Evaluating the effect of detection modalities in the Danish clinical follow-up program of cutaneous melanoma-a retrospective cohort study

Background A rising incidence of cutaneous melanoma causes a high prevalence of patients eligible for clinical follow-up, which increases the burden on the resources in the health care system. The objectives of this study are to investigate the effect of the current surveillance program in terms of detecting recurrence or development of de novo cutaneous melanomas and evaluate the efficacy of the different detection modalities including self-skin examination, physical examination, and routine imaging. Methods The study is designed as a retrospective cohort study. Patients with >= 1 follow-up visit(s) in the first 2 years after diagnosis of stage IB-IIIC disease in the melanoma surveillance program at Aarhus University Hospital in 2019 are included. Detection of recurrence rate by either physician-based examination, self-skin examination or routine imaging is compared. Results Two-hundred and ninety-one patients were included and 26 recurrences/de novo cutaneous melanomas were identified. Physician-based exams detected 39.5%, self-skin examination detected 34.9%, and imaging detected 27.8% of the recurrences. Conclusions Physician-based examination and self-skin examination are the most effective modalities to detect recurrences. Imaging modalities detected most recurrences when performed due to suspicion. The number needed to treat for stage IB was relatively high, which is why a prolonged interval between follow-up visits for this stage is advisable. The risk of recurrence is associated with disease stage which is why it is reasonable to base the follow-up program for melanoma patients on this parameter.