Epidemiological and Organizational Aspects of Remote Screening of Skin Melanomas (in the Novgorod Region)

BACKGROUND: The analysis of risk factors and features of the increase in the incidence of skin melanomas in the Novgorod region, the low quality and coverage of the population by preventive examinations of older age groups indicate the need for a qualitatively new approach to the organization of the detection of melanocytic neoplasms.

AIM: To study the epidemiological features of melanoma incidence in the Novgorod region in order to justify optimal approaches to organizing population screening examinations for the detection of melanocytic neoplasms using simple digital teleradioscopy technologies.

METHODS: Based on the pilot project, the results of using a portable USB microscope and a conventional laptop for photomicroscopy of pigmented "moles" prone to change (symptoms of ABSDE) at the stage of primary screening followed by remote consultation from the positions of 3 principal categories are presented: 1) with low transformation of nevi; 2) with melanoma-threatening nevi (for preventive measures); 3) melanocytic dysplasia and melanomas in the horizontal growth phase (in need of treatment).

RESULTS: The analysis consisted of 252 photographs taken after a questionnaire survey of 1902 patients who indicated the presence of dangerous moles Photomicroscopic diagnosis by the "second reading" type allowed 6 patients to assess the formations as superficial melanomas, 109 patients to identify melanoma-threatening nevi, 58 (53.2±2.18%) of whom had a high risk of melanoma (53.2±2.18%) were operated on. Histological examination of this group revealed melanocytic atypical dysplasia in 8 patients. The rest have been traced back to 2 years or more. The risk of melanoma (ROM) was calculated using the software and hardware complex (PAK) developed by us in an automated mode using a special formula. The PAK program generates a library of photographs of dangerous melanocytic neoplasms of the skin for medical examination in dynamics.

CONCLUSION: The data obtained indicate the effectiveness of teledermatoscopy of melanoid neoplasms using portable and low-cost USB microscopes with a laptop at the primary stage.