[Delay in the diagnosis of malignant melanoma]

We investigated delay in the diagnosis of malignant melanoma using the files of 180 patients diagnosed from January 1979 through October 1980, and interviewed 103 of the patients. 62% of the patients sought medical help more than 6 weeks after the appearance of symptoms, and the median delay was 6 months. There was no correlation between delay in diagnosis and sex or country of origin. Those in whom the primary tumor had bled were diagnosed earlier than those with other initial symptoms. Those with some knowledge of the signs of skin cancer did not seek medical care earlier than those without. The most frequent reasons for delay in diagnosis were that patients thought the lesions were insignificant or that they would heal without medical intervention. The first physician most patients consulted was their family physician or a dermatologist. Most family physicians (85%) immediately referred the patient to a dermatologist or plastic surgeon. 30% of the dermatologists did not refer the patient immediately for surgery, thus delaying diagnosis and treatment. Education of the public, and of physicians as well, is needed in the prevention and early detection of malignant melanoma.