Low Awareness of Small Diameter and the ABCDE Rule for Melanoma Self-Detection: A Survey-Based Study

There is limited data on the public awareness that melanoma can have a small size.

We performed a single-center, university hospital-based survey study in individuals who were screened for melanocytic nevi with total body skin photography and digital dermoscopy, to investigate the awareness that melanoma may be small and knowledge of the ABCDE rule.

In 547 individuals, the median age was 43 years, and 49.5% were females. The change (in color, shape, or size) in "a mole smaller than a pencil eraser" would be a sign of worry for 57.7% of participants. The appearance of a "new mole" would be a sign of worry for only 43.7%. Regarding reasons to visit a doctor, 54.7%, 65.7%, and 61.4% responded that they would worry about a weird mole of small, medium or large size, respectively. Approximately half of respondents (59.7%) were aware that melanoma can have a small size. Only a third of respondents (32.3%) answered that they had heard of the ABCD rule for melanoma. In multivariable logistic regression analysis, being aware that melanoma can have a small size was not associated with age or sex, while it was significantly associated with the number of digital dermoscopy visits (odds ratio [OR]: 1.62, 95% confidence interval [CI]: 1.12-2.33).

Our study showed low awareness that melanoma can be small in size and of the ABCDE rule for the detection of melanoma. Identifying gaps in knowledge about melanoma may guide the design of clear, targeted messages to educate the public and enhance early self-detection.