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August 14, 1996

Patient vs Physician Follow-up for Melanoma: A Clarification

Author Affiliations

Yale Comprehensive Cancer Center New Haven, Conn

JAMA. 1996;276(6):450-451. doi:10.1001/jama.1996.03540060026023

To the Editor.  —In 1995, our group1 wrote an abstract that was presented at the annual meeting of American Society of Clinical Oncology (ASCO) describing a series of melanoma patients whose recurrences were detected much more frequently (94%) by patient self-examination than at follow-up physician visits (6%). Weiss et al2 have cited our abstract in recommending that carefully educated patients may not need frequent follow-up examinations. When we were preparing our study for full publication, we found a critical flaw in our data collection mechanism. In fact, of the 66 recurrences, 29 patients (44%) had symptoms that signaled recurrence that they called to the attention of their physicians, and the other 37 recurrences (56%) were diagnosed solely by frequent physician surveillance. Although many recurrences were recognized by informed patients, half in our series might not have been found early without frequent and thorough follow-up examinations. The revised data