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

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Abstract

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.

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About the authors

Vyacheslav G. Cherenkov

Yaroslav-the-Wise Novgorod State University; Regional Clinical Oncological Dispensary

Author for correspondence.
Email: v.g.cherenkov@yandex.ru
ORCID iD: 0000-0003-0372-7443
SPIN-code: 8792-1449

MD, Dr. Sci. (Medicine), Professor

Russian Federation, 57 Alexandra Kоrsunov ave, Veliky Novgorod, Russia, 173024; Veliky Novgorod

Oksana A. Komarova

Regional Clinical Oncological Dispensary

Email: md.komarov@gmail.com
Russian Federation, Veliky Novgorod

Tamara V. Chistyakova

Regional Clinical Oncological Dispensary

Email: orgnovonko@mail.ru
ORCID iD: 0009-0004-9657-0362
SPIN-code: 8868-7167
Russian Federation, Veliky Novgorod

Alexey V. Shonia

Regional Clinical Oncological Dispensary

Email: iwaki95@mail.ru
ORCID iD: 0009-0005-9910-7311
SPIN-code: 8766-6985
Russian Federation, Veliky Novgorod

Mikhail S. Tokmachev

Yaroslav-the-Wise Novgorod State University

Email: mikhail.tokmachov@novsu.ru
ORCID iD: 0009-0009-9417-3773
SPIN-code: 6416-7369

Cand. Sci. (Physics and Mathematics), Assistant Professor

Russian Federation, Veliky Novgorod

References

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  3. Veronese F, Tarantino V, Zavattaro E, et al. Teledermoscopy in the Diagnosis of Melanocytic and Non-Melanocytic Skin Lesions: NurugoTM Derma Smartphone Microscope as a Possible New Tool in Daily Clinical Practice. Diagnostics. 2022;12(6):1371. doi: 10.3390/diagnostics12061371
  4. Lee C, Witkowski A, Żychowska M, Ludzik J. The role of mobile teledermoscopy in skin cancer triage and management during the COVID-19 pandemic. Indian J Dermatol Venereol Leprol. 2023;89(3):347−352. doi: 10.25259/IJDVL_118_2022
  5. Cherenkov VG, Pasevich KG, Gulkov IV, et al. Preliminary results of the creation of a robotic complex in the organization of primary diagnosis of risk factors and early forms of cancer. Russian Journal of Oncology. 2018;23(3–6):176–179. doi: 10.18821/1028-9984-2018-23-3-6-176-179
  6. Cherenkov VG, Pasevich KG, Gulkov IV, Prisyazhnyuk SL. Non-randomized study of a new USB chromomicroscopic method for the diagnosis of superficial spreading melanomas. FARMATEKA. 2020;27(11):42–45. doi: 10.18565/pharmateca.2020.11.42-45
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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Optical equipment: а — USB microscope (LED away. up to 300 and more); b — LEDs with adjustable focus and brightness.

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3. Fig. 2. Database of melanocytic formations.

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4. Fig. 3. The significance of microscopic patterns (%) in the diagnosis of superficial melanomas in comparison with melanoma-prone nevi (the patterns along the abscissa axis are in accordance with the order in table 2).

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5. Fig. 4. Ranking of the difference in frequency and significance of signs in melanoma and dangerous nevus.

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6. Fig. 5. Incidence of skin melanoma by age group.

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7. Fig. 6. Superficial melanoma of the skin of the back patient N: a Macrophoto 0,8×1,1 cm and USB-microphoto with UV. ×500, without staining; b with picrofuxin staining (melanomalike patterns: asymmetry on both axes 4 points; colors beige, brown, red, black 4 points; gray-blue veil 5; regression of the nevus site 3; diamond-shaped disorder 4; arachnid angioedema (see arrow) 4; points; Kittler’s chaos of pattern and color 5 points). Total points 29, the risk of melanoma 72,5%.

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8. Fig. 7. The scheme of the remote organizational and functional model of screening of melanocytic skin tumors. ФАП — feldsher-midwife station.

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