SELF EXAMINATION

‘˜SEND AN IMAGE’ ONLINE MOLE CHECK

GP MOLE CHECK

MOLE CHECK CLINICS WITH VIDEO DERMATOSCOPY

MELANOMAMOBIL FULL COMPARATIVE MOLE CHECK

The mole check is undertaken by:

The patient (lay person)

The patient (lay person)

The GP

Screening nurse/doctor

Screening doctor

Who decides which mole is suspicious and which is not?

The patient (lay person)

The patient (lay person) decides which moles to photograph.

The GP

Screening nurse/doctor

All moles are checked as standard. There is NO selection during the appointment as to which moles need to be investigated. Special images are taken of each and every mole following a particular procedure.

The decision is based on what?

Beliefs and possibly partial or mis-information

Beliefs and possibly partial or mis-information

An examination using just the naked eye. The selected mole(s) may be examined further with the use of dermatoscopy, but the initial decision as to which moles might be suspicious is made with naked eye

An examination using just the naked eye. The selected mole(s) may be examined further with the use of dermatoscopy, but the initial decision as to which moles might be suspicious is made with naked eye

NO decisions are made on spot. Special images are taken of each and every mole (detailed mole map) without making any pre-judgement.

Which part of the body is examined?

Uncertain

Uncertain

Uncertain: mainly only the part of the body about which the patient or GP is concerned.

Usually the entire body

Always the entire body

Assessment during the examination:

Made by the patient (lay person) without any specific knowledge or experience. See a tragic example of a patient who checked their own moles without seeking medical advice

There is NO assessment on spot as no medical professional examines the patient. The patient waits for the results of the remote assessment on those mole(s) which have been preselected by him or herself

GP’s verbal and written assessment

Verbal and/or written assessment by the screening nurse or doctor. If a suspicious mole or lesion were to be discovered then images would be taken and the results written up but only relating to the selected moles

Interim verbal assessment by the screening doctor. All the images will be sent for further evaluation and a detailed written report mailed to the patient following a second specialist’s assessment

Regular vs. continuous

Self examination can be regular but not continuous since there isn’t a basis for making anobjective comparison of changes. Every mole check is a ‘first mole check’

Can be regular but not continuous since the quality of images is not good enough to make a worthwhile comparison (lack of dermatoscopic images). Every mole check is a ‘first mole check’.

Can be regular but not continuous since there isn’t a basis for making an objective comparison of images to check for any changes. Every mole check is a ‘first mole check’

Can be regular and sometimes continuous, but not always. If images were taken of suspicious moles then continuous assessment is possible but only for those specific moles. For the rest every mole check is a ‘first mole check’.

Continuous mole check. On every occasion each and every mole is recorded and a full comparative analysis is made at the evaluation centre. In this way the moles can be observed on a continuous basis over time.

Comparative analysis (finding very early stage melanomas)

Not possible

Not possible

Not possible

Not possible, because a very early stage melanoma wouldn’t qualify as looking suspicious (as it looks normal). Therefore there would be no images or records of any early stage melanoma

Full comparative analysis that means each and every mole is compared to images taken previously. See how it is possible to spot a very early stage melanoma using comparative analysis.

Objectivity (two separate opinions on the same mole)

NO objectivity

NO objectivity

NO objectivity (the result of the mole check is based only on the GP’s opinion of which mole is suspicious and which is not)

NO objectivity (the result of the mole check is based only the screening nurse/doctor’s opinion of which mole is suspicious and which is not)

Objective: each and every mole is examined both by the screening nurse/doctor who attends the examination and by a second specialist at the assessment centre.

Suitable for spotting very early stage melanoma

NO

NO

NO

NO

YES

Suitable for spotting ‘middle’ stage melanoma

NO

NO

Possibly

YES

YES

Suitable for spotting late stage melanoma

Possibly

Possibly

YES

YES

YES

Recommended for mole check

NO

NO

NO (only where the patient already has some concerns, but this would no longer be a screening)

Better than having no mole check at all

The most effective screening method for melanoma and skin cancer