The Influence of Dermatologist and Primary Care Physician Visits on Melanoma Outcomes Among Medicare Beneficiaries
Open accessAbstract
BACKGROUND: Ambulatory visits to dermatologists and primary care physicians (PCPs) may improve melanoma outcomes through early detection. We sought to measure the effect of dermatologist and PCP visits on melanoma stage at diagnosis and mortality. METHODS: We used data from the database linking Surveillance Epidemiology and End Results (SEER) and Medicare data (1994 to 2005) to examine patterns of dermatologist and PCP ambulatory visits before diagnosis for 18,884 Medicare beneficiaries with invasive melanoma or unknown stage at diagnosis. Visits were assessed during the 2-year time interval before the month of diagnosis. We examined whether dermatologist and PCP visits were associated with diagnosis of thinner melanomas (defined as local stage tumors having Breslow thickness <1 mm) and lower melanoma mortality. RESULTS: Medicare beneficiaries visiting both a dermatologist and PCP before diagnosis had greater odds of diagnosis of a thin melanoma (adjusted odds ratio, 1.26; 95% confidence interval, 1.12-1.41) and lower melanoma mortality (adjusted hazard ratio 0.66, 95% confidence interval, 0.57-0.76) compared with those without such visits. The mortality findings were attenuated once stage at diagnosis was adjusted for in the multivariable model. CONCLUSION: Improved melanoma outcomes among Medicare beneficiaries may depend on adequate access and use of dermatologist and PCP services.
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Various authors have reported difficulties in obtaining an appointment with a dermatologist.
“However, various authors have reported difficulties in obtaining an appointment with a dermatologist [12,14-17].”
From Use of Smartphones for Early Detection of Melanoma: Systematic Review (2018) · cites this paper as [15]
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Tripathi, R., Knusel, K. D., Ezaldein, H. H., Scott, J. F., & Bordeaux, J. S. (2018) · JAMA Dermatology · doi:10.1001/jamadermatol.2018.3114 · Cited by 158 · see citing works
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“However, various authors have reported difficulties in obtaining an appointment with a dermatologist [12,14-17].”
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- Authors
- Roetzheim, R. G., Lee, J.-H., Ferrante, J. M., Gonzalez, E. C., Chen, R., Fisher, K. J., Love-Jackson, K., & McCarthy, E. P.
- Affiliations
- Beth Israel Deaconess Medical Center (US)
- Venue
- The Journal of the American Board of Family Medicine
- Published
- 2013-11-01
- Volume
- 26
- Issue
- 6
- Pages
- 637-647
- ISSN
- 1557-2625 (ISSN-L)
- 1558-7118
- PMC
- PMC4671079
- OpenAlex
- W2109495601
- Cited by
- 32
- References
- 63
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 4 · 2022: 2 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 5 · 2017: 5 · 2016: 1 · 2015: 2 · 2014: 1 · 2013: 3
- FWCI
- 1.25
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of the American Board of Family Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Rutgers University Community Repository (Rutgers University) (submittedVersion)
- Funders
- American Cancer Society
- National Cancer Institute (P30CA076292)
- Topics
- Health Sciences › Medicine › Oncology › Cutaneous Melanoma Detection and Management
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Keywords
- melanoma, dermatologist visits, primary care physician visits, outpatient care, early detection, Breslow thickness, melanoma mortality, Medicare beneficiaries, health care access, cancer screening
- MeSH terms
- Melanoma, Cutaneous Malignant, Cutaneous Malignant Melanoma, Aged, Aged, 80 and over, Dermatology, Female, Follow-Up Studies, Medicare, Humans, Male, Melanoma, Office Visits, Primary Health Care, Retrospective Studies, Skin Neoplasms, United States, Survival Rate, Outcome Assessment, Health Care, SEER Program, Physicians, Primary Care
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