis using a second reading approach identified superficial melanomas in 6 patients and melanoma-prone nevi in 109 patients, 58 of whom (53.2% ± 2.18%) with a high risk of melanoma underwent surgical treatment. Histologic examination in this group confirmed melanocytic atypia in 8 patients. The remaining patients were followed for 2 years or longer. The risk of melanoma was assessed using the software-hardware complex we developed in an automated mode. The software-hardware complex program generates a library of photographs of suspicious melanocytic skin neoplasms for longitudinal follow-up during dispensary observation. The proposed screening model complements individual mobile teledermatoscopy and increases the effectiveness of national dispensary programs.

CONCLUSION: The findings indicate the effectiveness of teledermatoscopy for detecting melanoma-prone neoplasms using portable, low-cost USB microscopes with a laptop at the primary care level.